General hypothermia
Last reviewed: 19.11.2021
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General supercooling causes a complex compensatory reaction in the form of reflex angiospasm, enhancement of heat formation by the liver, activation of the heart and blood flow, biochemical process of glycolysis. With a drop in body temperature below 30 °, there is a sharp decompensation with increased heat release due to paralytic vasodilation. Glycolysis is completely depleted. Survival of the body when exposed to cold is quite low. In such a state as total subcooling in water with a temperature of 15 ° C, a person can survive 6 hours, at 10 ° - 1 hour, at 1 ° - 30 minutes,
The severity is determined by the temperature in the rectum. Preserving it to 35 ° is defined as the total supercooling of the body, reducing it to 25 ° is defined as total supercooling, and a decrease below 25 ° is regarded as freezing.
The reaction of the body to total supercooling occurs step by step, determining the 4 stages of freezing.
- The first stage is compensatory. Clinically, the general hypothermia is manifested by excitation, chills, and muscle tremor. The skin is pale, cyanosis of the lips and acrocyanosis, goosebump. Arterial blood pressure is increased, pulse and breathing are frequent. Hypertension of muscles is noted. The temperature in the rectum is up to 35 °.
- The second stage is adynamic. Afflicted in consciousness, but inhibited, euphoric, worried headache, dizziness, weakness. General supercooling is characterized by adynamy, a decrease in muscle reflexes. Blood pressure is normal, bradycardia up to 60-50 per minute. Breathing is preserved, but tachypnea up to 40 per minute. The temperature in the rectum is reduced to 35-30 °.
- The third stage is a comparative one. There is a retardation, lethargy, drowsiness, memory disorders, dysarthria, false sensation of heat. Characterized by hypertonic muscle. The pupils are dilated. There may be incontinence of urine and feces. Arterial blood pressure is sharply reduced, the pulse is 30-50 per minute. The respiration rate is 8-10 per minute. The temperature in the rectum is 29-25 °.
- The fourth stage is comatose. Consciousness is absent. There are involuntary movements of the head, limbs, eye opening, trismus, tension of abdominal muscles and limbs. Pupils are narrowed, there is no reaction to light, there is no corneal reflex, the eyeballs are floating. Arterial blood pressure is sharply reduced, the pulse is weak, up to 20 per minute. Breathing is within 3-5 per minute. The temperature in the rectum is 25 °, the lethal income from paralytic heart and respiratory arrest, in which resuscitation is absolutely ineffective, quickly comes.
With all types of frostbite and chills, the victim should be hospitalized in the surgical department, usually into a purulent-septic. When transporting, warm the limb with wrapping and dry grinding with mittens or warm hands.