Extreme cold claims 11 lives in a week, over 100 patients reported

 FROZEN TO DEATH BY HYPOTHERMIA

Poor, homeless fall victim to chilly weather, inappropriate housing facility the major culprit

Islamabad

Exposure to extreme cold causing hypothermia has claimed as many as 11 lives in last one week in the twin cities of Islamabad and Rawalpindi, while well over 100 patients with critical disorders related to extreme cold weather have been reported at Pakistan Institute of Medical Sciences and Polyclinic hospitals.

Majority of the patients presented to the hospitals with extreme cold related disorders were with hypothermia, respiratory infections, burns, toxic gases inhalation from gas heaters and like problems.

Normal body temperature is about 98.6 degree Fahrenheit (37 degree centigrade) and hypothermia occurs when the body temperature drops below 95°F (35°C) due to prolonged exposure to cold temperatures.

Data collected by ‘The News’ on Monday has revealed that in last one week, as many as eight patients died of severe hypothermia including one old man from Christian Colony, two patients both beggars from Golra Sharif area and four persons including three minor girls from Shah Allah Ditta, Sector D-12, from same family.

According to details, 46-year-old Abdul Rauf, a resident of Shah Allah Ditta village brought his three daughters and mother to the hospital. He said that after heavy rainfall, the roof of their hut got damaged and his mother was found dead in the morning. His daughters also contracted severe cold disorder and had ice-cold hands and feet long with difficulty in breathing for which he took them to a local private hospital in Sector D-12. The private hospital referred the three minor girls to PIMS.

One of the three daughters aged two years stopped breathing on way and received dead at the emergency department of PIMS while the other two girls having five and seven years of age were admitted to the hospital but due to severe chest infection, they expired even after having treatment, said Medical Specialist at Intensive Care Unit of PIMS Dr. Muhammad Haroon while talking to ‘The News’.

He added that in last one week, two deaths have been reported at District Headquarters Hospital in Rawalpindi due to hypothermia in last one week. Both the victims were beggars of the same family and residents of Chontra.

Another death has been reported at Benazir Bhutto Hospital. The victim of the severe cold was a 12-year-old boy who got stuck in rain and drenched in cold water for nearly two hours. He was rescued later and transported to BBH where he was admitted in ICU but he expired after two days due to sudden heart arrest.

Hypothermia is a life threatening condition in which core body temperature falls below 35°C and even drops to 27 degree centigrade. Children and old people are vulnerable and often suffer from hypothermia in winter. The immediate risk of hypothermia is heart rhythm abnormalities or cardiac arrhythmias that can cause death within minutes. Extreme cold temperature affects overall metabolism and all body chemical reactions and organ functions impairment occurs if the patient is not treated in time, said Dr. Haroon.

He added the heart rate slows down progressively due to hypothermia till heart fails to beat or contract causing death.

The increasing toll of hypothermia over the past five years coincides with a surge in energy costs, especially gas prices which have gone up. The poor and homeless people are facing the worst environmental crisis, he said.

He said severe hypothermia may be preventable by implementing public health strategies that include education programmes targeting high-risk individuals such as the elderly and the homeless. Specific preventive measures include wearing adequate protective clothing, maintaining fluid and calorie intake, avoiding fatigue, ensuring heated shelter, and avoiding excessive alcohol consumption.

He said the emergency departments and intensive care units should be prepared to manage victims with hypothermia especially in the winter months. Social services should be adequately staffed to provide counseling and shelter to homeless persons during periods of extreme cold. Family members, home health care workers, and social service providers should closely monitor the elderly and patients with medical conditions, said Dr. Haroon.

He added the adage that the patient is ‘not dead until they are warm and dead’ has emerged from reports of patients with profound hypothermia, in cardiac arrest and in deep coma, making uncomplicated recoveries after resuscitation and re-warming. There are case reports that patients survived even after four hours of resuscitation and rewarming, he said.

To a query, Dr. Haroon said the snowfall has attracted bunch of people towards Murree hills and other hill stations in the region. It is important that as many as three people were brought with frostbite to private hospitals of Islamabad after snowfall, however they got treatment in time that saved their limbs from amputation, he said.

It is important to mention here that one of the popular healthcare websites citing a research says that nine out of 24 (37.5%) victims of accidental hypothermia with cardiac arrest survived hypothermic cardiac arrest from 1999 to 2013 in Norway through resuscitation and rewarming by extracorporeal circulation. The lowest measured core temperature among survivors was 13.7°C; the longest time from cardiac arrest to return of spontaneous circulation was 6 hours and 52 minutes.