Cold-induced injuries may pose life-threatening emergencies

Islamabad: The number of cases of cold-induced injuries including hypothermia and frostbite that may cause serious life-threatening complications is on the rise after the severe cold wave hit this region of the country including upper parts in the mountainous ranges.

The increased number of cases of cold-induced injuries has so far been reported at two public sector hospitals in the federal capital including Pakistan Institute of Medical Sciences and Federal Government Services Hospital (Polyclinic).

Of 54 patients so far brought to PIMS and Polyclinic with cold induced injury, hypothermia or frostbite, majority were from hilly areas of Margallah, Murree and Azad Kashmir while some 17 poor victims of hypothermia were brought to PIMS who had spent longer period of time in extreme cold in open due to lack of home and heating facilities, said Intensive Care Physician at PIMS Dr. Muhammad Haroon while talking to ‘The News’ on Sunday.

He added that hypothermia causes not less than 100 deaths per year in Pakistan though many of them remain unreported. Majority of victims are found to be homeless who freeze to death in the freezing or sub-zero winter in cold and snow, he said.

Hypothermia occurs when the body loses heat faster than it produces heat in extreme cold weather conditions or immersion in to cold water. It results in a dangerously low body temperature. Normal body temperature is about 98.6 °F (37 °C), but hypothermia occurs when the body temperature drops below 95 °F or 35 °C.

Hypothermia is more common in males and the elderly. Three of hypothermia’s main causes are alcohol consumption that makes one feel warmer while increasing heat loss, poverty due to an inability to afford adequate heating and water immersion from swimming or diving in cold water, said Dr. Haroon.

He added the rapid drop in the body’s temperature does not allow heart, nervous system, and other organs to function normally. It can also cause effects such as confusion and strange behaviours like clumsiness and fatigue. Death generally occurs due to complete failure of heart and nervous system, he said.

He explained that the first aid for victims of hypothermia begins by moving them out of the cold and removing any wet clothing they are wearing. Cover the victim with blankets and extra clothes while serving warm, sweet beverages to avoid hypoglycaemia, fall in blood sugar to levels below normal. Avoid excessive massaging or rubbing when sharing body heat as well as alcohol or caffeinated drinks, he said.

He added that vigorous, jarring movements may trigger cardiac arrest while alcohol or caffeine speeds up heat loss. Those suffering from unconsciousness or other symptoms of severe hypothermia should be taken to the nearest hospital where they can receive more supportive care.

He said hypothermia is a life threatening emergency and should be promptly recognized and treated. Patients of hypothyroidism, diabetes, age less than eight or more than 65 are at high risk for hypothermia and they should not stay outside in extreme cold for longer period of time.

Dr. Haroon explained that frostbite is a condition where excess heat loss and ice cold temperature impair blood circulation in extremities like hands, feet etc. Blood is frozen in severe cases causing gangrene and minutes are vital to save limbs from amputation. Frostbite is common in residents of mountains, elderly people and diabetics, he said.