Specialist from Medical Park Karadeniz Hospital Internal Diseases Clinic. Dr. Nuh Kaya made statements about hypothermia. Stating that the central body temperature drops below 35 degrees is called 'hypothermia', Internal Medicine Specialist from Medical Park Karadeniz Hospital. Nuh Kaya, “Body temperature between 32-35 degrees is defined as mild hypothermia, between 28-32 degrees as moderate and lower than 28 degrees as deep hypothermia. The patient with hypothermia should first be removed from the cold environment, his wet clothes should be removed, and he should be covered with dry clothes or blankets. Since most of the body heat losses are through radiation, it should also be wrapped with aluminum foil and aluminum blankets.
Defining hypothermia, Dr. Dr. Kaya said, “A decrease in central body temperature below 35 degrees is called hypothermia. A body temperature between 32 and 35 degrees is defined as mild hypothermia, between 28 and 32 degrees as moderate and less than 28 degrees as deep hypothermia. In case of prolonged stay in adverse climatic conditions due to accidents or disasters, primary hypothermia or secondary hypothermia may occur in cases where thermoregulation mechanisms are impaired.
exp. Dr. Kaya stated that there are various compensatory mechanisms of the body against hypothermia, but their effectiveness is not unlimited and shared the following information:
“Hypothalamic regulation begins to deteriorate when body temperature drops below 34 degrees and disappears completely at 29 degrees. Reducing peripheral (vessels other than the heart) circulation by vasoconstriction (narrowing of the vessels) ensures the balance of changes in ambient temperature up to 4 degrees. The other balancing mechanism starts when the body temperature drops below 37 degrees, and disappears when the body temperature drops below 31 degrees. Although shivering can increase body heat production threefold, its effectiveness in increasing body temperature is low. Because the increase in heat production with shivering occurs in areas close to the body surfaces, and therefore approximately 75 percent of the heat produced is given to the environment.
“Life is in danger”
Stating that hypothermia, where the body temperature does not fall below 32 degrees, is relatively safe, Dr. Dr. Kaya said, “In cases where the body temperature drops below 32 degrees, the body temperature becomes dependent on the ambient temperature, as the compensation mechanisms are gradually disabled. This situation is seriously life threatening. However, the physiological effects of hypothermia vary depending on the amount of decrease in body temperature, the length of time it remains low, the rate of decrease and other factors. used the phrases.
“As hypothermia deepens, metabolic rate decreases”
exp. Dr. Kaya stated that an increase in the metabolic rate may occur due to tremors, muscle activity and muscle stiffness in the initial period of hypothermia. A decrease in body temperature to 30 degrees causes a 50 percent decrease in oxygen consumption, and a decrease to 20 degrees causes an 80-90 percent decrease. Disseminated intravascular coagulation occurs due to rhythm disturbances, changes in consciousness, shallow breathing, decrease in digestive system functions, increase in blood viscosity, decrease in platelet function and number. The duration of the effect of the drugs used during this period may also be prolonged and may reach the toxic level.
“Wet clothes should be removed”
exp. Dr. Kaya said the following about the first aid guidelines that can be applied to a person with hypothermia:
“When helping an individual with hypothermia, the patient should first be removed from the cold environment, removed from wet clothing, and covered with dry clothes or blankets. Since most of the body heat losses are through radiation, it should also be wrapped with aluminum foil and aluminum blankets. Since more than 50 percent of the heat losses are from the head and neck region, wrapping and covering these regions should not be neglected. Oxygen should be applied with a mask, and warm drinks that do not contain alcohol should be given. Since hypothermia is usually accompanied by fluid loss and low blood pressure, warmed serum (isotonic) should be started immediately through the intravenous line. However, the use of vasoconstrictors should be avoided during hypothermia because of their increased arrhythmia potential.
“Drug use should be avoided”
Emphasizing that although hyperglycemia (increase in blood sugar) usually occurs in hypothermic patients, the use of insulin should also be avoided. Dr. Nuh Kaya, “Hypothermia causes resistance to insulin. When insulin is used in this environment, there is no significant decrease in blood glucose level, while the accumulated insulin can cause severe hypoglycemia (the individual's blood sugar level is lower than normal values) with the increase in body temperature. Since the same problem is valid for all drugs to be administered, the use of drugs should be avoided as much as possible in the hypothermic period and the drugs that should be administered should be administered at the lowest possible doses.