Severe hypothermia consequences. Hypothermia of the body: what to do? Problems of the functioning of the heart and central nervous system

Hypothermia is a decrease in a person's own body temperature due to the action of low temperatures. The only reason for this phenomenon is a long stay in the cold without additional protective equipment, that is, in inappropriate clothing. At first, changes in the body are reversible, and all processes return to normal when they enter a warm room. However, the chances of a full recovery depend on the time spent in the cold. In the last stages, it may not be possible to raise the temperature.

Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

The total work experience is more than 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitology, in 1997 he completed residency in the specialty "Traumatology and Orthopedics" at the Central Research Institute of Traumatology and Orthopedics named after I.I. N.N. Prifova.

Hypothermia (hypothermia) It is the body's response to cold. There are certain mechanisms of thermoregulation that are responsible for maintaining normal body temperature. If you stay in the cold for a short time, muscle tremors appear - a way to generate endogenous heat and not overcool. Then the rate of metabolic processes decreases, and vital organs begin to freeze, especially the cardiovascular system. The tissues do not receive oxygen, the person feels tired and freezes.

Causes and symptoms

Freezing is the result of exposure to low temperatures. Every person who spends a long time in the cold has a risk of overcooling the body. However, there are several factors that increase the chances of freezing:

• inappropriate clothing that does not retain body heat;
• tight and insufficiently warm shoes;
• low body weight - the body uses energy from the processing of adipose tissue to maintain temperature;
• pathology of the heart and blood vessels;
• unbalanced and low-calorie diet;
• overwork.

Children and the elderly are more likely to suffer from cold. Them vascular system either underdeveloped or they already have chronic diseases.

In an adult, the body is more adapted to compensate for temperature changes, so it can stay in the cold longer due to its own reserves.

The first symptoms of hypothermia are fatigue and drowsiness. There may be signs of frostbite of the limbs and certain parts of the body. In the future, they intensify, and treatment is possible only if first aid is provided in a timely manner.

Things to remember to avoid hypothermia

Classification and stages

Signs of hypothermia gradually progress. At first, the cold affects only the peripheral parts of the body (limbs, ears), then it spreads to deeper tissues and internal organs. The symptoms by which it manifests itself will also depend on the degree of freezing of the body.

The unified international classification highlights 3 stages of hypothermia. Not only the symptoms depend on this, but also the prognosis - in the early stages it is much easier to treat the victim.

1. The first stage is characterized by inhibition of reflexes and mental activity. Speech is difficult. Body temperature drops to 32-34 degrees, but these changes are reversible. The skin is pale, covered with "goose bumps". Slight frostbite of the extremities (1 or 2 degrees) is possible.
2. The second stage is a decrease in temperature to 29-32 degrees. The condition of the victim worsens, areas of frostbite may appear up to the 3rd degree. Breathing becomes more rare, the heartbeat slows down. A person feels drowsiness, which gradually increases.
   
3. The third degree of hypothermia is the most severe, the temperature can drop below 29 degrees. The skin acquires a bluish tint, swelling and areas of frostbite of the 4th stage may appear. The body suffers from oxygen starvation, and a person can lose consciousness from the cold.

The consequences of hypothermia can be serious even if first aid is provided in a timely manner. You can fully recover at the first stage, and if a person has spent a lot of time in the cold, irreversible changes can occur in the body. Frostbite of the limbs of the 4th degree is especially dangerous, since they injure soft tissues and bones.

Features of hypothermia

Hypothermia is not a disease, but complex changes in the work of the whole organism. When there is a shortage of heat, they start reflex mechanisms to generate their own energy. Then the blood supply to the peripheral organs, which are less important for the body, is stopped. Initially, the fingers and ears are affected, then the hands and feet, after which the upper sections of the arms and legs freeze. If during this time the heat supply is not resumed, the blood supply to vital organs, including the heart and brain, slows down.

First aid for hypothermia

When hypothermia, it is necessary to do everything possible to get to the heat source and not fall asleep.

If there is an opportunity to contact someone and ask for help, do not put it off. If a person who has suffered from cold is found, it is urgent to transport him to warmth, even if he is unconscious.

However, immediately place the victim in hot water prohibited - it can cause hyperthermia.

There is a certain algorithm on how to act correctly so as not to harm the victim:

• move him to a warm room and change clothes to dry;
• put under the covers in a horizontal position, you do not need to cover your head;
• per area chest you can attach a heating pad, but it should not be too hot;
• provide food and plenty of warm drink;
• take a bath with water 37-40 degrees;
• if there are signs of frostbite, the limbs are not rubbed, but simply covered with a warm cloth.

With hypothermia in the last stages, it is also necessary to do first aid. It is not necessary to wait until the victim regains consciousness - you can cover him with a blanket and constantly monitor the pulse and heartbeat. Until the arrival of doctors, the main task remains to control the maintenance of life, and if necessary, it is important to be able to do it right artificial respiration and indirect heart massage.

Accompanying illnesses

Low temperatures are the main reason for the exacerbation of all chronic diseases. After warming up, it is recommended to spend several days warm, dress warmly and eat well. A weakened body often reacts to hypothermia respiratory diseases, inflammation of the genitourinary system. Moreover, there is a risk dangerous complications as meningitis, neuritis, inflammation of the inner ear.

Consequences and prevention

If first aid is not provided in time, hypothermia can cause dangerous consequences. AT best case it will be a cold that will pass in a few days. You can get sick even more seriously - prolonged cooling of the body often causes inflammatory diseases of internal organs, including cystitis and pyelonephritis.

However, one of the most dangerous complications is frostbite of the last degree, in which the damaged parts of the limbs have to be amputated.

There are several rules for the prevention of hypothermia:

• wear warm clothes, shoes, hats and gloves that will protect from frost;
• eat well, especially in the cold season;
• do not go on long winter walks without escort and means of communication;
• do not stay on the street while intoxicated.

You can freeze in winter even with a slight minus. Each person reacts differently to the action of low temperature, which is explained by a combination of various factors. In case of hypothermia, it is important to provide first aid to the victim until irreversible changes begin in his body. If you feel worse in the cold, limbs go numb, speech becomes difficult - do not be shy to seek help.

Why is hypothermia dangerous? How to quickly warm up if you feel that you are very cold

Good day, dear readers!

In today's article, we will consider with you such a state of the body as - hypothermia, as well as symptoms, causes, degrees, prevention and first aid for hypothermia. In addition, consider what can happen to a person after hypothermia, or rather, how it can affect his health. So…

What is hypothermia?

Hypothermia (hypothermia)- the general condition of a person, in which it falls to + 35 ° C and below. The main cause of hypothermia is the effect of cold on the body, i.e. the presence of a person or animal in a cold environment without protective equipment, such as warm clothing.

Hypothermia is characterized by depression normal functioning many of its systems and organs. So, when metabolism, blood circulation, heartbeat slows down, processes of oxygen starvation of tissues occur, and so on. If the process of heat loss from the body is not stopped, after a while the person or animal may die.

Most often, hypothermia is observed in young children and the elderly, too thin or immobilized people. If we talk about specific patients, we can distinguish - people in a state of alcoholic or drug intoxication, children and fishermen who fell through the ice, as well as people who tried to move a long distance in light clothing. Doctors testify that every third person who died from hypothermia was in a state of alcoholic intoxication.

It should also be noted that in addition to hypothermia due to being in a cold environment, there are general and medical hypothermia. local character artificially induced. Local hypothermia is commonly used to treat bleeding, injury, and inflammation. General hypothermia of the body is used for more serious purposes - in the treatment of traumatic brain injury and intracranial hemorrhage, as well as in the surgical treatment of heart diseases.

Hypothermia (hypothermia) has the opposite condition - hyperthermia, which, due to the effect of heat on the body, is characterized by an increase in body temperature, which can cause.

Hypothermia - ICD

ICD-10: T68;
ICD-9: 991.6.

