COOLING OF THE ORGANISM

COOLING OF ORGANISM - the state of the body caused by the effects of cold, and characterized by general and local reactions. In conditions of heat transfer over heat production, cooling leads to a decrease in body temperature, or hypothermia (for human 35 ° C and lower in the rectum). Cooling can cause freezing, which is understood as pathological hypothermia, accompanied by severe disorders of the body's functions until its death.

The speed and depth of cooling depend on the strength and duration of the cold effect, as well as on the state of the organism and the conditions in which it is located. Cooling contributes to strong wind, high humidity, unsuitable clothing, as well as severe trauma, blood loss, fatigue, starvation, alcoholic intoxication. Especially quickly the person cools when it gets into cold water. In some cases, the development of cold shock is possible in this case, in the pathogenesis of which the main importance is not hypothermia, but overexcitation of the central nervous system due to severe irritation of cold skin receptors, emotional stress, and sudden vasospasm and cerebral ischemia. Death with cold shock occurs before the critical drop in body temperature. Children, especially breastfed, are more prone to cooling due to imperfect thermoregulation mechanisms and a relatively larger body surface compared to adults.

There are the following four stages of cooling: compensatory, in which the temperature of the body is not yet reduced; Adynamic, co-morbid, coma, in which the body temperature, measured in the rectum, is 35 - 30 ° C, 29-25 ° C, 24 ° C and lower, respectively. Reducing body temperature to 17-18 ° C is fatal. In the first stage, the victims can be excited, they develop chills, muscle tremors, goosebumps , tachycardia, and blood pressure. In the second stage, there is a retardation or euphoria, a headache , dizziness , a sharp decrease in motor activity; While breathing, pulse and blood pressure are not significantly altered. The third stage is characterized by a more pronounced general retardation up to the soporus, rare, shallow breathing, bradycardia , a decrease in blood pressure. In the fourth stage, consciousness is lost, involuntary movements and convulsive muscle contractions are possible, superficial breathing, very rare, BP is sharply reduced.

Measures of assistance. In the first stage, it is enough to stop the effects of cold. In the second stage, in addition, it is necessary to actively warm the victim (warm drink, warmers, etc.). In the third and fourth stages, the victim needs urgent help. The main efforts are focused on maintaining breathing and circulation, preventing further cooling and warming the body; First of all eliminate the tongue's tongue, suck the mucus from the mouth and pharynx, introduce the airway, provide oxygen inhalation. In case of stopping breathing and cardiac activity, the entire complex of resuscitation measures is necessary. As early as possible, you should begin active warming of the victim. He is wrapped in warm blankets, transferred to a warm room. The most effective is warming in a bath with warm water (37 ° C). It is acceptable to use heaters, electric clothes, reflectors. In some cases, it is advisable to warm up in conditions of superficial general anesthesia, muscle relaxation and artificial ventilation, which requires the participation of an anesthesiologist. During warming, heated solutions of glucose, sodium chloride, polyglucin or reopolyglucin are dripped intravenously. Active heating is stopped, when the temperature in the rectum rises to 34 - 33 ° C. Simultaneously with the removal of the victim from the state of hypothermia, prophylaxis and treatment of complications are carried out, since cooling of the body contributes to the occurrence of bronchitis, pneumonia, nephritis, exacerbation of chronic inflammatory diseases.