Expert name explained: The biggest risk with hypothermia is cardiac arrest

Anesthesia and resuscitation specialist Prof. Dr. Anış Arıboğan made an assessment of hypothermia and the initial response to hypothermia.

Noting that hypothermia is a drop in body temperature below 35 degrees Celsius, Prof. Dr. Anış Arıboğan said, “The problem 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 exposure to cold, homelessness, disaster situation, drowning by falling into water, accidentally falling into cold water, Prof. Dr. Anış Arıboğan said: “Because the body always exchanges heat with its environment to regulate the temperature. This is the main issue here. Exposure to wind can also lead to hypothermia. Body heat can be lost through 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 state of the body, Prof. Dr. Anış Arıboğan said, “In cases where hypothermia occurs, some symptoms occur when the body loses its temperature regulation and drops below 25 degrees. With the recognition of cold, these symptoms give us an idea about the degree and severity of hypothermia. Symptoms vary depending on the degree of hypothermia. Early symptoms include cold hands and feet, pale skin, tremor, slurred, slowed speech, hoarseness, fatigue, and mild confusion. said.
Prof. Dr. Anış Arıboğan stated that the symptoms of advanced hypothermia include slowness of 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 the pupils and being unresponsive. to light, cessation of breathing and circulation. .

How many types of hypothermia are there?

prof. Dr. Anış Arıboğan said: “If the body is a factory, the enzymes need energy and heat to produce proteins and sugars here. This energy and heat has a normal body temperature, there is also body PH. 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 starts with vibrations first. Meanwhile, blood sugar drops to produce energy. This stage is a noticeable stage, there is a feeling of discomfort. But when it drops below 32, we call this stage mild. He begins 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 light phase: Under 35, to 32, there are tremors, a feeling of discomfort and hunger. Hands and feet are cold, blood circulation in the body is disturbed, there are bruises and cold, but it is not life-threatening.

Second middle stage: In cases where this continues and the body temperature drops to 32-28, deep sleep begins. No shaking. Now at this stage the body loses its metabolism. The person sleeps and does not wake up. Mountaineers have this story a lot. That’s why they don’t sleep in mountaineering.

Third severe stage: There is no consciousness anymore. You can’t wake the person up even if you wanted to, there’s no shaking. Highly uncontrolled movements at this stage can be seen in agitation. There is no consciousness here. As soon as you can’t wake a person, you need to pay close attention to their breathing. Here is now a high risk of cardiac arrest.

Fourth very severe stage: It can be specified as below 22 degrees. There are no signs of life. A state of death ensues, requiring chest compressions. The greatest risk of hypothermia is cardiac arrest and is the cause of death. If you are severely hypothermic, that is, if you are constantly exposed, such as in the current earthquake, if you do not have a warm environment to protect yourself, if your body clothing is too thin, and if you do not have a condition to prevent heat loss, first mild shivering. This is followed by deep 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 also protects the brain, but it must be controlled.

How do you give first aid for hypothermia?

Note that especially if there are signs of advanced hypothermia, such as indifference to the environment or mental confusion, the emergency center 112 should be called immediately. Dr. Anış Arıboğan said: “Consciousness should be checked by talking to the patient or shaking him lightly. In case of unconsciousness, it is necessary to control breathing and blood circulation, namely the pulse. If necessary, CPR and artificial respiration should be initiated. If possible, the patient should be moved to a warm environment. The risk of hypothermia must be known with the incoming case. You should have an idea with the degrees of frostbite. You have to move very slowly. If we move someone who is dealing with hypothermia too quickly, that periphery (hand and foot) can return to the center in a cold moment. So your excessive movement causes cardiac arrest. It has to be moved very gently,” 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 take these people out of 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 warm compresses while externally warming these patients. You mainly put them in the groin area, neck area and chest. Because if you suddenly warm up the periphery, at the same time cold blood returns to the heart and can cause sudden cardiac arrest. It can cause continuation of hypothermia in the body. It is very important for that. The hand and foot area should be protected, but the warm-up should mainly be started from the groin area, chest and neck. said.

Internal heating is applied via serum or mouth

Providing information on indoor heating, Prof. Dr. Anış Arıboğan said, “You warm the internal organs by applying serums at room temperature, directly through the mouth or by giving a hot drink to the body with a nasogastric tube, depending on the situation. First the veins expand, then the blood gets there and you begin to heat it from the inside. Rapid heating should never take half an hour and an hour. The heating action should not be fast. To avoid side effects in the body, an increase of 0.5-1°C (degrees Celsius) per hour should be ensured and it is important to increase body temperature in a controlled manner. If unconscious, airway patency should be assessed. The main thing is to monitor breathing. If the number of breaths is small, it indicates depth. It shows the severity in the brain. Skin wounds can occur as a result of a cold. They should not be rubbed too much. Since the depth of the wound is unknown, you can inflict larger wounds. The greatest risk of hypothermia is cardiac arrest.” he said.