Symptoms of hypothermia

Symptoms of hypothermia are characterized by 3 degrees of hypothermia, each of which has its own symptoms. Consider the degree of hypothermia of the body in more detail.

1 degree of hypothermia (mild degree)- the body temperature of the body drops to levels - 32-34 ° C. At this body temperature, the skin begins to turn pale and covered with goosebumps (“goosebumps”), which occurs with the help of which the body tries to keep the loss of heat. In addition, a person begins to experience oppression of the speech apparatus - it becomes more difficult to speak. Blood pressure usually remains within limits or rises slightly. At this stage, the process of frostbite of the body of 1-2 degrees is possible.

2 degree of hypothermia (medium degree)- the body temperature of the body drops to levels - 32-29 ° C. The skin begins to turn blue, the heartbeat slows down to 50 beats per minute, and functioning is inhibited. respiratory system- breathing becomes more rare and superficial. Due to a decrease in blood circulation, all systems and organs do not receive the required amount of oxygen, a person manifests increased drowsiness. At this stage, it is very important to prevent a person from falling asleep, because. during sleep, the body's energy production is significantly reduced, which in total can provoke an even faster drop in body temperature and provoke a fatal outcome. Usually, the 2nd degree of hypothermia of the body is characterized.

3 degree of hypothermia (severe degree)- the body temperature of the body drops to 29 ° C and below. The heart rate decreases to 36 beats per minute, oxygen starvation manifests itself, a person often loses consciousness or falls into a deep coma. The skin becomes bluish in color, and the face and limbs swell. Convulsions often appear in the body, it appears. In the absence of emergency care, the victim can die quickly. In most cases, the 3rd degree of hypothermia of the body is characterized by frostbite of the victim of the 4th degree.

The causes of hypothermia, or factors that contribute to hypothermia, can be:

Weather- reduced or low temperature of the environment in which a person stays. Most often this happens when a person gets into cold water when ice falls through. Another common cause of hypothermia is the lack of the required amount of clothing on a person at sub-zero or minimally positive ambient temperatures. It is also worth noting that high humidity and strong winds increase the rate of heat loss from the body.

Clothing and footwear. Insufficient amount of clothing on a person in a cold season also contributes to hypothermia of the body. Here it should also be noted that natural fabrics retain heat better - natural wool, fur and cotton, but synthetic analogues not only cope worse with protecting the body from the cold, but can also increase the risk of freezing. The fact is that synthetic fabrics they don’t “breathe” well, because of which, the moisture formed by the body has nowhere to evaporate, and it begins to contribute to the accelerated loss of body heat. In addition, tight shoes or thin shoe soles (less than 1 cm) are also common causes of cold feet. Remember, when shoes or clothes are a little too big, there is a layer of warm air underneath, which is an additional “wall” between the body and the cold. And do not forget, tight shoes contribute to the development of leg edema with all the consequences that come up.

Diseases and pathological conditions, which can contribute to hypothermia of the body: alcohol or drug intoxication, heart failure, bleeding, traumatic brain injury, cachexia, Addison's disease, and others.

Other causes of hypothermia include:

• Lack of movement in the cold for a long time;
• Walking in the cold without a hat;
• Overwork;
• Malnutrition, diet (lack of dietary fat, carbohydrates or);
• Staying in constant nervous tension.

First aid for hypothermia

Help with hypothermia must be provided correctly, otherwise the condition of the victim can only be aggravated.

Consider first aid for hypothermia:

1. It is necessary to eliminate the effect of cold on the victim - to cover the person from the cold in a warm room, or at least hide him in a place where there will be no precipitation and wind.

2. It is necessary to take off wet clothes and change them to dry ones, wrap the person in a blanket and put them in horizontal position. At the same time, you do not need to wrap your head.

3. Apply a heating pad with warm water to your chest, or wrap yourself in an electric blanket.

4. If the victim has signs of frostbite of the limbs, it is impossible to warm them with hot water. Cover them with heat-insulating clean sterile dressings.

5. Give the victim to drink hot tea or fruit drink, in extreme cases, heated water. Alcohol and coffee for warming are strictly prohibited!

6. For additional heating, if a person cannot warm himself with the above methods, he can take a bath with warm water - no higher than 37-40 ° C, after which you need to go back to bed, put on warm heating pads and wrap yourself in a blanket. Taking a bath as the first step in heating is not allowed!

7. If the victim has lost consciousness and his pulse is not felt, start doing and. It's good if someone calls an ambulance at this time.

8. Make sure that in case of vomiting, the head of the victim is tilted to the side, otherwise there is a risk of vomit entering the respiratory system and the person may simply suffocate.

9. If, after heating the victim, he has convulsions, speech disorder, heart rhythm disturbances and other abnormalities in the functioning of the body, he must be taken to a medical facility.

When warming a person, you need to remember one rule - you need to warm up gradually! You can not immediately plunge into after the cold hot shower, or put your hands under a stream of hot water from a faucet. A sharp temperature drop from cold to hot damages the capillaries, which can cause internal hemorrhages and other dangerous complications.

Consequences of hypothermia

Hypothermia of the body contributes to the inhibition of the activity of the immune system, which is a protective barrier of a person from various pathogenic microflora - (influenza, parainfluenza), (,) and others. Precisely because the immune system is weakened, after hypothermia of the body, a person often gets sick the following diseases:

• , and others ;
• – ,
• Changes in the functioning of the cardiovascular system, brain;
• Exacerbations of chronic diseases of various systems.

Prevention of hypothermia of the body includes compliance with the following rules and recommendations:

- Do not drink alcoholic beverages, coffee, do not smoke in the cold, which create only the illusion of warming;

- Do not walk in the cold or frost tired, hungry, after injuries or blood loss;

- In cold weather, dress warmly, in loose clothing, do not forget to wear a hat, mittens and a scarf;

- Try to give preference to natural fabrics, wool in clothes;

- Shoes should be in size, do not pinch anything, with a sole - at least 1 cm;

- Outerwear must be waterproof;

- In windy and frosty weather, open areas of the body can be lubricated with a special protective cream or animal oil (but not vegetable oil!);

- But carry heavy bags and other burdens that constrict your fingers and disrupt the normal circulation of blood in them;

- In cold weather, do not use a moisturizer for face and hands;

- In frosty weather, do not wear earrings, rings and other metal jewelry, because. they cool faster and transfer cold to the body;

- As soon as you feel a feeling of cold inside yourself outside in cold weather, go to a warm place and warm yourself;

- If your car has stalled far from a populated area, and it is cold outside, call for help, do not get out of the car, unless another car is approaching you;

- In cold weather, hide from direct wind currents;

- If you are somewhere far from the settlement, there is a large amount of snow under your feet and there is a blizzard around, dig into the snow, so you will lose less heat;

- In cold weather, avoid wetting the skin.

- Thermoregulation in children is not yet fully formed, while in the elderly, this function is already upset in many cases, so control the amount of time these groups of people stay in the cold.

- Avoid going to the first ice.

Short description

General hypothermia occurs when long-term exposure low ambient temperature, which leads to a disruption of the compensatory reactions of the body with subsequent inhibition of the functions of the central nervous system, respiratory organs and cardiovascular system. Fatal hypothermia at 0 ° C develops in 10-12 hours spent without movement, in water at the same temperature - in 30 minutes.

Code by international classification ICD-10 diseases:

Symptoms (signs)

Clinical picture I degree (adynamic). Rectal temperature - 35–33 °С. Chills, lethargy, pale skin, goosebumps, bradycardia. Breathing is normal II degree (stuporous). Rectal temperature - 32 °C. Stupor, weakness, chills; skin is cold, pale, acrocyanosis. The pulse is weak, 50–30/min; BP is lowered; shallow breathing, rare (8-10/min) III degree (convulsive). Rectal temperature is about 30 °C. The victim is unconscious, vomiting, convulsions, muscle rigidity (rigidity), trismus of masticatory muscles. The pupils are constricted. The pulse on the peripheral arteries and blood pressure are not determined, the heart sounds are muffled, the heart rate is less than 30/min. Respiration is rare (up to 4/min) of the Cheyne-Stokes type. At a rectal temperature of less than 23 ° C, the chances of saving the victim are very small.

