FEATURE
INCORPORATING COLD CHAIN
In moderately cold environments, the body’s core
temperature does not usually fall more than 1°C to 2°C
below the normal 37°C because of the body’s ability
to adapt. However, in intense cold without adequate
clothing, the body is unable to compensate for the
heat loss and the core temperature starts to fall. The
sensation of cold followed by pain in exposed parts of
the body is one of the first signs of mild hypothermia.
As the temperature continues to drop, or as the
exposure time increases, the feeling of cold and pain
starts to diminish because of increasing numbness
(loss of sensation). If pain cannot be felt, serious
injury can occur without the victim noticing it. Next,
muscular weakness and drowsiness are experienced.
This condition is called hypothermia and usually
occurs when the body temperature falls below
33°C. Additional symptoms of hypothermia include
interruption of shivering, diminished consciousness and
dilated pupils. When the body temperature reaches
27°C, coma (profound unconsciousness) sets in.
Heart activity stops around 20°C and the brain stops
functioning around 17°C.
Hypothermia is a medical emergency. At the first
sign, find medical help immediately. The survival of
the victim depends on their co-worker’s ability to
recognise the symptoms of hypothermia. The victim is
generally not able to notice his or her own condition.
First aid for hypothermia includes the following steps:
a. Seek medical help immediately. Hypothermia is a
medical emergency.
b. Ensure that wet clothing is removed.
c. Place the victim between blankets (or towels,
newspaper, etc.) so the body temperature can
rise gradually. Body-to-body contact can help
warm the victim’s temperature slowly. Be sure to
cover the person’s head.
d. Give warm, sweet (caffeine-free, non-
alcoholic) drinks unless the victim is rapidly losing
consciousness, unconscious or convulsing.
e. Transport the victim to an emergency medical
facility.
f. Do not attempt to re-warm the victim on a site (do
not use hot water bottles or electric blankets).
g. Perform CPR (cardiopulmonary resuscitation) if
the victim stops breathing. Continue to provide
CPR until medical help is available. The body
slows when it is very cold and, in some cases,
hypothermia victims that appear ‘dead’ can be
successfully resuscitated.
HYPOTHERMIA
There are various health effects of exposure to cold and
wet conditions found in cold room and freezer room
environments.
Hypothermia is a medical
emergency. At the first sign, find
medical help immediately.
All of this is of course preventable. Correct personal
protective equipment (PPE) is a must and, in this instance,
includes the use of a good quality thermal suit.
REFERENCES
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•
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SARACCA
Pressure vessel regulations
ACRA CLA
SIGNS OF HYPOTHERMIA
Stage
Mild
hypothermia
Core temperature Signs and symptoms
37.2-36.1°C Normal shivering may begin.
36.1-35°C Cold sensation, goose bumps, unable to perform complex tasks with hands,
shivering can be mild to severe, hands numb.
35-33.9° Shivering intense, muscles in co-ordination becomes apparent, movements
slow and laboured, stumbling pace, mild confusion, may appear alert. Use a
sobriety test – if unable to walk a 9m straight line, the person is hypothermic.
33.9-32.2°C Violent shivering persists, difficulty speaking, sluggish thinking, amnesia starts
to appear, gross muscle movements sluggish, unable to use hands, stumbles
frequently, difficulty speaking, signs of depression, withdrawn.
32.2-30°C Shivering stops, exposed skin blue or puffy, muscle coordination very poor,
inability to walk, confusion, incoherent/irrational behaviour, but may be able
to maintain posture and appearance of awareness.
30-27.8°C Muscle rigidity, semi-conscious, stupor, loss of awareness of others, pulse and
respiration rate decrease, possible heart fibrillation.
27.8-25.6°C Unconscious, a heartbeat and respiration erratic, a pulse may not be
obvious.
25.6-23.9°C Pulmonary oedema, cardiac and respiratory failure, death. Death may occur
before this temperature is reached.
Moderate
hypothermia
Severe
hypothermia
COLD LINK AFRICA • July/August 2019
www.coldlinkafrica.co.za
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