Cold Weather Injuries

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Cold Weather Injuries
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Cold Weather InjuriesTerminal Learning Objective

• Action Manage cold weather injuries
• Condition Given the ECWCS, other issued cold
  weather clothing items, and issued cold weather
  sleep system with insulating pad, access to a
  warming shelter, under field conditions where
  temperatures range from 40º F to 60º F
• Standard Soldier
• identified all of the signs and symptoms of each
  type of cold weather injury.
• selected and applied the recommended treatment
  for the specified cold weather injury.
• did not sustain a cold weather injury during the
  conduct of the course

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Cold Weather Injuries
Total - 3446 Soldiers (approximately 1 BCT)
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Cold Stress

• Environmental Risk Factors
• Temperature, wind, rain/snow, immersion,
  altitude
• Mission Risk Factors
• Work intensity, duration of cold exposure and
• availability of adequate shelter, clothing and
  food
• Individual Risk Factors
• Physical fitness, body composition, fatigue,
  race,
• gender, health

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How does the body lose heat?
Radiation - 60 Convection - variable Conduction
- variable Respiration - 6 - 10 Evaporation
- 12 - 15
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How does the Body Respond to the Heat Loss?

• Shell/Core Effect body pulls blood from
  extremities in an effort to keep the core warm.
• Cold Diuresis result of the shell/core effect
  body rids itself of fluid (increased urination),
  because the kidneys sense an increase of volume
  in the core thirst mechanism is also disrupted
• Shivering involuntary reaction of skeletal
  muscles which produces heat

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Wind Chill Chart
WCT (F) 35.74 0.6215T - 35.75(V0.16)
0.4275T(V0.16) Where T is temperature (F) and V
is wind speed (mph)

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Risk Of Frostbite
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Windchill Category
These guidelines are generalized for worldwide
use. Commanders of units with extensive extreme
cold-weather training and specialized equipment
may opt to use less conservative guidelines.
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Individual Factors
Fatigue Gender and Race Nutrition Prior
cold weather injuries Water intake Diseases or
injuries Individual differences Drugs/Tobacco/Al
cohol Fitness Psycho-Social
Factor Age Discipline, Training, Experience

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Food and Water Requirements
Calories 4500-6,000 calories per day 3.5-5
quarts of water per day
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Personal Hygiene
Washing/Shaving Oral Hygiene Water Sources Food
Sources Nicotine and Alcohol Latrines Clothing
Sleeping Bags
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Dehydration
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Hypothermia
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Chilblain
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Frostbite
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Immersion Foot
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Cold Weather InjuriesSummary

• Action Manage cold weather injuries
• Condition Given the ECWCS, other issued cold
  weather clothing items, and issued cold weather
  sleep system with insulating pad, access to a
  warming shelter, under field conditions where
  temperatures range from 40º F to 60º F
• Standard Soldier
• identified all of the signs and symptoms of each
  type of cold weather injury.
• selected and applied the recommended treatment
  for the specified cold weather injury.
• did not sustain a cold weather injury during the
  conduct of the course

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Altitude IllnessTerminal Learning Objective

• Action Manage altitude illness
• Condition Under any field condition
• Standard Soldier
• identified all of the signs and symptoms of
  altitude sickness
• selected and applied the recommended treatment
  for the specified altitude sickness

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Altitude Classifications

• Altitude 8,000-12,000
• High altitude 12,000-18,000
• Extreme altitude 18,000-29,000
• Reference Medicine for Mountaineering, 5th
  edition by James A. Wilkerson, M.D.
• Low Sea Level to 5,000 feet
• Moderate 5,000-8,000 feet
• High 8,000-14,000 feet
• Very High 14,000-18,000
• Extreme 18,000 and higher
• Reference FM 3-97.6 Mountain Operations

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Altitude Overview

• At all altitudes the air is made up of 21 oxygen
• As you gain altitude the air pressure drops
• Less oxygen is available to the body because of
  this reduced pressure
• Less oxygen available means you suffer the
  effects of altitude

BarP barometric pressure PIO2 pressure of
inhaled oxygen PaO2 arterial oxygen
pressure PaCO2 arterial carbon dioxide
pressure SaO2 percent of arterial oxygen
saturation
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Initial Physiological Response to Altitude

• Increased rate and depth of breathing
• Decreased oxygen saturation
• Changes in pH
• Pulse Rate and Cardiac Output
• Blood Volume
• Sleep Hypoxia

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Acclimatization

• Increased Respiratory Volume
• Increased Pulmonary Artery Pressure
• Increased Cardiac Output
• Increased Number of Red Blood Cells
• Changes in Oxygen-Carrying Capacity
• Changes in Body Tissues

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Acute Mountain Sickness
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High Altitude Pulmonary Edema (HAPE)
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High Altitude Cerebral Edema (HACE)
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Gamow Bag
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Tips for Operations at Altitude

• Driving or flying to altitudes above 10,000 feet
  is not recommended it will take 24-72 hours to
  adjust if you do fly to altitudes above 10,000
  feet
• Stay properly hydratedyou can lose up to 4
  liters per day just breathingthink about water
  sources, and the resources required to make the
  water drinkable (filters, stoves, iodine etc.)
• High carbohydrate diets are recommended
• If an individual shows symptoms of altitude
  illness, you cannot take that person to a higher
  altitude until the symptoms have subsided if the
  symptoms worsen, it is time to evacuate that
  individual to a lower altitude. Even a wait of a
  few hours can mean the difference between life
  and death.

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Tips for Operations at Altitude

• 24-72 hours after arrival at altitude, begin a PT
  program that will mimic the operations you will
  be conducting if possible train at higher
  altitudes and sleep at lower altitudes
• Diamox can help but may not be appropriate for
  all individuals
• Tobacco, alcohol, dehydration, depressant drugs
  and over-exertion will inhibit acclimatization
• Remember that you and your soldiers will never be
  able to perform to sea level capacity everything
  will take longer to accomplish

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Altitude IllnessSummary

• Action Manage altitude illness
• Condition Under any field condition
• Standard Soldier
• identified all of the signs and symptoms of
  altitude sickness
• selected and applied the recommended treatment
  for the specified altitude sickness

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Cold Weather and Mountain Environmental
InjuriesTerminal Learning Objective

• Action Manage common cold weather and mountain
  environmental injuries
• Condition Given the ECWCS, other issued cold
  weather clothing items, and issued cold weather
  sleep system with insulating pad, access to a
  warming shelter, under field conditions where
  temperatures range from 40º F to 60º F
• Standard Soldier
• identified all of the signs and symptoms of
  common cold weather and mountain environmental
  injuries.
• selected and applied the recommended treatment
  for common cold weather and mountain
  environmental injuries

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Snow Blindness
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Improvised Slit Glasses
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Carbon Monoxide Poisoning
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Giardia
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Constipation
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Heat Exhaustion
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Heat Stroke
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Hyponatremia
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Cold Weather and Mountain Environmental
InjuriesSummary

• Action Manage common cold weather and mountain
  environmental injuries
• Condition Given the ECWCS, other issued cold
  weather clothing items, and issued cold weather
  sleep system with insulating pad, access to a
  warming shelter, under field conditions where
  temperatures range from 40º F to 60º F
• Standard Soldier
• identified all of the signs and symptoms of
  common cold weather and mountain environmental
  injuries.
• selected and applied the recommended treatment
  for common cold weather and mountain
  environmental injuries