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       #Post#: 102--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Michael Candella
       Date: January 4, 2012, 5:06 pm
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       First on the scene I would bring some blankets.  Next I would
       evaluate her starting with airway,breathing, and circulation.
       Any problems I would address them.  Next I would check for
       injuries and  fi there were any major c-spine problems or  hip/
       leg injuries I would stabilize. Next i would get her loaded and
       into a warm enviromnent. Provide warm O2. and warm her slowly
       and handle her gently. I would continue to assess her and check
       vitals. Call for AlS if any Cardiac warning signds or alterd
       mental status where evident.
       #Post#: 105--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Leslie Myers
       Date: January 5, 2012, 10:19 am
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       Great replies...however we seem to have a difference of opinion
       on whether to passively or actively rewarm the patient..I bet
       you know where you can look to find the answer!
       Another question, during your SAMPLE gathering you find that she
       is a diabetic and has a history of high blood pressure and is
       meds for both.  She is on a beta blocker drug (google it if you
       do not know what it is).  How will these conditions and drugs
       affect her ability to maintain her body temperature?
       #Post#: 106--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Leslie Myers
       Date: January 5, 2012, 10:20 am
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       Anyone have any thoughts on the 80 year old neighbor?
       #Post#: 107--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: dustin hite
       Date: January 5, 2012, 10:48 am
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       You should take C - Spine precautions, get her on a backboard
       and get her out of the weather as soon as possible.  This should
       be done with the most amount of comfort as possible.  Once into
       a warm location back of rescue or ambulance most likely she
       needs to get much of her wet clothing off if at all possible.
       Continue with O2 therapy and assess for injuries which may have
       occurred.  Treat for shock if needed and keep the patient as
       warm as possible as hypothermia may have already started.
       Transport.
       #Post#: 110--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Lisa White
       Date: January 5, 2012, 1:42 pm
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       First I would probably take full precautions for c-spine and to
       the best of the circumstances get her packaged and into the back
       of the rig as soon as possible. In warming her up I'd probably
       just use the natural heat of the rig and blankets. As far as
       injuries given her age, the way she fell and landed and the
       weather conditions she could have anything from scraps and
       bruises to broken bones and hips. Worse is she might claim to be
       fine but because shes been in the cold so long she may not even
       feel an injury if she had one. Also taking into the
       circumstances the weather and how long shes been down there is
       concerns for frostbite and hypothermia related ailments.
       #Post#: 111--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Lisa White
       Date: January 5, 2012, 1:52 pm
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       Well as for the blood pressure and diabetes doesn't that slow
       all the systems down? So it would take longer for her to warm
       herself, beta blocker lowering the BP and circulation rate and
       then diabetic slowing down the sugar process and conversion of
       energy/ heat process, right?
       As for the 80 year old I'd still take the precautions to cover
       my end but the age may affect his perception to how long the
       patient was out there really and the circumstances of the event
       and weather.
       #Post#: 118--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: anthony larocco
       Date: January 7, 2012, 2:48 pm
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       I would take c-spine precautions then get her off the ground
       as soon as possible and into a warm environment.Remove any
       clothing if wet and cover with warm dry blankets. Hot packs or
       hot water  bottles may be applied to the core areas chest neck
       armpit groin  if the conditions deem necessary. do not heat
       extremities first. She may be allowed to sip warm liquids
       slowly. Continue to monitor for shock and taking vitals., I'd
       also give o2. also would question what caused the fall? a slip
       on ice or another reason which may need to be addressed.
       #Post#: 122--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: mhundt
       Date: January 9, 2012, 11:08 pm
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       Both beta blockers and diabetes medication will decrease the
       pt's ability to maintain her normal body temperature, putting
       her at a greater risk for hypothermia.
       #Post#: 134--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Brendan
       Date: January 20, 2012, 12:15 pm
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       If the beta blocker works by constricting the blood vessels it
       may make re-warming very challenging. This will effect the blood
       flow to the periferal points of the body, the patient may
       normally have cool hands and feet due to being on the beta
       blocker.
       If transport time to an emergency room is extended due to travel
       time, ALS response may be in order.
       #Post#: 150--------------------------------------------------
       Re: COLD RELATED EMERGENCIES
   DIR By: Michael Candella
       Date: January 24, 2012, 5:10 pm
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       Beta blockers may make the pt more sensitive to the cold also
       they effect the  pt diabetes with circulation problems and make
       blood sugar levels to high or to low. I would also want to get
       the 80 yr old neighbor inside before she goes down.
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