Treatment

Treatment First Aid Protection from further exposure to cold IVL (III degree of general hypothermia). With severe muscle rigidity, an indirect heart massage should not be performed and the victim's head should be tilted back. vasodilators, with convulsions - diazepam, sodium oxybate (with caution), 40% r - r glucose 20-40 ml. The use of analeptics and alcohol is strictly contraindicated. Active external warming. The victim is immersed in a bath with warm water (28 ° C). The body temperature should be increased gradually (by 0.5-2 ° C per hour); optimally, if the rectal temperature rises to 34 ° C. Sometimes this causes paradoxical acidosis, hyperkalemia and a decrease in body temperature (return of blood from the periphery to the main vessels), therefore this way used only in the treatment of young and somatic healthy people under the constant supervision of a doctor Active internal warming of the body Inhalation of heated (42 ° C) oxygen Infusion solutions are heated and injected only into peripheral veins In case of hypothermia of the III degree, the stomach and bladder are washed, peritoneal lavage is carried out with heated solutions. Infusion therapy is aimed at combating acidosis, hypoglycemia, and improving microcirculation Symptomatic therapy and dealing with complications.

Complications Most formidable complication developing in short time, - cerebral edema Pulmonary edema of acute renal failure At later stages - abscessing pneumonia General hypothermia is usually combined with frostbite of varying severity.

ICD-10 T68 Hypothermia

Hypothermia - how dangerous is this condition
and how to deal with it?

Do you regularly dress inappropriately for the weather? Are you forced to stay in conditions of low temperature and high humidity all the time? You give your preference very tight shoes and clothes? Do you behave carelessly on ice-covered waters?
If your answer is Yes", then remember! In all these cases, you can easily expose your body to hypothermia leading to a number of adverse effects.

Hypothermia - what is it?

Causes of hypothermia

• Long stay in wet clothes in the cold at air temperatures below 10 degrees;
• Drinking large amounts of cold liquids;
• Stay in cold water;
• Transfusion of a large amount of cold blood or its components;
• state of shock;
• Prolonged exposure to low temperatures.

Degrees of hypothermia

1. Light degree is the result of a decrease in body temperature to 32 - 34 degrees. Blood pressure in such cases remains normal. It is possible to develop frostbite of 1-2 degrees ( damage to any part of the body up to necrosis under the influence of low temperatures).
Symptoms of mild hypothermia:

• awkwardness of movement;
• Forgetfulness;
• Shiver;
• fuzzy speech;
• Rapid pulse;
• Clouding of consciousness;
• Rapid breathing;
• Apathy ( indifference to what is happening);
• blanching skin.

• disorientation ( loss of understanding of something);
• Blueing of the skin;
• Stupor ( immobility);
• Weak pulse;
• Memory loss;
• cardiac arrhythmia ( abnormal heart rhythm);
• Violent trembling, which causes very strong muscle tension;
• sudden sleepiness ( sleeping is strictly prohibited).

• Heart failure;
• Constant slowing of breathing and heart rate;
• Pupil enlargement;
• Termination of the normal functioning of the brain;
• Permanent decrease in blood pressure;

What problems can arise with hypothermia in various parts of the body?

Nasopharynx
The mucous membranes of the nose, auditory canals and pharyngeal tonsils are located at a close distance from each other. With inflammation of one of these organs, the infectious process almost immediately captures all the others. As a result, about yourself can let you know how acute otitis media and runny nose, sore throat ( pathology associated with palatine tonsils ), frontite ( inflammation frontal sinus ) or sinusitis. If there is any chronic illness may develop tonsillitis tonsillitis). In all these cases, there is a persistent increase in body temperature. Considering the fact that in these parts of the body there are also points responsible for the functioning of internal organs, it is not surprising that their inflammation can cause reflex vasospasm. Such spasms often cause the development of bronchial asthma ( chronic pathology respiratory tract) or an attack of angina pectoris ( diseases accompanied by pain and discomfort behind the sternum).

Head
Hypothermia of the head is fraught with the development of spasms of the vessels of this organ. As a result, a person begins to suffer from drops in blood pressure, as well as regular bursting headaches. There is a risk of developing meningitis ( inflammation meninges ), as well as frontite.

Hair
Extremely sensitive to cold hair follicles. As a result, they weaken and become inflamed, making the hair brittle, thin and dull. The inflammation of the bulbs is especially dangerous for all those people whose hair is weakened by nature, since they also begin to experience excessive hair loss. Dandruff is another consequence of a long stay in the cold without a hat.

Nerves
Under the influence of cold, there is a clear violation of the blood supply to the nerves. If the facial nerve is damaged, this can lead to the fact that half of the face is distorted in a person. Inflammation of the trigeminal nerve is accompanied by excruciating "shooting" pain sensations. Under the influence of cold, intracranial pressure may also increase or migraine may develop.

upper body
Intercostal neuralgia ( compression or irritation of the intercostal nerves), bronchitis ( inflammation of the bronchi), myositis ( inflammation of the back and neck muscles) - all these are possible consequences of a long stay in the cold in clothes that are not suitable for the weather. Myocarditis may also develop ( inflammation of the heart muscle) or pneumonia ( pneumonia). If a person has had chickenpox ( chickenpox), then the cold can provoke the awakening of the virus herpes zoster, which makes itself felt in the form of shingles ( a disease of a viral nature, characterized by unilateral rashes on the skin with severe pain syndrome ). Pain in this pathology is noted along the ribs, as well as in the chest area.

upper limbs
To keep your hands protected from the cold, buy mittens, not gloves. Gloves do not retain heat. Before going out, regularly lubricate your hands with a protective cream. Remember that both on the hands and on the palms there are bioactive points that are directly connected with the respiratory system and the head. By protecting your hands, you will also protect these organs. If the hands freeze, then it is quite possible to exacerbate any chronic inflammatory processes. In addition, their freezing can lead to frequent headaches or polyarthritis ( inflammation of the small joints of the fingers and hands).

lower body
Inflammation of the organs of the genitourinary system is the most common consequence resulting from hypothermia of the lower body. Can become inflamed as uterine appendages ( adnexitis), and the kidneys (nephritis), bladder (cystitis) or prostate (prostatitis). When the lower back freezes, sciatica can also develop ( a disease characterized by damage to the roots of the spinal nerves).

lower limbs
Given the fact that cold slows down the blood circulation process, the legs freeze in the very first place, since a small amount of blood does not have time to warm them. There are numerous bioactive points on the feet that are responsible for the work of both the respiratory and cardiovascular systems. As a result, when the legs freeze, both sinusitis and bronchitis, tonsillitis, and also myocarditis can let you know about yourself.

Hypothermia of the child's body

• Lowering the air temperature in the children's room below the optimum;
• Prolonged lying in wet diapers;
• Bathing a baby in cold water;
• Long walks in very light clothing;
• Poor diet combined with frequent fatigue.

• muscle tremors and weakness;
• blanching of the skin;
• Rapid breathing and heartbeat;
• Drowsiness and lethargy;
• Unusually calm demeanor.

Transient hypothermia

First aid for hypothermia

Measures for hypothermia at home

Rules for performing artificial respiration

Rules for performing chest compressions

Measures for hypothermia outside

Hypothermia is strictly prohibited

• Move vigorously;
• Consume alcoholic beverages;
• Take a hot bath;
• Use hot bottles to keep warm.

Treatment

Modern specialists have also produced special devices designed to treat various degrees of hypothermia. In the fight against this condition, the victim is offered to inhale artificial gas mixtures, which are preheated to 75 - 95 degrees. Mixtures include oxygen and helium. They should be inhaled while sitting or lying position. With the help of such procedures, it is possible to restore respiratory function and normal body temperature, relax smooth muscle, as well as prevent the development of bronchitis, bronchial asthma, tonsillitis, pharyngitis and other diseases.

