Environmental Emergencies – Part 2 “Cold Exposure – Hypothermia”

To continue our detailed explanation of how to handle environmental emergencies including exposure to both “Heat” and “Cold”, and explain how we can help, we must again refer back to a previous post about “Burns”, as we are talking about a “Thermal Dynamic Energy” your body can take damage from to much exposure to both heat and cold, it always depends on the amount you are exposed to that will detail the severity of the injury. The slogan from our post about Burns is, if “Hot is Fast, then Cold must be Slow“. Once again this will help us distinguish the difference in the injuries and potential treatments we can use to help the patient.

Just remember that Thermal energy in either direction Hot or Cold will result in levels of severity and symptoms that are very similar but on opposite ends of the spectrum “Fire / Ice“, Lets focus on Cold exposure within the core of your body for this article and explain how a low core temperature can effect treatments .

To help with the explanation of Hypothermia we must also bring in your “Normal Body Temperature 37C / 98.6F“. “Hypo” literally means “Low” and “thermia” temperature, put them together and you get low temperature within your body. Your body has three stages of Hypothermia “Mild / Moderate & Severe” and each stage has its own symptoms until you reach about “30C or 86F” which would be unconsciousness.

Hypothermia What it looks like:

  1. Mild -“37C to 35C” -Shivering and complaining of the cold, numbness, body temperature slightly below normal.
  2. Moderate35C to 33C – Shivering and sometimes complaining of the cold, Numbness, Lack of coordination and / or speech “Slurr“, Confused or unusual behavior, impaired judgement.
  3. Severe 33C to 27C – Person has stopped shivering, persona has stopped complaining of the cold, Numbness, lack of coordination and / or speech, confused or unusual behavior, impaired judgment, breathing has slowed down or stopped, possible unconsciousness and body feels stiff.


  • Exposure to cold temperatures for too long.

Prevention of Hypothermia:

“Low body temperature”

  • If you are in, on, or around a cold environment, prepare properly, wear layer of clothing and warm yourself if you feel cold.
  • Wear a tuque and layers of clothing made of tightly woven fibers, such as wool or synthetics like fleece. “AVOID COTTON!
  • Cover Up vulnerable areas such as your fingers, toes, cheeks, ears, and nose “But don’t cover them too tightly
  • Drink plenty of warm fluids to help your body stay warm, if warm drinks are not available, drink plenty of plain water or electrolyte drinks “Not energy drinks“.
  • Avoid caffeine & alcohol because they can cause dehydration, which stops your body from controlling its temperature properly.
  • Take frequent breaks from the cold to let your body warm up. This will help you cope better with short periods of extreme cold.
  • Check the weather forecast before you plan an outdoor activity.
  • Shivering is your body’s first response to cold, Blue lips and vigorous shivering are warning signs of hypothermia.
  • Be extremely careful around water. Hypothermia can occur in any body of water, warm or cold. If you clothes get wet and you are in the cold, change into dry clothing immediately.

How to Treat Hypothermia:Low body temperature

  1. Check the area, once the area is safe, Check the person and ensure the persons ABC’s are present “Airway / Breathing / CirculationREMEMBERWear gloves if available to avoid bodily fluids.
  2. Call 911 and get an AED if the cold related injury includes frost nip or frost bite, the person is in a great deal of pain, there is blackening on the wound, the person has stopped shivering or has wet clothing and EMS may be delayed.
  3. Care for the Hypothermia by:

Always follow recommendations by your Emergency Response professionals and 911 Dispatch personnel. ” Never endanger yourself and maintain a safe distance from the source of the injury”

a) Treat the person gently and monitor breathing carefully.

b) Get the person away from the cold environment and into some kind of shelter, if possible.

c) Remove any wet clothing and dry the person.

d) Warm the person by wrapping him or her in blankets or putting on dry clothing. Cover the head and neck. Warm the person slowly. Warming too quickly can cause heart problems and lead to shock.

e)Hot is Fast / Cold is Slow” If hot water bottles, heating pads, or other heat sources are available put them in each armpit, the groin and the back of the neck. If you use a heating pad, make sure the person is dry. Keep a blanket, towel, or clothing between the heat source and the skin to avoid burns.

f) If the person is alert, give him or her warm liquids to drink “No alcohol or caffeine

g) Continue care until EMS arrive or you seek further medical attention.

Freezing of Skin to Metal Objects:

“This is a common injury in children during winter, the tongue, lips and other moist parts of skin can freeze to cold metal objects”

How to Help:

  1. Ensure the ABC’s are present “Airway, Breathing, Circulation
  2. Pour warm water on the surface of the object and/or the skin that is stuck to the object. “DO NOT USE HOT WATER!”
  3. Gradually and gently help release the person from the metal object
  4. Treat any non life threatening injuries “Any torn skin is an open wound” and provide continual care.


  • Don’t rub the frozen area or put snow on it. Warm the area only if you are sure it will not freeze again.
  • Avoid “Direct” heat as this may damage the tissue further, use heat sources closer to the core above the injury. “Put the Hot Pack at the Point, Nearest the coldest Joint
  • Never aggressively warm with friction or patting, the injured person may go into shock with sudden movements.

As you can see, the treatment on Cold Exposure in this tutorial are the same regardless of the name “Frost Nip / Frost Bite” or even “Hypothermia“. Once you master the First Aid technique on how to aid a Thermal injury caused from a Cold source you can aid anyone who has been exposed to too much Cold energy. Just remember that it does not matter what the name of the cold exposure injury is, the treatments are often the same “Hot is Fast & Cold is Slow“. Put a heat source at the joint nearest the coldest point and gradually warm the cold exposure related injury.

In any emergency just remember to Protect Yourself!!! Call 911!!! Don’t Waste Time!!!

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