Temperature (WBGT) must be monitored regularly,
and the results interpreted with the Physiological Heat
Exposure Limit (PHEL) chart before work assign-
ments are made. In addition, unnecessary heat sources,
especially steam leaks, must be eliminated, and vents
and exhaust blowers must be checked for adequate
circulation. The results will be a happier, healthier, and
more productive crew.
COLD EXPOSURE INJURIES
LEARNING OBJECTIVE: Identify the
signs, symptoms, and emergency treatment
of each type of cold exposure injury.
When the body is subjected to extremely cold
temperatures, blood vessels constrict, and body heat is
gradually lost. As the body temperature drops, tissues
are easily damaged or destroyed.
The cold injuries resulting from inadequate
response to the cold in military situations have spelled
disaster for many armiesthose of Napoleon and
Hitler in their Russian campaigns, for example. The
weather (i.e., temperature, humidity, precipitation, and
wind) is the predominant influence in the development
of cold injuries. Falling temperature interacting with
high humidity, a wet environment, and rising wind
accelerates the loss of body heat.
Other factors that influence the development of cold
injuries are the individual's level of dehydration, the
presence of other injuries (especially those causing a
reduction in circulatory flow), and a previous cold injury
(which increases susceptibility by lowering resistance).
In addition, the use of any drug (including alcohol) that
modifies autonomic nervous system response or alters
judgment ability can drastically reduce an individuals
chance for survival in a cold environment.
Like heat exposure injuries, cold exposure injuries are
preventable. Acclimatization, the availability of warm,
layered clothing, and maintenance of good discipline and
training standards are important factors.
commandnot medicalresponsibilities, but the
Corpsman plays a crucial role as a monitor of nutritional
intake and personal hygiene (with emphasis on foot care)
and as an advisor to the commanding officer. ACorpsman
is also responsible for acquainting the troops with the
dangers of cold exposure and with preventive measures.
Two major points must be stressed in the
management of all cold injuries: Rapid rewarming is
of primary importance, and all unnecessary manipula-
tions of affected areas must be avoided. More will be
said about these points later.
In military operations the treatment of cold injuries is
influenced by the tactical situation, the facilities available
for the evacuation of casualties, and the fact that most
cold injuries are encountered in large numbers during
periods of intense combat when many other wounded
casualties appear. Highly individualized treatment under
these circumstances may be impossible because
examination and treatment of more life-endangering
wounds must be given priority. In a high-casualty
situation, shelter cold-injury victims, and try to protect
them from further injury until there is sufficient time to
All cold injuries are similar, varying only in the
degree of tissue damage. Although the effects of cold
can, in general, be divided into two typesgeneral
cooling of the entire body and local cooling of parts of the
bodycold injuries are seldom strictly of one type or the
other; rather, these injuries tend to be a combination of
both types. Each type of cooling, however, will be
discussed separately in the sections that follow.
General Cooling (Hypothermia)
General cooling of the whole body is caused by
continued exposure to low or rapidly falling
temperatures, cold moisture, snow, or ice.
exposed to low temperatures for extended periods may
suffer ill effects, even if they are well protected by
clothing, because cold affects the body systems slowly,
almost without notice. As the body cools, there are
several stages of progressive discomfort and disability.
The first symptom is shivering, which is an attempt to
generate heat by repeated contractions of surface
muscles. This is followed by a feeling of listlessness,
indifference, and drowsiness. Unconsciousness can
follow quickly. Shock becomes evident as the victims
eyes assume a glassy stare, respiration becomes slow
and shallow, and the pulse is weak or absent. As the
body temperature drops even lower, peripheral
circulation decreases and the extremities become
susceptible to freezing. Finally, death results as the
core temperature of the body approaches 80F.
The steps for treatment of hypothermia are as
1. Carefully observe respiratory effort and heart
beat; CPR may be required while the warming
process is underway.