Measures to prevent hypothermia

Hypothermia or hypothermia, as it is called in medicine, develops under the influence of low temperatures, which in intensity exceed the internal potential of the thermoregulation system. In the body, the metabolism slows down, there is a failure in the work of all organs and systems. When body temperature drops below 24 ᵒС, changes in the body are considered irreversible.

Types of hypothermia

In accordance with clinical manifestations, several phases or degrees of hypothermia are distinguished. Here they are:

Signs of hypothermia

It is clear that hypothermia of the body occurs gradually. It is very important to be able to determine the severity of hypothermia in order to properly help a freezing person.

At a body temperature of less than 33 ᵒС, a person ceases to realize that he is freezing and cannot get himself out of this state. This is easy to understand by lowering the threshold pain sensitivity, confused
consciousness, impaired coordination of movement. Hypothermia, at which body temperature drops to 30 ᵒС, causes bradycardia, and a further decrease provokes arrhythmia and signs of heart failure.

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The development of hypothermia is facilitated by worsening weather, poor quality outerwear and footwear, as well as various diseases and pathologies, such as:

• hypothyroidism;
• heart failure;
• cirrhosis of the liver ;
• alcohol intoxication;
• bleeding.

First aid

First aid for hypothermia involves the elimination of contact of the victim with a cold environment. That is, he must be placed in a warm room, take off his clothes and change into dry and clean clothes. After this, it is recommended that the patient be wrapped in a heat-insulating material, which is used as special blankets based on dense foil, but in the absence of such, simple blankets and blankets, outerwear can be used.

A good therapeutic effect can be achieved from a warm bath. First, the water temperature is maintained at around 30–35 ᵒС, gradually increasing it to 40–42 ᵒС. As soon as the body warms up to a temperature of 33–35 ᵒС, heating in the bath must be stopped.

In extreme conditions, when it is not possible to transfer a person to a room, hot water bottles are placed in the armpits and groin area. You can warm the victim by intravenous administration of warm infusion solutions.

It is forbidden to frequently move the patient from place to place, as any movement causes him pain, and this can lead to heart rhythm disturbance.

You can massage the body, easily rubbing the skin and accelerating the recovery processes in the tissues. Treatment of hypothermia is accompanied by the use of antispasmodics, painkillers, non-steroidal anti-inflammatory drugs. In addition, the patient is given allergy medications and vitamins.

At the first dynamic stage of hypothermia, a person can be treated at home. In all other cases, he is hospitalized, as he requires intensive supportive care. Oxygenation is carried out with humidified oxygen, the level of glucose in the blood and the electrolyte composition of the blood are corrected, and blood pressure is maintained at the proper level.

A person who cannot breathe on his own is connected to artificial ventilation mild, and in severe cases heart rate using a defibrillator and a cardioverter. Cardiac activity is monitored using an electrocardiograph.

General hypothermia is caused by exposure to cold and is characterized by general and local reactions of the body.

With hypothermia, the body is not able to function normally, there is a violation of all metabolic processes.

The most common cause of hypothermia is the presence of a person at a low temperature for a long time, especially if the air humidity is increased. The immobile position of a person on cold ground or metal surfaces contributes to the development of hypothermia. Hypothermia occurs very quickly when a person is immersed in ice water.

Significantly more heat is given off by bare human skin, in particular, the scalp. This is due to the evaporation of sweat.

General hypothermia is more susceptible to small children, the elderly, physically exhausted, forcedly immobilized people. Strong wind, wet clothes, overwork, drug or alcohol intoxication, and injuries significantly aggravate hypothermia.

Degrees and symptoms of hypothermia

Depending on the severity of the damage, there are three degrees of general hypothermia.

Easy degree. It occurs when the overall body temperature drops to 32-34ºС. The victim's skin becomes pale, chills appear, bluish color of the lips and nasolabial triangle. Because of the trembling of the lips and mandible it is difficult for a person to speak. In some cases, blood pressure rises slightly. The victim is able to move independently. With this degree of hypothermia, frostbite of I and II degrees of individual parts of the body often occurs.

The average degree of hypothermia. It occurs with a further decrease in body temperature to 29-32ºС. The victim's pulse rate drops to 50 beats per minute. At the same time, his skin becomes cold to the touch, acquires a bluish tint. A person's blood pressure decreases, breathing slows down, drowsiness, apathy, and indifference to what is happening appear. He does not respond to external stimuli, speech addressed to him. In this condition, a person may experience frostbite, even of the most severe degree. It is very important to avoid sleep with moderate hypothermia. During sleep, a small amount of energy is produced, which can contribute to the death of the victim.

Severe degree of general hypothermia. Occurs when the overall body temperature drops below 31ºС. In this case, the pulse rate drops to 36 beats per minute. The skin and mucous membranes of the victim acquire a pronounced bluish tint, the face, lips, hands and feet become swollen. In humans, breathing becomes rare, blood pressure drops sharply. The victim loses consciousness, he often has convulsions. In many cases, a person falls into a coma. With a severe degree of hypothermia, quite serious frostbite is possible. If the victim is not provided with urgent assistance, death may occur.

First aid

It begins with the cessation of exposure to cold on the body of the victim. If possible, the person is brought into a warm room. In the absence of such an opportunity, the victim is placed in a place protected from precipitation and wind.

First you need to remove wet clothes from a person and wrap him in a dry blanket. Then the victim, who is conscious, should be allowed to drink hot tea, milk, water, juice.

In case of general hypothermia, it is recommended to take a warm bath. The temperature of the water in the bath must be constantly raised, but not higher than 40ºС. Then the person needs to be laid in a warm bed and overlaid with warm heating pads. When providing first aid for hypothermia, it is necessary to pay attention to the presence of frostbitten areas of the body. Sterile, or at least clean, dressings are applied to such areas.

If the victim is unconscious, it is very important to constantly monitor his breathing and pulse. In the absence of breathing, it is necessary to immediately proceed to artificial respiration, in the absence of a pulse - to an indirect heart massage.

It is very important when providing first aid for hypothermia not to make some mistakes that can lead to negative consequences. Doctors do not recommend giving the victim coffee or alcoholic beverages. In addition, you can not put it in a hot bath without first warming it. In no case should you intensively rub the skin with snow, alcohol-containing liquids, oils, use an open fire for heating. All of these actions contribute sharp drop body temperatures. As a result, small capillaries are damaged, internal hemorrhages and other serious complications appear.

After providing first aid, the victim of hypothermia must be taken to the hospital. Even if his condition improves, there may be some complications that only a doctor can diagnose.

Hypothermia of the legs

Human feet are the first to suffer from hypothermia. This is due to the fact that in this part of the body there is no subcutaneous adipose tissue, which is able to warm at low temperatures. In addition, there is a large area of ​​skin that gives off its heat to the environment.

There are many reasons for cold feet. One of them may be improperly selected shoes - too narrow, with very high heels, or simply uncomfortable while walking.

Another cause of hypothermia of the lower extremities is increased sweating. It contributes to increased moisture in the legs, and, as a result, their frequent hypothermia.

In some people, hypothermia of the legs may be due to a violation of capillary circulation. Such disorders can be caused by certain diseases, low blood pressure, constant stress or an unbalanced emotional state.

Even mild hypothermia of the legs can contribute to the development of many diseases - cystitis, bronchitis, tonsillitis and many others. Many women can become aggravated chronic diseases reproductive system.

To prevent hypothermia of the legs, you need to abandon synthetic socks and tights in favor of cotton and wool products. Winter shoes should be 1-2 sizes larger than demi-season shoes. In this case, besides the fact that it will not be tight, such shoes will retain an air gap between the foot and the shoe. It is she who keeps warm.

If the legs freeze and begin to lose sensitivity, it is urgent to go to a warm room. Then you need to make vigorous leg swings to increase blood circulation in them.

