There is a risk of hypothermia for people extracted from the rubble in an earthquake. According to this risk, there are four stages of hypothermia. According to experts, the biggest risk of hypothermia is cardiac arrest. In hypothermia, patients can be heated externally and internally. Hot water bags and hot compresses can be used to warm these patients externally. Care should be taken while heating. If the periphery is suddenly heated, cold blood returns to the heart at the same time and may cause sudden cardiac arrest.
Prof. Dr. Anış Arıboğan noted that hypothermia is a decrease in body temperature below 35 degrees Celsius and said, "What is in question here is the internal temperature of the body. However, it is usually the external temperature that we can measure."
Prof. Dr. Anış Arıboğan noted that there should be reasons such as being exposed to cold, homelessness, disaster situation, drowning in water, accidentally falling into cold water for hypothermia, "Because the body always exchanges heat with its surroundings in order to regulate the temperature. This is the main issue here. Being in contact with the wind can also lead to hypothermia. The body can lose body heat with air movement on the body surface. There may be problems in the brain related to the regulation of the heat center."
How Many Degrees Is Hypothermia?
Noting that hypothermia is a status of the body, Prof. Dr. Anış Arıboğan said, "In cases where hypothermia develops, some symptoms occur when the body loses its temperature regulation and falls below 25 degrees. These symptoms, along with the realization of coldness, give us an idea about the degree and severity of hypothermia. Symptoms vary according to the degree of hypothermia. Early symptoms include cold hands and feet, pale skin color, shivering, unclear, slowed speech, hoarseness of voice, fatigue and mild confusion."
Prof. Dr. Anış Arıboğan stated that the symptoms of advanced hypothermia are slowing down in body movements and coordination, clumsiness, dizziness, drowsiness, indifference to the environment, slowing of heart rate, slowing of respiration, confusion or loss of consciousness, dilated pupils and unresponsiveness to light, respiratory and circulatory arrest.
How Many Types of Hypothermia Are There?
Stating that hypothermia also has stages, Prof. Dr. Anış Arıboğan said, "If the body is a factory, there is a need for energy and heat for protein production, sugar production and enzymes to work. This energy and heat has a normal body temperature, and there is also body PH. And these need to be at a certain standard for the body to function. 35 degrees is a standard for us, first it starts with shivering, something we are all used to. Meanwhile, blood sugar drops to produce energy. This is a noticeable phase, there is a feeling of discomfort. But if it goes below 32, we call this phase mild. He starts to sleep moderately. We are talking about this in relation to what happened in the recent earthquake." Prof. Dr. Anış Arıboğan also listed the stages of hypothermia as follows
First mild stage: Below 35, up to 32, there are shivering, discomfort and hunger. Hands and feet are like ice, circulation in the body is impaired, there is bruising and coldness, but there is no vital risk.
Second middle stage: In cases where this continues and the body temperature drops to 32-28, a deep sleep begins. There is no shivering. The body loses its metabolism at this stage. The person sleeps and does not wake up. This story is very common in mountaineers. That's why they don't put them to sleep in mountaineering. (This stage was left in the middle, which stage should it be included in?) (Corrected and included in the second stage)
The third severe stage: There is no consciousness anymore. You cannot wake the person even if you want to, there is no shaking at all. Very uncontrolled movements and agitation can be seen at this stage. There is no consciousness here. When you cannot wake a person up, you need to pay close attention to their breathing. There is now a high risk of cardiac arrest.
The fourth very severe stage: Below 22 degrees Celsius. There are no signs of life. A state of death occurs that requires CPR. The greatest risk of hypothermia is cardiac arrest and is the cause of death. Severe hypothermia, that is, if you are under constant exposure, as in the earthquake, if you do not have a warm environment to be protected, if your body clothes are very thin and you do not have a condition to prevent heat loss, first a mild shivering occurs. (He connected this with the next sentence) This is followed by a deep beautiful sleep, complete loss of consciousness and then death. Hypothermia is in a sense a silent death. At the same time, hypothermia is a protective mechanism, it protects the brain, but it must be controlled.
How to provide first aid in hypothermia?
Prof. Dr. Anış Arıboğan noted that the emergency call center 112 should be called immediately, especially if there are signs of advanced hypothermia such as indifference to the environment or mental confusion, and said, "Consciousness should be checked by talking to the patient or shaking him slightly. In case of loss of consciousness, respiration and circulation, i.e. pulse, should be checked. If necessary, heart massage and artificial respiration should be started. If possible, the patient should be moved to a warm environment. The risk of hypothermia should be known in the incoming case. You should have an idea of the degrees of frostbite. Move very slowly. If we move someone with hypothermia too fast, the cold in the periphery (hands and feet) may suddenly return to the center. Thus, your excessive movement may cause cardiac arrest. You should move very softly.
In hypothermia, the heating process is divided into two as internal and external heating. Noting that hot water bags can be used in external heating, Prof. Dr. Anış Arıboğan said, "In external heating, you immediately remove these people from the wetness, from the cold environment where they are lying, or you take off their clothes (dry material should be dressed) or you surround them with materials that heat them with hot and dry material. You can use hot water bags and hot compresses to warm these patients from the outside. You put them especially on the groin, neck and chest. Because if you suddenly warm the periphery, the cold blood returns to the heart at the same time and can cause sudden cardiac arrest. It can cause hypothermia to persist in the body. It is very important for this. The hands and feet should be protected, but the heating action should be started especially in the groin area, chest and neck.
Prof. Dr. Anış Arıboğan, who also gave information aboutinternal heating , said, "You heat the internal organs by applying serums at ambient temperature, directly through the mouth or with a nasogastric catheter, by giving hot drinks, hot water to the body depending on the situation. First, the vessels dilate, then the blood gets there and you start heating from the inside. Rapid heating should never be done for half an hour or an hour. The heating action should not be fast. In order to prevent side effects in the body, an average increase of 0.5-1°C per hour should be achieved, and it is important to raise the body temperature in a controlled manner.
If the patient is unconscious, airway patency should be ensured. The most important thing is to monitor breathing. If respiration is few, it shows its depth. It shows the severity in the brain. Skin wounds may occur with the effect of cold . They should not be rubbed too much. Since the depth of the wound is not known, you can cause bigger wounds. The biggest risk of hypothermia is cardiac arrest."