Weather Injury Prevention & Hot/Cold Weather Injury Prevention

6/22/2011

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Heat Injury Prevention

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Objectives

Soldiers are able to describe how the body handles heat to include; conditions affecting body heat, heat gain or loss, effects of heat stress and the bodys cooling system Soldiers can describe the causes, symptoms, and apply initial first aid to soldiers that are victims of minor heat stress disorders. Soldiers are able to describe prevention measures. Soldiers can describe the causes, symptoms, and apply initial first aid to soldiers that are victims of major heat stress disorders. Soldiers are able to describe prevention measures. Soldiers can describe factors that control heat stress.

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Heat Stress

High temperatures put stress on our bodies. The bodys cooling system has to work hard to reduce the effects of heat stress. This physical strain -- combined with other stresses such as energy loss and heat production through physical work and loss of fluid from sweating -- may lead to heat disorders, disability, or even death.

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The Hazard of Heat Stress

In addition to the medical hazards of bodily illness or injury caused by heat stress, there is also a higher frequency of accidents in hot environments.
Direct causes of accidents include;
Fogged glasses Sweat in the eyes Slippery hands Dizziness or fainting Physical discomfort Fatigue Irritability and anger Poor judgment Diverting attention from the job Slower mental and physical job reactions

Indirect causes of accidents include;

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Coping with the hazards

Heat disorders are preventable with proper planning, supervision and training. Steps you can take to cope with the hazards of heat stress include: Understanding the effects of heat stress. Knowing the symptoms and treatment for heat stress disorders. Taking personal precautions against heat disorders.

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How the Body Handles Heat Conditions Affecting Body Heat

To understand the effects of heat stress you need to know how the body handles heat. Your body always generates internal heat, but the amount of heat that stays stored in your body depends on your: Surroundings Level of physical activity Type of work Time spent working Recovery time between work periods Ability of the body to dissipate heat (clothing, ability to sweat). Battering Rams!!

How the Body Handles Heat (cont.) Heat Gain or Loss

The amount and speed of heat gain or loss depends on:

Temperature of the air and surrounding objects. Air movement (wind or fans). Humidity (amount of water vapor in the air).

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How the Body Handles Heat (cont.) Effects of Heat Stress

While resting, the body loses 75 percent of its heat through conduction, convection or radiation from the blood flow at the skin surface. However, as internal body heat rises as the result of work or high temperatures, blood flow to the skin increases and the pulse rate goes up, putting a strain on the heart and circulatory system.

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How the Body Handles Heat (cont.) Your Bodys Cooling System When more blood is pumped close to the skin, less blood goes to the brain. Sudden movements can result in dizziness or a momentary blackout, which could cause secondary injuries or accidents at a job site. If the temperature of the air and surrounding objects in your work area rises above body temperatures, it becomes very difficult for your body to cool. The evaporation of sweat becomes the bodys most important-and sometimes only-cooling method.

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How the Body Handles Heat (cont.) Your Bodys Cooling System Sweating can make things worse by causing you to lose body fluids and salt. Most people lose about a quart of sweat an hour while working in extreme heat. This strains the circulatory system since it actually lowers the volume of blood in your body. Sweating may not be enough to get rid of heat, since sweat must evaporate to cool your body. If the air is too full of water vapor to absorb any more, you can work directly in front of a fan and still not lose sufficient heat to keep cool.

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How the Body Handles Heat (cont.) Your Bodys Cooling System Finally, if your bodys natural defenses against heat are pushed beyond their limits, they may simply shut down, leading to an uncontrolled and explosive rise in body temperature that can cause heat stroke, permanent damage to the central nervous system or death.

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Minor Heat Stress Disorders Sunburn

Sunburn is often overlooked as a danger when working outdoors in direct sunlight. Besides the discomfort of the burn itself, sunburn can prevent your body from eliminating heat efficiently and can contribute to one of the more dangerous heat disorders.