Further measures for warming the legs are similar to the above first aid measures.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

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hypothermia

The human body is able to withstand a lot, but there are boundaries that are undesirable to cross because of the possible tragic consequences. One of the factors provoking a violation of human activity is low ambient temperature. If a person is exposed to cold for a long time, he may develop hypothermia of the body, in which the body temperature drops to critical numbers and there is a violation in the work of all organs and systems.

Children are most susceptible to general hypothermia younger age, elderly, forcedly immobilized, physically exhausted, unconscious people. The course of the disease is aggravated by strong wind, high humidity, overwork, damp clothes, injuries, alcohol or drug intoxication.

Hypothermia of the legs and the whole body can be obtained even when swimming in a cool pond, the consequences will depend on the length of stay in water of this temperature.

Signs of hypothermia

It's not that hard to recognize. At first, a person experiences a surge of strength, he is overly excited, but at the same time there is a cyanosis of the nasolabial triangle, blanching of the skin. The patient is disturbed by severe chills, shortness of breath, frequent pulse.

If during this period no medical measures, excitation is replaced by apathy, lethargy, lethargy. A person loses the ability to move, he is overcome by weakness and drowsiness, often there is a loss of consciousness. Failure to provide assistance with hypothermia leads to the cessation of cardiac and respiratory activity, as a result of which a person dies.

Degrees of hypothermia

Depending on the patient's condition, there are three degrees of hypothermia:

1. Lightweight. Body temperature is reduced to degrees. The patient has chills, pale coloration of the skin, a bluish tint of the lips and nasolabial triangle, "goose bumps", a person can hardly speak due to trembling of the lower jaw and lips. Arterial pressure with a mild degree of hypothermia remains within the normal range, sometimes slightly increased. The patient is able to move independently. At this stage, frostbite foci of 1-2 degrees may appear.

2. Average. There is a further decrease in body temperature, it can reach degrees. The skin becomes bluish, cold to the touch. The patient embraces indifference to what is happening, apathy and drowsiness. With general hypothermia, a state of "stupor" is observed, in which the patient does not respond to addressed speech and other external stimuli.

Arterial pressure is slightly reduced, there is a slowdown in the pulse, while breathing becomes more rare. The ability to move independently is lost. Frostbite can be up to the fourth degree. The lack of help with hypothermia in the middle stage leads to the development of various complications, in some cases to the death of the patient.

3. Heavy. Below 31 degrees, the temperature of the human body drops, while there is a loss of consciousness, a slowdown in the pulse of up to beats per minute. With general hypothermia, the skin and mucous membranes become a pronounced cyanotic hue, swelling of the face, lips, hands and feet appears. The patient loses consciousness, convulsions appear, the condition is aggravated by the transition to a coma. Blood pressure drops sharply, breathing becomes very rare. Frostbite in this stage of general hypothermia is quite severe. A person needs emergency medical care, otherwise he will die.

First aid for hypothermia

First aid for hypothermia is to stop the effect of the cold factor on the human body. To do this, the victim must be brought to a warm room or, if this is not possible, laid in a place protected from wind and precipitation. Wet clothes should be immediately disposed of, after which the patient should be wrapped in dry linen or a blanket. If hypothermia of the legs or head is noted, it is enough to remove wet shoes and put something warm on the head.

If a person is conscious, it is necessary to give him hot milk, fruit drink, water or tea to drink. With general hypothermia, it is advisable to take a bath first with warm water, and then hotter, but not higher than 40 degrees. After water procedures the victim is placed in a warm bed and covered with heating pads or bottles of hot water. Frostbitten areas should be covered with clean, preferably sterile, dressings.

In an unconscious patient, it is necessary to control the presence of breathing and pulse. In the absence of such, you should immediately start an indirect heart massage and artificial respiration.

After providing first aid to a person affected by hypothermia, it is imperative to take him to the hospital, even if at first glance his condition is satisfactory. Some complications can only be identified by a doctor.

What not to do when hypothermia

To not cause more more harm, do not give the patient coffee and alcoholic beverages. It is not recommended to place a person in hot water without first warming. In case of hypothermia, it is forbidden to intensively rub the skin with snow, oil, alcohol-containing liquids or simply with dry hands, as well as pierce the blisters formed at the site of frostbite. Do not use open fire to warm the victim. The use of these methods leads to a sharp temperature drop, which is fraught with damage small capillaries, the appearance of internal hemorrhages and other, no less severe complications.

Prevention of hypothermia

Children should walk in fairly spacious and seasonal clothing. It is not recommended to tie your mouth and nose with a scarf, so as not to expose the skin of the face to humid and cold air. Gloves and socks must be dry. On frosty days, the child needs to go into a warm room every minute to warm up.

Adults should always use a scarf, hat and mittens. You can not go out into the cold with damp hair.

It is advisable to dress in such a way that several thinner pieces of clothing are worn than one, but dense and heavy. The air layer saves from premature hypothermia. Shoes should also not be tight and wet.

Do not moisten with liquids or lubricate the skin with a moisturizer before going outside.

During the walk, you need to vigilantly monitor your well-being. At the first sign of hypothermia, you need to go into a warm room.

The preventive measures taken will allow, if not to completely avoid hypothermia, then at least significantly reduce its negative impact on the body.

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hypothermia

Hypothermia is a pathological condition that is characterized by excessive heat transfer from the body and, accordingly, a decrease in body temperature or a separate body, whose tissues may lose viability (frostbite).

General hypothermia occurs when a low temperature from the outside affects a person for a long time, that is, with a short stay, even at critical levels of thermometers, the risk of failure is low. Many have heard about cryosaunas, in which the air temperature is about -120 ° C, while a minute stay in such conditions relieves many diseases. Things are different with hypothermia due to certain circumstances, which leads to failures in the compensatory reactions of the body with further inhibition of the functions of the central nervous system, cardiovascular system and respiratory organs.

General hypothermia with lethal outcome can occur at 0 ° C if a person is in these conditions without movement for more than 10 hours. If the water temperature is the same, then irreversible consequences can occur after half an hour of stay.

The human body is more adversely affected by hypothermia under the following conditions:

• Starvation;
• Severe fatigue and stress;
• Alcohol and drug intoxication;
• Blood loss after injury;
• Being in cold water;
• Increased air humidity;
• Strong wind;
• Being in wet, light or tight clothing;
• Unconscious state.

Hypothermia of the legs occurs most often, since these limbs are the most distant from the heart, and last of all receive their "portion" of blood flow and, accordingly, heat.

Types and signs of hypothermia

Hypothermia is divided into the following types:

• Local (hypothermia of the legs, arms, ears, cheeks);
• General hypothermia.

Local damage to body tissues occurs as a result of local exposure to cold (frostbite). At first, a person feels a piercing cold in the limbs or other parts of the body, after which numbness occurs without any pain, then all sensitivity disappears. In severe forms of hypothermia of the legs, the skin darkens, which indicates the death of tissues and the need for amputation of the limbs.

For general hypothermia, symptoms such as excitement and a surge of energy are characteristic. initial stage, while pallor and cooling of the skin, cyanosis of the nasolabial triangle is already noted. The person begins to complain of chills, palpitations, shortness of breath, stiffness, fatigue, drowsiness, weakness. Further, elementary motor functions become difficult. Prolonged exposure to low temperatures leads to loss of consciousness. If first aid is not provided in time for hypothermia, the victim stops breathing and heart, death occurs.

