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Cold Weather Injuries

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Title: Cold Weather Injuries


1
Cold Weather Injuries
2
Cold Weather InjuriesTerminal Learning Objective
  • Action Manage cold weather injuries
  • Condition Given the ECWCS, other issued cold
    weather clothing items, and issued cold weather
    sleep system with insulating pad, access to a
    warming shelter, under field conditions where
    temperatures range from 40º F to 60º F
  • Standard Soldier
  • identified all of the signs and symptoms of each
    type of cold weather injury.
  • selected and applied the recommended treatment
    for the specified cold weather injury.
  • did not sustain a cold weather injury during the
    conduct of the course

3
Cold Weather Injuries
Total - 3446 Soldiers (approximately 1 BCT)
4
Cold Stress
  • Environmental Risk Factors
  • Temperature, wind, rain/snow, immersion,
    altitude
  • Mission Risk Factors
  • Work intensity, duration of cold exposure and
  • availability of adequate shelter, clothing and
    food
  • Individual Risk Factors
  • Physical fitness, body composition, fatigue,
    race,
  • gender, health

5
How does the body lose heat?
Radiation - 60 Convection - variable Conduction
- variable Respiration - 6 - 10 Evaporation
- 12 - 15
6
How does the Body Respond to the Heat Loss?
  • Shell/Core Effect body pulls blood from
    extremities in an effort to keep the core warm.
  • Cold Diuresis result of the shell/core effect
    body rids itself of fluid (increased urination),
    because the kidneys sense an increase of volume
    in the core thirst mechanism is also disrupted
  • Shivering involuntary reaction of skeletal
    muscles which produces heat

7
Wind Chill Chart
WCT (F) 35.74 0.6215T - 35.75(V0.16)
0.4275T(V0.16) Where T is temperature (F) and V
is wind speed (mph)

8
Risk Of Frostbite
9
Windchill Category
These guidelines are generalized for worldwide
use. Commanders of units with extensive extreme
cold-weather training and specialized equipment
may opt to use less conservative guidelines.
10
Individual Factors
Fatigue Gender and Race Nutrition Prior
cold weather injuries Water intake Diseases or
injuries Individual differences Drugs/Tobacco/Al
cohol Fitness Psycho-Social
Factor Age Discipline, Training, Experience

11
Food and Water Requirements
Calories 4500-6,000 calories per day 3.5-5
quarts of water per day
12
Personal Hygiene
Washing/Shaving Oral Hygiene Water Sources Food
Sources Nicotine and Alcohol Latrines Clothing
Sleeping Bags
13
Dehydration
14
Hypothermia
15
Chilblain
16
Frostbite
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Immersion Foot
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Cold Weather InjuriesSummary
  • Action Manage cold weather injuries
  • Condition Given the ECWCS, other issued cold
    weather clothing items, and issued cold weather
    sleep system with insulating pad, access to a
    warming shelter, under field conditions where
    temperatures range from 40º F to 60º F
  • Standard Soldier
  • identified all of the signs and symptoms of each
    type of cold weather injury.
  • selected and applied the recommended treatment
    for the specified cold weather injury.
  • did not sustain a cold weather injury during the
    conduct of the course

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Altitude IllnessTerminal Learning Objective
  • Action Manage altitude illness
  • Condition Under any field condition
  • Standard Soldier
  • identified all of the signs and symptoms of
    altitude sickness
  • selected and applied the recommended treatment
    for the specified altitude sickness

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Altitude Classifications
  • Altitude 8,000-12,000
  • High altitude 12,000-18,000
  • Extreme altitude 18,000-29,000
  • Reference Medicine for Mountaineering, 5th
    edition by James A. Wilkerson, M.D.
  • Low Sea Level to 5,000 feet
  • Moderate 5,000-8,000 feet
  • High 8,000-14,000 feet
  • Very High 14,000-18,000
  • Extreme 18,000 and higher
  • Reference FM 3-97.6 Mountain Operations