Cause
Exposure of unprotected skin to ultraviolet light. First degree-red, painful skin. Second degree-blistering and/or peeling. Skin lotions. Topical anesthetics Staying in a shaded area. Limit exposure on bare skin. Use sunscreen instead of tanning lotion.

Symptoms

Treatments

PREVENTION IS THE KEY

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Minor Heat Stress Disorders Heat Rash

Heat rash, also known as prickly heat, is another minor annoyance that can lower the bodys ability to lose heat. Cause
Hot, humid environment. Sweat wont evaporate. Skin stays wet most of the time. Red rash Itching Ointment Bathe regularly. Keep skin clean and dry

Symptoms

Treatment

Prevention

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Major Heat Stress Disorders Heat Cramps

Heat cramps are always a danger signal since they may occur alone or be combined with one of the other major heat stress disorders. These are painful-sometimes severe-cramps of the muscles used while working, such as the arms, legs, back, or abdomen. Cause
Sweating heavily Replacing water but not salt. Sudden onset of muscle cramping. Normal pulse. Normal to slightly high body temperature Move into the shade or improvise. Loosen clothing. Drink lightly salted liquids Wait to see if symptoms go away Seek medical aid if the cramps persist.

Symptoms

Prevention

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Major Heat Stress Disorders Heat Exhaustion

Heat exhaustion occurs when the bodys heat-control mechanism is overactive but hasnt broken down completely. The victim may also be having heat cramps, and there is a high risk that the victim will continue on to a state of heat stroke. This disorder also causes special risk to older personnel or those with coronary artery disease or emphysema. Cause
Surface blood vessels that enlarged to cool the blood collapse from loss of body fluids and minerals. Heavy sweating Intense thirst from dehydration. Weak and rapid pulse (120 to 200) Low to normal blood pressure. Fatigue, weakness or loss of coordination. Anxiety or agitation. Clouded senses, impaired judgment, fainting. Tingling in hands and feet, headache. Loss of appetite, nausea or vomiting. Hyperventilation (rapid breathing or panting).

Symptoms

Other Symptoms of Heat Exhaustion

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Major Heat Stress Disorders Heat Exhaustion (cont.)

First-aid Treatment
Move the victim into the shade. Loosen or remove clothing and boots. Cool the victim as fast as possible. Fan the victim. If necessary, pour water on the victim Elevate the victims legs and massage limbs. Have the victim drink water-with salt, if available. Stay with the victim until medical aid arrives.

Victims of heat exhaustion must be examined by a qualified medical practitioner and should not participate in strenuous activity for the rest of the day. Bed rest and restoration of body water and salt usually are all the treatment needed. Battering Rams!!

Major Heat Stress Disorders Heat Stroke

Heat stroke is a medical emergency requiring immediate medical attention. Outwardly, it may first progress through the symptoms of heat cramps and/or heat exhaustion, with a dramatically sudden onset of heat stroke symptoms followed by rapid deterioration of the victim. Cause
When the bodys cooling mechanisms fail, rising internal body temperature begins to damage internal organ systems. Death can result if the internal temperature remains high.

Early Symptoms of Heat Stroke

High body temperature -- usually above 104 degrees F. Confusion or delirium. Bizarre behavior. Rapid pulse. Difficult breathing. Headache or dizziness. Weakness, nausea or vomiting.

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Major Heat Stress Disorders Heat Stroke (cont.)

Advanced Symptoms
Seizure or convulsions. Collapse. Loss of consciousness. Deep coma. No detectable pulse. Body temperature over 108 degrees F.

First-aid Treatment The most important step is prompt recognition of heat stroke symptoms and immediate treatment.
You must lower the victims body temperature as fast as possible. Immerse him in cold water. Dont give liquids to unconscious victims. Call an ambulance and evacuate the victim to a hospital.