Degrees of hypothermia

Hypothermia can occur in varying degrees, depending on the condition of the victim and the time of his stay in adverse conditions:

• A mild degree is characterized by a decrease in body temperature to 34 ° C, sometimes up to 32. A person complains of chills and weakness, while outwardly one can observe blanching of the skin, blue lips and skin between the nose and mouth, the appearance of "goose bumps". The patient's jaws tremble, so he answers questions with difficulty. The pressure remains normal, although in some cases it may increase slightly. At this stage of hypothermia, a person can move independently, frostbite foci can be 1 or 2 degrees;
• The average degree is characterized by a decrease in body temperature to 29 ° C, blueness of the skin and their cooling to the touch. The patient becomes apathetic, drowsy, weak and indifferent to everything that happens. There is also a numbness in which the victim is not able to respond to external stimuli. If you measure blood pressure, it is reduced, the pulse is slow, and breathing is rare. At this stage, it is already difficult to move, while frostbite can reach the 4th degree;
• Severe - extremely serious condition, at which the body temperature is below 31 ° C, the pulse is no more than beats per minute, the person loses consciousness. Hypothermia of this stage leads to swelling of the limbs and face, bluish tint of the skin, loss of consciousness, convulsions, and also to coma.

Hypothermia treatment

The elimination of symptoms of hypothermia consists of several stages, while the set of further measures depends on the patient's condition at the time of seeking medical help. So the treatment is:

• Providing first aid for hypothermia;
• Protect from further influence cold;
• Artificial ventilation of the lungs (at 3 degrees);
• The introduction of vasodilators;
• Active external warming;
• Active internal warming;
• Inhalation of heated oxygen;
• The introduction into the peripheral veins of infusion heated solutions;
• gastric lavage and Bladder(at stage 3);
• Symptomatic therapy and elimination of complications.

Complications of hypothermia of the legs, hands or the whole body can be of the following nature:

• tissue necrosis;
• Pulmonary edema;
• swelling of the brain;
• Acute honorary insufficiency;
• Abscessing pneumonia.

First aid for hypothermia

The consequences of hypothermia directly depend on how soon and correctly first aid is provided to the victim. First of all, it is necessary to stop the effect of low temperature on a person: pull him out of the water, take him to a warm room, give him extra warm clothes and blankets. If the victim’s own belongings are wet, then you need to urgently remove them from him and put on dry ones.

First aid for hypothermia of 1-2 degrees also consists in internal heating, which implies drinking warm drinks. A warm bath also helps to warm up, which is then replaced with a hot one, but not more than 40 ° C. After that, the victim should be put in a warm bed and overlaid with heating pads and bottles of hot water, and sterile dressings should be applied to frostbitten areas.

If a person is unconscious, then you need to control the frequency of breathing and pulse until the ambulance arrives. In the absence of breathing, it is necessary to do artificial. In any case, regardless of the patient's condition, you should immediately call an ambulance.

Prohibited techniques for hypothermia

In case of contact with a situation associated with hypothermia, in no case should you give the victim alcohol or coffee. Also, the prohibition is imposed on rubbing the skin with oil, snow, dry hands or alcohol-containing liquids. If blisters form on frostbitten areas, then you can not touch them with your hands.

A sudden change in temperature can lead to serious consequences faster than hypothermia itself, so warming should be gradual and moderate.

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Hypothermia (hypothermia). Causes, first aid, degrees and possible consequences

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician.

• When the body temperature drops below 33 degrees, the victim ceases to realize that he is freezing and cannot help himself.
• Sudden warming of a supercooled patient can lead to his death.
• When the skin temperature is less than 10 degrees, its cold receptors are blocked and stop notifying the brain about the danger of hypothermia.
• According to statistics, every third person who died from hypothermia was intoxicated.
• Any working skeletal muscle warms up by 2 - 2.5 degrees.
• The most active areas of the brain are warmer than the passive ones, on average, by 0.3-0.5 degrees.
• Shivering increases heat generation by 200%.
• The "point of no return" is considered to be a body temperature of less than 24 degrees, at which it is almost impossible to return the victim of frostbite to life.
• In newborns, the thermoregulation center is underdeveloped.

How is body temperature regulated?

Receptors

There are approximately 250 thousand receptors in the thickness of the skin. Approximately the same number of receptors are found in other tissues of the body - in the liver, gallbladder, kidneys, blood vessels, pleura, etc. Skin receptors are located most densely on the face. With the help of peripheral thermoreceptors, information is collected about the temperature of the environment in which they are located, and a shift in the temperature of the "core" of the body is also prevented.

There are much fewer central receptors - about a few thousand. They are located exclusively in the hypothalamus and are responsible for measuring the temperature of the blood flowing to it. Upon activation of central receptors, more intense reactions of heat generation are triggered than upon activation of peripheral receptors.

Hypothalamus

Mechanisms of heat generation

• strengthening the work of muscles;
• increase in basal metabolism;
• specific dynamic action of food;
• acceleration of hepatic metabolism;
• increase in heart rate;
• increase in the volume of circulating blood;
• acceleration of the functioning of other organs and structures.

Strengthening muscle work

At rest, striated muscles produce on average 800-1000 kcal per day, which is 65-70% of the heat produced by the body. The body's response to cold is shivering or chills, in which the muscles involuntarily contract at a high frequency and low amplitude. Shivering increases heat generation by 200%. Walking increases heat generation by 50 - 80%, and hard physical work - by 400 - 500%.

Basal metabolism is a value corresponding to the average rate of all chemical reactions in the body. The body's response to hypothermia is an increase in basal metabolism. Basal metabolism is not synonymous with metabolism, since the term "metabolism" is characteristic of any one structure or system. In some diseases, the basal metabolic rate may decrease, which ultimately leads to a decrease in comfortable body temperature. The rate of heat production in such patients is much lower than in other people, which makes them more susceptible to hypothermia.

Eating and digesting food requires the body to release some additional energy. Part of it is converted into thermal energy and is included in the overall process of heat generation, although only slightly.

The liver is likened to the body's chemical factory. Every second, thousands of reactions occur in it, accompanied by the release of heat. For this reason, the liver is the "hottest" internal organ. The liver produces an average of 350-500 kcal of heat per day.

Being a muscular organ, the heart, like the rest of the muscles of the body, generates heat during work. It produces 70-90 kcal of heat per day. With hypothermia, the heart rate increases, which is accompanied by an increase in the amount of heat produced by the heart up to 130-150 kcal per day.

The human body circulates from 4 to 7 liters of blood, depending on body weight. 65 - 70% of the blood is constantly in motion, and the remaining 30 - 35% is in the so-called blood depot (an unused blood reserve needed in emergency situations, such as heavy physical work, lack of oxygen in the air, bleeding, etc. ). The main blood depots are veins, spleen, liver, skin and lungs. With hypothermia, as indicated above, the basal metabolism increases. An increase in basal metabolism needs more oxygen and nutrients. Since the blood is their carrier, its amount should increase in proportion to the increase in basal metabolism. Thus, the blood from the depot enters the bloodstream, increasing its volume.

The kidneys produce 70 kcal of heat per day, the brain - 30 kcal. The respiratory muscles of the diaphragm, working continuously, supply the body with an additional 150 kcal of heat. With hypothermia, the frequency of respiratory movements increases from one and a half to two times. Such an increase will lead to an increase in the amount of thermal energy released by the respiratory muscles up to 250-300 kcal per day.

Heat loss mechanisms

• centralization of blood circulation;
• increase in subcutaneous fat;
• decrease in the open area of ​​the body;
• reduction of heat loss by evaporation;
• skin muscle response.

Centralization of blood circulation

The body is conditionally divided into "core" and "shell". The “core” of the body is all the organs and vessels of the abdominal cavity. The temperature of the core practically does not change, since maintaining its constancy is necessary for the correct functioning of vital organs. "Shell" refers to the tissues of the limbs and the entire skin covering the body. Passing through the "shell", the blood cools, giving energy to the tissues through which it flows. The farther away from the "core" a part of the body is, the colder it is. The rate of heat loss directly depends on the amount of blood passing through the "shell". Accordingly, during hypothermia, in order to reduce heat loss, the body reduces blood flow to the “sheath”, directing it to circulate only through the “core”. For example, at a temperature of 15 degrees, the blood flow of the hand is reduced by 6 times.

