JSP 539 Climatic Injury The Prevention and Recognition

JSP 539 Climatic Injury The Prevention and Recognition of Cold Injury

Outline of Presentation • • • Background Types of Cold Injury Description, Signs and Prevention Additional Risks General Advice Summary

Background • Cold Injuries DO occur in the UK • Prevention is better than cure • Early recognition and action is vital

Why? • A cold injury could happen to YOU! • YOU have a responsibility to reduce the risk • Cold injury can be prevented by following simple rules and looking after yourself and your mates

Cold Injuries • Non-freezing Cold Injury (NFCI) - Trench Foot - Jungle Foot - Paddy Foot • Hypothermia (general cold) • Freezing Cold Injury (FCI) - Frost Nip - Frost Bite

Non-Freezing Cold Injury - Description • Can cause disability • Most common type of Cold Injury in UK • Usually affects the feet and may be called ‘trench foot’, ‘jungle foot’ or ‘paddy foot’ • Numbness of the affected area • Caused by periods of not moving around and spending a long time in damp and cold weather, it does not have to be freezing

Non-Freezing Cold Injury - Signs Stage 1 – Tissue is not swollen, but is white, numb and cold – Feels like “wearing someone else’s feet” – There may be a history of waterlogged boots and socks

Non-Freezing Cold Injury - Signs Stage 2 – With gentle early re-warming there will be slight swelling and blotchy skin – Pain – often like “pins and needles” lasting for up to 24 hours

Non-Freezing Cold Injury - Signs Stage 3 – Limb(s) swollen, red and very painful, especially at night – Pain will not respond to normal pain killers and may last for some weeks

Non-Freezing Cold Injury - Signs • In the early stages, the signs can be difficult to identify and the injured person will often try to continue training for a number of reasons: – They do not recognise the signs – Fear of being removed from training – They do not know damage is being caused • Reporting these signs early may prevent permanent damage and possible medical discharge

Non-Freezing Cold Injury - Prevention • • • Be prepared for the risk Correct use of equipment Self and buddy checks Recognise the signs Act and report them

Non-Freezing Cold Injury – First Aid • • Keep casualty warm Insulate DO NOT rapidly re-warm Evacuate

Non-Freezing Cold Injury - What to do next • Stay sheltered until evacuation can take place • Dry the feet if wet, change socks and footwear • If the limb has been re-warmed, it should not be used e. g. NFCI of the foot – do not walk / ski • Evacuate by stretcher

Hypothermia - Description • Can be a killer • Definition: Drop of a body temp below 35 o. C (normal 37 o. C) • A fall below 32 o. C is a life-threatening emergency

Hypothermia - Signs • Initial - Feels very cold (maybe thirsty) - Stiffness, tiredness - Violent shivering - Increased heart rate • Later: Severe Hypothermia (Body temperature less than 32 o. C) - Probably not shivering - Stiff limbs – muscles and joints rigid - Confusion or loss of consciousness (could appear to be dead)

Hypothermia - Prevention • Be prepared even in fairly cool weather (particularly if cold and wet) • Recognise the signs • Act on them and report immediately

Hypothermia – First Aid • Stop the casualty getting colder • Get them under cover then start to slowly re-warm them • Cover them, use the “buddy system” to swap warmth, add layers – even plastic sacks are good • Replace wet clothing with dry • Give them warm food and drink (not alcohol) • Urgent evacuation is necessary

Freezing Cold Injury - Description • Can cause disability • Face, fingers, toes, the soles of the feet and the heels are more prone to freezing • Frost Nip → Frost Bite • FROST NIP: a freezing cold injury which fully recovers within 30 minutes once rewarming of the injured part has started • FROST BITE: the flesh freezes, the longer in the cold and the colder the temperature, the deeper the damage

Freezing Cold Injury - Signs • Early – FROST NIP: – The affected part will feel very cold and may be painful – If freezing continues a tingling may be felt followed by numbness – There may be a total loss of feeling when the affected part is moved – Skin is white and blotchy

Freezing Cold Injury - Signs • Later – FROST BITE: – Loss of feeling – The skin tissue becomes very white and wax-like and there is usually a clear line between white and pink skin – Later (usually after re-warming) the skin may appear bruised and blistered • Important – The full extent of the damage is not always clear until a few days after the injury

Freezing Cold Injury - Prevention • • • Be prepared for the risk Correct use of equipment Recognise the signs Regular self and buddy checks Act and report them immediately

Freezing Cold Injury – First Aid • Do not re-warm if there is any danger of re-freezing • Shelter the casualty and protect the affected part • Do not apply direct heat or rub the frozen part in an attempt to thaw • Smoking can delay or even prevent recovery and must not be allowed • Do not use protective creams e. g. “Deep Heat”

Freezing Cold Injury - What to do next • Stay sheltered until evacuation can take place • Evacuate by stretcher • If the limb has been re-warmed, it should not be used e. g. FCI of the foot – do not walk / ski

Additional Risks • Individual risk is increased if: – – – Unwell Unfit Hungry Previous history of cold injury Ethnic background Work load • High e. g. fire and movement – likely to sweat and then get cold when activity stops • Low e. g. lying/standing still for long periods of time

General Prevention Advice • Clothing – Clothing and equipment – get to know how to use kit and clothing properly – Wear many layers of clothing rather than one thick layer – Always have spare socks and boots and change them when wet – Use gloves – Remove damp/wet clothing before getting into your sleeping bag and put on dry clothing

Off Duty • Wear the correct level of cold and wet weather clothing, to prevent the onset of NFCI/FCI

Summary • Cold Injuries can and will occur in UK

Impact • Since 1998, over 800 servicemen and women have suffered with cold injury • Every year about 20 personnel are medically discharged and many others will remain permanently downgraded • It could be the difference between a career in the Armed Forces or NO career in the Armed Forces

Questions?