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Controlling Heat Stress Acclimatization

If you cant control temperature or humidity in your workplace, you must become acclimatized to it. Acclimatization is the ability to perform a maximum amount of strenuous work in the heat by gradually getting yourself used to the climate you work in. First, get yourself into good physical condition. Physical work in the heat is necessary for full acclimatization, but it should consist of increasingly longer work periods each day, alternating with rest or lighter work. Some workers reach full acclimatization within a week, while others take longer. But if you go on vacation, remember that you will start losing your resistance to heat after one week and youll lose it completely in a month.

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Controlling Heat Stress Work Procedures

Follow scheduled work/rest cycles that keep any individual from overdoing it. Remember, rest means minimal activity, not stopping work completely. Workers may alternate light and heavy work, indoor and outdoor work, etc. Duties may also be rotated among several workers to protect them from heat, and workload can be adjusted on body size or physical strength. Exertional heat illness is produced primarily by working people too hard, too fast, and/or too long for their physical and medical state and the environmental conditions.

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Controlling Heat Stress Food and Water Intake

Heavy meals reduce your ability to get rid of heat because they redirect blood flow to your digestive tract instead of your skin surface. Be sure your noon meal is light and cool, then try to rest for a while right after eating. Plan your heaviest meal of the day for evening after the workday is over. Drink 5 to 7 ounces of water every 15 to 20 minutes, even if you dont feel thirsty. Water temperature should be 50 to 60 degrees F for better absorption by the body. If sweating heavily, one quart of water per hour is recommended. Consuming drinks designed to replace blood fluids and electrolytes is okay, but never drink alcoholic beverages, since alcohol dehydrates the body. Except when treating specific disorders, salt supplements are not recommended. Normally-salted meals provide adequate salt even in hot environments.

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Summary
Some of the factors affecting heat stress are things you can control -such as the amount of water you drink -- while others are not. For your safety, here is a summary of physical conditions that can hurt your bodys natural ability to withstand high temperatures: Dehydration y Diarrhea Exposure to high temperatures at night Fatigue y Recent immunizations Improper work procedures y Loss of sleep Lack of acclimatization y Medications Older age (over 40) y Obesity Previous occurrence of heat stroke. Poor physical conditioning Recent drug or alcohol use (within 24 hours) Skin Trauma (heat rash or sunburn) Wrong type or amount of clothing. (Light, loose-fitting clothing is recommended)

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COLD INJURIES: DESCRIPTION, TREATMENT AND PREVENTION

Prepared by: U.S. Army Center for Health Promotion and Preventive Medicine (800) 222-9698/ DSN 584-4375/(410) 436-4375 http://chppm-www.apgea.army.mil

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Susceptibility Factors
Previous cold weather injury Inadequate nutrition Alcohol, caffeine, nicotine Dehydration Overactivity Underactivity Long exposure to the cold Sick or injured Acclimatization Ethnic/geographic origin Wind, cold, rain Age Discipline and morale Physical stamina Inadequate training Poor clothing and equip

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Prevention
Eat properly and often Drink warm liquids (non-caffeinated) and water Wear uniform properly (layers worn loosely) Keep active Stay dry Use warming tents Get plenty of rest Buddy watch/observation/NCO checks

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Hypothermia
MEDICAL EMERGENCY; life threatening condition Severe body heat loss-body temp falls below 95oF Occurs when:
conditions are windy, clothing is wet, and/or the individual is inactive extended water exposure or immersion
1 hour or less when water temp is below 45oF prolonged exposure in slightly cool water (e.g. 60oF) thunderstorms, hail, rain and accompanying winds

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Hypothermia
Initial Symptoms
shivering dizzy, drowsy withdrawn behavior irritability confusion slowed, slurred speech altered vision stumbling

Severe Stages
stops shivering desire to lie down and sleep heartbeat and breathing is faint or undetectable unconsciousness followed by DEATH