With prolonged exposure to a cold climate, the human body is rebuilt in such a way as to reduce heat loss. The total mass of adipose tissue increases and is redistributed throughout the body more evenly. Its main part is deposited under the skin, forming a layer 1.5 - 2 cm thick. A smaller part is distributed throughout the body and settles between the muscle fascia in the large and small omentums, etc. The essence of this rearrangement lies in the fact that adipose tissue conducts heat poorly, ensuring its preservation inside the body. In addition, adipose tissue does not require such high oxygen consumption. This provides it with an advantage over other tissues in conditions of oxygen deficiency due to a prolonged spasm of the vessels that feed it.

The rate of heat loss depends on the temperature difference and the area of ​​contact of the body with the environment. If it is not possible to influence the temperature difference, then it is possible to change the contact area by taking more closed posture. For example, in cold weather, animals curl up into a ball, reducing the area of ​​contact with the environment, and in hot weather, on the contrary, they tend to increase it, straightening up as much as possible. Likewise, a person, falling asleep in a cold room, subconsciously draws his knees to his chest, taking a more economical position in terms of energy costs.

The body loses heat when water evaporates from the surface of the skin or mucous membranes. Scientists have calculated that the evaporation of 1 ml of water from the human body leads to a loss of 0.58 kcal of heat. During the day, through evaporation, an adult loses an average of 1400 - 1800 ml of moisture during normal physical activity. Of these, 400 - 500 ml evaporates through Airways, 700 - 800 ml through perspiration (imperceptible seepage) and 300 - 500 ml through sweat. Under conditions of hypothermia, perspiration stops, breathing slows down, and vaporization in the lungs decreases. Thus, heat loss is reduced by 10 - 15%.

In nature, this mechanism is very common and consists in the tension of the muscles that lift hair follicles. As a result, the undercoat and cellularity of the coat increase, and the layer of warm air around the body thickens. This results in improved thermal insulation, since air is a poor conductor of heat. In humans, in the course of evolution, this reaction has been preserved in a rudimentary form and has no practical value.

Causes of hypothermia

• weather;
• quality of clothing and footwear;
• diseases and pathological conditions of the body.

Weather

• ambient temperature;
• air humidity;
• wind power.

Ambient temperature

Ambient temperature is the most significant factor in hypothermia. In physics, in the section of thermodynamics, there is a pattern that describes the rate of drop in body temperature depending on the temperature of the environment. In essence, it boils down to what more difference temperatures between the body and the environment, the more intense the heat exchange. In the context of hypothermia, this rule will sound like this: the rate of heat loss by the body will increase as the ambient temperature decreases. However, the above rule will only work if a person is in the cold without clothes. Clothing greatly reduces the loss of heat from the body.

Atmospheric humidity affects the rate of heat loss in the following way. As humidity increases, the rate of heat loss increases. The mechanism of this pattern is that at high humidity, a layer of water invisible to the eye is formed on all surfaces. The rate of heat loss in water is 14 times higher than in air. Thus, water, being a better conductor of heat than dry air, will quickly transfer the body's heat to the environment.

Wind is nothing more than a unidirectional movement of air. In a calm environment around the human body is formed thin layer warm and relatively still air. Under such conditions, the body spends a minimum of energy to maintain a constant temperature of this air shell. In conditions of wind, the air, having barely warmed up, moves away from the skin and is replaced by a colder one. To maintain optimal body temperature, the body has to speed up the basal metabolism, activate additional reactions of heat generation, which ultimately requires a large amount of energy. At a wind speed of 5 meters per second, the heat transfer rates increase approximately twice, at 10 meters per second - four times. Further growth occurs exponentially.

The quality of clothes and shoes

Diseases and pathological conditions of the body

Heart failure is a serious disease in which the pumping function of the heart muscle suffers. The rate of blood flow throughout the body is reduced. As a result, the residence time of blood in the periphery increases, which leads to its stronger cooling. With heart failure, edema often forms, starting in the feet and eventually rising higher, up to the chest. Edema further aggravates blood circulation in the extremities and leads to even more cooling of the blood. To maintain the required body temperature, the body is forced to constantly use the mechanisms of heat generation, even when normal temperature environment. However, when it decreases, the mechanisms of thermogenesis are exhausted, and the rate of drop in body temperature increases sharply, introducing the patient into a state of hypothermia.

This disease is the result of a long-term replacement of functional liver tissue with non-functional connective tissue. With a long course of the disease, free fluid accumulates in the abdominal cavity, the volume of which can reach 15-20 liters. Since this fluid is within the body, additional resources must be constantly expended to maintain its temperature and some of the mechanisms of heat generation must be activated. The abdomen of such patients is tense. Internal organs and vessels are subjected to compression. With compression of the inferior vena cava, edema of the lower extremities rapidly develops. As mentioned earlier, edema leads to additional cooling of the blood, requiring additional efforts of the heat generation system. With a decrease in ambient temperature, the mechanisms of heat generation will cease to cope with their task, and the patient's temperature will begin to fall steadily.

Addison's disease is an insufficiency of the adrenal cortex. Normally, three types of hormones are produced in the adrenal cortex - crystalloids (aldosterone), glucocorticoids (cortisol) and androgens (androsterone). With insufficient amounts of two of them (aldosterone and cortisol) in the blood, blood pressure decreases. A decrease in blood pressure leads to a slowdown in the rate of blood flow throughout the body. Blood travels one circle through the human body per more time while cooling more strongly. In addition to the above, the lack of glucocorticoids leads to a decrease in the body's basal metabolism, a decrease in the rate of chemical reactions, accompanied by the release of energy. As a result, the "core" produces less heat, which, combined with more cooling of the blood, leads to a significant risk of hypothermia, even at moderately low temperatures.

Hypothyroidism is endocrine disease caused by insufficient production of hormones thyroid gland. Like glucocorticoids, thyroid hormones (triiodothyronine and thyroxine) are responsible for the regulation of many biological processes in the human body. One of the functions of these hormones is to maintain a uniform rate of reactions accompanied by the release of heat. With a decrease in the level of thyroxin, a decrease in body temperature occurs. The more severe the hormone deficiency, the lower constant temperature body. Such patients are not afraid high temperatures, but in the cold they quickly supercool.

Cachexia is a state of extreme exhaustion of the body. It develops over a relatively long time (weeks and even months). The causes of cachexia are cancer, AIDS, tuberculosis, cholera, prolonged malnutrition, extremely high physical exercise and others. With cachexia, the weight of the patient is greatly reduced, mainly due to adipose and muscle tissues. This is what determines the mechanism for the development of hypothermia in this pathological condition. Adipose tissue is a kind of thermal insulator of the body. With its lack, the rate of loss of body temperature increases. In addition, adipose tissue, when broken down, produces 2 times more energy than any other tissue. In its absence, the body has to use proteins for its own heating - the “bricks” from which our body is built.

This condition is a consequence of the presence in the human blood of a certain amount of alcohol that can cause a certain biological effect. According to scientists, minimal amount of an alcoholic drink, necessary to start the development of the processes of inhibition of the cerebral cortex, ranges from 5 to 10 ml pure alcohol(96%), and for expanding the blood vessels of the skin and subcutaneous fat is from 15 to 30 ml. For the elderly and children this measure half as much. With the expansion of the vessels of the periphery, a deceptive sensation of warmth is created.

Bleeding is the outflow of blood from the bloodstream into the external environment or into the body cavity. The mechanism of action of blood loss leading to hypothermia is simple. Blood is a liquid medium that, in addition to oxygen and nutrients, transfers thermal energy to organs and tissues. Accordingly, the loss of blood by the body is directly proportional to the loss of heat. Slow or chronic bleeding is tolerated by a person much better than acute. With prolonged slow bleeding, the patient can survive, losing even half the blood.

With traumatic brain injury, as well as with profuse bleeding there is a risk of loss of consciousness. The danger of hypothermia during loss of consciousness is detailed above.

Degrees of hypothermia

Violent muscle tremors. The ability to move independently was preserved.

Lethargy and drowsiness, slow speech, slow response to stimuli.

Rapid breathing and heartbeat.