35
Altitude Overview
  • At all altitudes the air is made up of 21 oxygen
  • As you gain altitude the air pressure drops
  • Less oxygen is available to the body because of
    this reduced pressure
  • Less oxygen available means you suffer the
    effects of altitude

BarP barometric pressure PIO2 pressure of
inhaled oxygen PaO2 arterial oxygen
pressure PaCO2 arterial carbon dioxide
pressure SaO2 percent of arterial oxygen
saturation
36
Initial Physiological Response to Altitude
  • Increased rate and depth of breathing
  • Decreased oxygen saturation
  • Changes in pH
  • Pulse Rate and Cardiac Output
  • Blood Volume
  • Sleep Hypoxia

37
Acclimatization
  • Increased Respiratory Volume
  • Increased Pulmonary Artery Pressure
  • Increased Cardiac Output
  • Increased Number of Red Blood Cells
  • Changes in Oxygen-Carrying Capacity
  • Changes in Body Tissues

38
Acute Mountain Sickness
39
High Altitude Pulmonary Edema (HAPE)
40
High Altitude Cerebral Edema (HACE)
41
Gamow Bag
42
Tips for Operations at Altitude
  • Driving or flying to altitudes above 10,000 feet
    is not recommended it will take 24-72 hours to
    adjust if you do fly to altitudes above 10,000
    feet
  • Stay properly hydratedyou can lose up to 4
    liters per day just breathingthink about water
    sources, and the resources required to make the
    water drinkable (filters, stoves, iodine etc.)
  • High carbohydrate diets are recommended
  • If an individual shows symptoms of altitude
    illness, you cannot take that person to a higher
    altitude until the symptoms have subsided if the
    symptoms worsen, it is time to evacuate that
    individual to a lower altitude. Even a wait of a
    few hours can mean the difference between life
    and death.


43
Tips for Operations at Altitude
  • 24-72 hours after arrival at altitude, begin a PT
    program that will mimic the operations you will
    be conducting if possible train at higher
    altitudes and sleep at lower altitudes
  • Diamox can help but may not be appropriate for
    all individuals
  • Tobacco, alcohol, dehydration, depressant drugs
    and over-exertion will inhibit acclimatization
  • Remember that you and your soldiers will never be
    able to perform to sea level capacity everything
    will take longer to accomplish


44
Altitude IllnessSummary
  • Action Manage altitude illness
  • Condition Under any field condition
  • Standard Soldier
  • identified all of the signs and symptoms of
    altitude sickness
  • selected and applied the recommended treatment
    for the specified altitude sickness

45
Cold Weather and Mountain Environmental
InjuriesTerminal Learning Objective
  • Action Manage common cold weather and mountain
    environmental injuries
  • Condition Given the ECWCS, other issued cold
    weather clothing items, and issued cold weather
    sleep system with insulating pad, access to a
    warming shelter, under field conditions where
    temperatures range from 40º F to 60º F
  • Standard Soldier
  • identified all of the signs and symptoms of
    common cold weather and mountain environmental
    injuries.
  • selected and applied the recommended treatment
    for common cold weather and mountain
    environmental injuries

46
Snow Blindness
47
Improvised Slit Glasses
48
Carbon Monoxide Poisoning
49
Giardia
50
Constipation
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Heat Exhaustion
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Heat Stroke
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Hyponatremia
54
Cold Weather and Mountain Environmental
InjuriesSummary
  • Action Manage common cold weather and mountain
    environmental injuries
  • Condition Given the ECWCS, other issued cold
    weather clothing items, and issued cold weather
    sleep system with insulating pad, access to a
    warming shelter, under field conditions where
    temperatures range from 40º F to 60º F
  • Standard Soldier
  • identified all of the signs and symptoms of
    common cold weather and mountain environmental
    injuries.
  • selected and applied the recommended treatment
    for common cold weather and mountain
    environmental injuries
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