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Hypothermia
Treatment
prevent further cold exposure evacuate immediately if severe hypothermia remove wet clothing rewarm with body-to-body contact or in a warmed sleeping bag warm, sweet liquids if conscious give CPR if needed

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Frostbite
Air temps below 32oF
skin freezes at 28oF

Superficial frostbite (mild)

freezing of skin surface

Deep frostbite (severe)

freezing of skin and flesh, may include bone

Hands, fingers, feet, toes, ears, chin, nose, groin area

 Symptoms
initially redness in light skin or grayish in dark skin tingling, stinging sensation turns numb, yellowish, waxy or gray color feels cold, stiff, woody blisters may develop

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Frostbite

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Frostbite
Treatment
remove from cold and prevent further heat loss remove constricting clothing and jewelry rewarm affected area evenly with body heat until pain returns
when skin thaws it hurts!! do not rewarm a frostbite injury if it could refreeze during evacuation or if victim must walk for medical treatment

do not massage affected parts or rub with snow evacuate for medical treatment

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Chilblains
Nonfreezing cold injury Cold, wet conditions (between 32-60oF, high humidity) Repeated, prolonged exposure of bare skin Can develop in only a few hours Ears, nose, cheeks, fingers, and toes

 Symptoms: initially pale and colorless worsens to achy, prickly sensation then numbness red, swollen, hot, itchy, tender skin upon rewarming blistering in severe cases

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Chillblains

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Chilblains Treatment
prevent further exposure wash, dry gently rewarm (apply body heat) dont massage or rub dry sterile dressing seek medical aid

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Trench/Immersion Foot
Potentially crippling, nonfreezing injury (temps from 50oF-32oF) Prolonged exposure of skin to moisture (12 or more hours, days) High risk during wet weather, in wet areas, or sweat accumulated in boots or gloves

 Symptoms
initially appears wet, soggy, white, shriveled sensations of pins and needles, tingling, numbness, and then pain skin discoloration-red, bluish, or black becomes cold, swollen, and waxy appearance may develop blisters, open weeping or bleeding in extreme cases, flesh dies

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Trench/Immersion Foot

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Trench/Immersion Foot
Treatment prevent further exposure dry carefully DO NOT break blisters, apply lotions, massage, expose to heat, or allow to walk on injury rewarm with body heat clean and wrap loosely elevate feet to reduce swelling evacuate for medical treatment

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Dehydration A loss of body fluids to the point of slowing or preventing normal body functions Increases chance of becoming a cold weather casualty, esp hypothermia Can lead to heat cramps or heat exhaustion

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Dehydration
Symptoms
dark urine headache dizziness, nausea weakness dry mouth, tongue, throat, lips lack of appetite stomach cramps or vomiting irritability decreased amount of urine being produced mental sluggishness increased or rapid heartbeat lethargic unconsciousness

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Dehydration Treatment
drink WATER or other warm liquids avoid caffeinated liquids (sodas, coffee, tea) do not eat snow rest

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Conclusion Dress properly Drink plenty of fluids Eat right Keep in shape Get plenty of rest Minimize periods of inactivity Maintain a positive attitude
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Reference Materials
Center for Army Lessons Learned Newsletter No. 97-5 Winning in the Winter Technical Note No. 92-2 Sustaining Health and Performance in the Cold: Environmental Medicine Guidance for Cold-Weather Operations TC 21-3 Soldiers Handbook for Individual Operations and Survival in Cold-Weather Areas FM 31-70 Basic Cold Weather Manual FM 21-10 Field Hygiene and Sanitation FM 21-11 First Aid for Soldiers TB MED 81 Cold Injury FD Pam 40-5 Win in the Heat and Cold: Climatic Injury Prevention Guide

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Reference Materials
Calculating Wind Chill Equivalent Temperature (WCET)
Find wind speed on left side of chart Find actual temperature on top row Wind chill equivalent temperature located where the two intersect

Website: www.nws.noaa.gov/om/wind chill

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