First Aid Management of Hypothermia and Cold Injuries

Abstract

Introduction:Best practice first aid management of accidental hypothermia and cold injuries in the prehospital setting is relevant for disaster management in cold environments as well as for wilderness and expedition medicine, and space medicine. In the Australasian context, guidance is currently taken from the Australian Resuscitation Council (“ARC”) Guidelines dealing with these issues.Aim:To review and update the recommendations of the ARC Guideline 9.3.3 Hypothermia: First-Aid Management (February 2009) and ARC Guideline 9.3.6 Cold Injury (March 2000).Method: The review is being undertaken through a combination of a focused literature review and expert opinion. Through the author’s membership of the International Commission for Alpine Rescue (“ICAR”) Alpine Emergency Medicine Commission, two northern-hemisphere experts on hypothermia have reviewed the guidelines and provided commentary and recommendations.Results:Much of the literature around accidental hypothermia and cold injuries (including frostbite, frostnip, and chilblains), relies on expert opinion and case studies. There are relatively few randomized controlled trials, and these are often confined to the laboratory setting. As a result, there is a heavier reliance on expert opinion than in any other areas of medicine.Discussion:This presentation will summarize the current best practice recommendations for the first aid management of accidental hypothermia and cold injuries through combining the existing ARC Guidelines with key advances identified through the literature review, and the key management recommendations stemming from expert opinion. This will provide attendees with a cohesive set of clinical practice recommendations which can be used in the field.