Absence muscle tremors. Muscle stiffness, up to the inability to straighten the limb. Pose "boxer".

superficial coma. The pupils are moderately dilated, the reaction to light is positive. Reaction only to strong painful stimuli.

Breathing slows down and becomes shallow. Decreased heart rate.

Damage to peripheral tissues due to prolonged lack of blood supply.

Extreme deterioration of the metabolic processes of the brain. Complete separation of the work of various parts of the brain. The appearance of foci of convulsive activity.

Severe depression of the cerebral centers of respiration and heartbeat.

Slowdown of the conduction system of the heart.

Severe muscle stiffness.

deep coma. The pupils are maximally dilated. Reaction to light is absent or very weakly expressed. There is no response to any stimuli.

Attacks of generalized convulsions recurring every 15 to 30 minutes.

Lack of rhythmic breathing. Reducing the heart rate to 20 - 30 per minute. Rhythm disturbances. At 20 degrees, breathing and heartbeat usually stop.

Because the stages clinical manifestations hypothermia do not always correspond to certain temperature limits, there is a secondary classification of degrees of hypothermia depending on body temperature in terms of clinical information.

Symptoms of hypothermia

First aid for hypothermia

1. Stop contact of the victim with the cold environment. It is necessary to deliver him to a warm room, take off his frozen and wet clothes and change into clean, dry clothes.
2. Offer the victim any warm drink (tea, coffee, broth). It is important that the temperature of the drink does not exceed body temperature by more than 20 - 30 degrees, otherwise the risk of burning the mucous membranes increases. oral cavity, burns of the esophagus and stomach.
3. Wrap the patient in any thermally insulating material. Most effective in this case There will be special thick foil blankets. In their absence, you can use wadded blankets or any other.
4. Avoid excessive movement of the victim from place to place, as unnecessary movement can cause pain and contribute to the appearance of cardiac arrhythmias.
5. Massage of the body in the form of light rubbing promotes heat generation through friction, and also accelerates the recovery processes of the skin and subcutaneous tissue. However, rough massage can provoke the arrhythmias mentioned above.
6. A good therapeutic effect is brought by warm baths. The water temperature at the beginning of the procedure should be equal to body temperature or exceed it by 2 - 3 degrees. Then slowly increase the temperature of the water. The rise in temperature should not exceed 10 - 12 degrees per hour. It is extremely important to monitor the patient's condition during his active rewarming in a warm bath, because with rapid rewarming, there is a possibility of developing the “Afterdrop” syndrome, in which blood pressure drops sharply, up to a state of shock.

First aid medicines for hypothermia:

• Antispasmodics. This group of medicines should be used only after the victim has begun to warm up. Their appointment to a patient under the influence of cold will sharply aggravate his condition. The rate of temperature decrease will increase and develop more early decline respiratory rate than it does without prescribing the drug. As antispasmodics, papaverine 40 mg 3-4 times a day is used; drotaverine (no-shpa) 40 - 80 mg 2 - 3 times a day; mebeverine (duspatalin) 200 mg twice a day.
• Painkillers. Pain is a factor that in itself contributes to the worsening of the course of any disease. The presence of pain during hypothermia is a direct indication for the use of painkillers. Analgin 500 mg 2-3 times a day are used as painkillers for hypothermia; dexketoprofen 25 mg 2-3 times a day; ibuprofen 400 mg 4 times a day.
• Non-steroidal anti-inflammatory drugs (NSAIDs). This group drugs are used to prevent inflammatory processes after warming the victim, as well as to reduce the intensity of pain. With a stomach ulcer and duodenal ulcer, this group of drugs is used with caution. For the treatment of hypothermia, the following non-steroidal anti-inflammatory drugs are used: acetylsalicylic acid (aspirin) 250-500 mg 2-3 times a day; nimesulide 100 mg 2 times a day; ketorolac (ketanov) 10 mg 2-3 times a day.
• Antihistamines. This group of drugs is actively used in allergic diseases. However, they are no less effective in combating any inflammatory process of non-bacterial origin, and, accordingly, are also suitable for reducing the symptoms of hypothermia. The most common are the following antihistamines: suprastin 25 mg 3-4 times a day; clemastine 1 mg 2 times a day; Zyrtec 10 mg once a day.
• Vitamins. Most effective drug in case of hypothermia is vitamin C. Its positive action is to strengthen the walls of blood vessels damaged low temperatures. It is used 500 mg 1-2 times a day.

The above preparations are given in doses corresponding to an adult without significant impairment of the excretory function of the kidneys. When adverse reactions on any of the medicines taken, you should immediately seek qualified medical help.

Hypothermia treatment

• Eliminate contact of frozen clothing with the body of the victim.
• Wrapping the victim in a thermal insulation material, such as a special "space" blanket, the main component of which is foil.
• Placement of the patient under a lamp with dosed infrared radiation.
• Covering the patient with heating pads with warm water. The water temperature in them should not exceed body temperature by more than 10 - 12 degrees.
• Immerse yourself in a warm bath. The water temperature at the beginning of the procedure is 2-3 degrees higher than body temperature. Subsequently, the water temperature rises by 8 - 10 degrees per hour.
• Applying heat to the projections of large blood vessels.
• Intravenous administration of warm infusion solutions, the temperature of which should not exceed 40 - 42 degrees.
• Gastric lavage with warm water (40 - 42 degrees). With spasm chewing muscles and the impossibility of inserting the probe through the mouth, diazepam is injected into the muscles of the bottom of the mouth, and then reintroduction probe. With a spasm of the masticatory muscles, a tube can be inserted through the nose (nasogastric tube), but with great care, since the risk of vomiting and ingestion of stomach contents into the respiratory tract is significantly increased.

Correction of vital signs:

• Oxygenation with humidified oxygen. The percentage of oxygen in the inhaled air should be selected in such a way that the saturation (saturation) of the blood with oxygen is more than 95%.
• Maintaining blood pressure within 80/60 - 120/80 mmHg. At low blood pressure atropine 0.1% - 1 ml is injected intravenously (in a dilution of 10 - 20 ml of saline); prednisolone 30 - 60 mg; dexamethasone 4 - 8 mg.
• Correction of the electrolyte composition of the blood - Ringer-Locke solution, Ringer-lactate, dextran-40, dextran-70, etc.
• Correction of blood glucose levels - glucose 5, 10 and 40%; insulin.
• Artificial ventilation of the lungs is used for extremely severe hypothermia, when the victim is unable to breathe on his own.
• An external cardioverter and defibrillator are used when serious heart rhythm disturbances occur. Cardioverter artificially causes a contraction of the heart muscle when an excessively long pause occurs. A defibrillator is used when ventricular fibrillation and pulseless tachycardia occur.
• An electrocardiograph is used continuously to monitor cardiac activity.

When the patient's condition improves and the threat to life disappears, he is transferred to the general therapy department or any other department at the discretion of the attending physician for further recovery.

Prevention of hypothermia

• Clothing should be warm and dry, preferably made from natural materials.
• The exposed parts of the clothing must be tightened as tightly as possible to prevent air from entering under it.
• The hood is an extremely useful piece of clothing, as it significantly improves the protection of the head from wind, rain and snow.
• Find natural shelter from the wind, such as cliffs, caves, building walls, and driveways. Good protection from the wind can be achieved by building a canopy of branches, or simply burrowing into a pile of leaves or a haystack. In order not to suffocate, it is necessary to provide a small hole for ventilation.
• Shoes must match the size of the foot. The sole must be at least 1 cm thick.
• Active movements, such as squats, running in place, increase heat production and reduce the chances of hypothermia.
• If possible, hot drinks should be consumed as often as possible.
• Alcohol is contraindicated for use in the cold, as it increases heat transfer.
• In cold weather, it is necessary to provide a diet with a large amount of fats and carbohydrates, as well as introduce an additional meal into the daily routine.
• An external heat source, such as a campfire, greatly increases the chances of avoiding hypothermia.
• If necessary, ask passers-by for help and stop passing cars.