Search and rescue efforts continue on the 8th day of the Kahramanmaraş earthquake. Drawing attention to the risk of hypothermia in those waiting to be rescued under the rubble, experts state that there are four stages of hypothermia. Anesthesia and Reanimation Specialist Prof. Dr. Anış Arıboğan warned, “The biggest risk of hypothermia is cardiac arrest.” Mentioning what should be done in first aid in hypothermia, Prof. Dr. Anış Arıboğan stated that patients can be heated externally and internally, “You can use hot water bags and hot compresses when warming these patients externally. You put them especially in the groin, neck area and chest. If you suddenly warm the periphery, the cold blood returns to the heart at the same time and can cause sudden cardiac arrest.” he said.
Üsküdar University NPİSTANBUL Hospital Anesthesia and Reanimation Specialist Prof. Dr. Anış Arıboğan made an assessment on hypothermia and the first response to hypothermia.
Noting that hypothermia is a decrease in body temperature below 35 degrees Celsius, Prof. Dr. Anış Arıboğan said, “The issue here is the internal temperature of the body. But what we can usually measure is the outside temperature.” said.
Noting that for hypothermia, there must be reasons such as being exposed to cold, homelessness, disaster situation, drowning by falling into water, falling into cold water by accident, Prof. Dr. Anış Arıboğan said, “Because the body always exchanges heat with its surroundings in order to regulate the temperature. This is the main issue here. Exposure to wind can also lead to hypothermia. Body heat can be lost by air movement on the body surface. There may be problems in the brain with the regulation of the heat center.” said.
An early sign of hypothermia is coldness and chills in the hands and feet.
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. With the recognition of coldness, these symptoms 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, tremor, unclear, slowed speech, hoarseness, fatigue, and mild confusion. said.
prof. Dr. Anış Arıboğan stated that the symptoms of advanced hypothermia are slowness in body movements and coordination, clumsiness, dizziness, drowsiness, indifference to the environment, slowing of heart rate, slowing of breathing, clouding of consciousness or loss of consciousness, dilation of pupils and unresponsiveness to light, cessation of breathing and circulation. .
How many types of hypothermia are there?
Stating that there are stages of hypothermia, Prof. Dr. Anış Arıboğan said, “If the body is a factory, there is a need for energy and heat for the enzymes to make protein and sugar production here. This energy and heat has a normal body temperature, there is also body PH. In order for the body to function, these must be in a certain standard. 35 degrees is a measure for us, something we are all used to first starts with tremors. Meanwhile, blood sugar drops to produce energy. This phase is a noticeable phase, there is a feeling of discomfort. But if it goes below 32, we call this phase mild. He is starting to sleep moderately. We are talking about what happened in the last earthquake.” said.
There are four stages of hypothermia.
prof. Dr. Anış Arıboğan listed the stages of hypothermia as follows:
First mild stage: Below 35, up to 32, there are tremors, discomfort and hunger. Hands and feet are cold, circulation is impaired in the body, there is bruising and coldness, but it is not life-threatening.
Second middle stage: In cases where this continues and the body temperature drops to 32-28, a deep sleep begins. No shaking. Now the body loses its metabolism at this stage. The person sleeps and does not wake up. Mountaineers have this story a lot. Therefore, they do not sleep in mountaineering.
Third severe phase: No more consciousness. You cannot wake the person even if you want to, there is no shaking. Very uncontrolled movements at this stage can be seen in agitation. There is no consciousness here. As soon as you can not wake a person, you need to pay close attention to his breathing. Here there is a high risk of cardiac arrest now.
The fourth very severe stage: It can be specified as below 22 degrees. There are no signs of life. A state of death ensues, requiring cardiac massage. The greatest risk of hypothermia is cardiac arrest and is the cause of death. If you are under severe hypothermia, that is, if you are under constant exposure, as in the current earthquake, if you do not have a warm environment to protect, your body clothes are too thin and if you do not have a condition to prevent heat loss, a mild shivering will occur first. This is followed by a deep sleep, complete loss of consciousness, and then death. Hypothermia is, in a sense, silent death. At the same time, hypothermia is a protective mechanism, it also protects the brain, but these should be controlled.
How to give first aid in hypothermia?
Noting that especially if there are signs of advanced hypothermia such as indifference to the environment or mental confusion, the 112 emergency call center should be called immediately. Dr. Anış Arıboğan said, “Consciousness should be checked by talking to the patient or shaking them slightly. In case of unconsciousness, it is necessary to control the breathing and circulation, namely the pulse. If necessary, CPR 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 with the degrees of freezing. You should move very slowly. If we move someone who is dealing with hypothermia too fast, that periphery (hand and foot) may return to the center in a cold moment. Thus, your excessive movement causes cardiac arrest. It should be moved very softly,” he said.
Hot water bags can be used for outdoor heating
Noting that two types of heating are applied as external and internal heating, Prof. Dr. Anış Arıboğan said, “In external heating, you either remove these people from the wet, cold environment or take off their clothes (dry material should be put on) or you surround them with hot and dry materials and materials that heat them. You can use hot water bags and hot compresses while warming these patients externally. You put them especially in the groin, neck area and chest. Because if you heat the periphery suddenly, cold blood returns to the heart at the same time and can cause sudden cardiac arrest. It can cause continuation of hypothermia in the body. It’s very important for that. The hand and foot area should be protected, but the warming action should be started especially from the groin area, chest and neck.” said.
Internal warming is applied via serum or mouth
Providing information on interior heating, Prof. Dr. Anış Arıboğan said, “You warm up the internal organs by applying serums at ambient temperature, directly orally or with a nasogastric tube, depending on the situation, by giving the body a hot drink and a hot wall. First the veins expand, then the blood comes there and you start to heat it from the inside. Rapid heating should never be done for half an hour and an hour. The heating action should not be rapid. In order to prevent side effects in the body, an increase of 0.5-1°C (degrees Celsius) per hour should be ensured, and it is important to raise the body temperature in a controlled manner. If unconscious, airway patency should be established. The most important thing is to monitor breathing. If the number of respirations is small, it indicates its depth. It shows the seriousness 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 unknown, you may cause larger wounds. The greatest risk of hypothermia is cardiac arrest.” he said.
Source: (BYZHA) – Beyaz News Agency
