The cold wave is coming to Israel: this is how you will recognize and treat hypothermia

In adults, prolonged exposure to cold can lead to hypothermia, a life-threatening medical condition called hypothermia. This is a situation where the body temperature drops below 35.5 degrees, instead of a normal body temperature that ranges between 37 and 37.8 degrees. Body temperature regulation is carried out through an area of ​​the brain called the hypothalamus, which serves as a kind of internal thermostat. The hypothalamus is responsible for maintaining a stable temperature necessary for the normal activity of the body’s systems.

Our body can handle an ambient temperature ranging from 35.5 to 41 degrees Celsius, but exceeding this range, and especially exposure to extreme cold as occurs in the winter cold waves, may end in serious damage and even disaster. To maintain body heat, the hypothalamus causes vasoconstriction, shivering and increased cardiac output. At the same time, the blood flow to less vital organs, such as the fingertips, ears and nose, is reduced, in order to pump blood to the heart and brain. However, as the exposure to cold continues, other body systems are damaged, and in advanced stages this may also lead to death.

Mild hypothermia is defined when the body temperature ranges between 32 and 35 degrees. This is the stage where tremors in the hands, legs and lips often appear. When the temperature drops below 34 degrees, neurological signs begin to appear, including impaired judgment, forgetfulness and difficulty speaking, and at the same time the breathing rate increases. At a temperature of about 33 degrees, difficulty in movement and apathy appear. At this stage, the patients are usually still stable in terms of blood pressure and heart function, but breathing and heart rate increase, and urine output decreases in order to reduce heat loss.

Moderate hypothermia develops when the body temperature ranges between 28 and 32 degrees. At this stage, severe damage is caused to the functioning of the brain and nervous system, the reflexes in the limbs weaken and the flow of urine almost stops. Most victims at a temperature of 32 degrees are already in a state of unconsciousness. When the temperature drops to 31 degrees or below, the body loses the ability to produce heat through shivering. Around 30 degrees, life-threatening disturbances in the heart rhythm begin, the pulse drops, the cardiac output deteriorates and the heart has difficulty supplying blood and oxygen to the vital organs.

In the range of 28 to 30 degrees, the pupils are dilated and do not react to light, a sign of severe brain damage, a condition approaching brain death. Severe hypothermia is defined when the body temperature drops below 28 degrees. At this stage, the heart rhythm disturbances worsen until it ceases to function, the blood pressure is very low and sometimes unmeasurable, the brain activity is almost invisible, and below 27 degrees most victims are already in a coma.

If hypothermia is suspected, seek medical help immediately. The initial treatment focuses on preventing further heat loss, gradual warming of the body and in difficult situations also on resuscitation. The victim should be moved to a warm place, remove wet or frozen clothes and cover the body with dry clothes and blankets. If the patient is unconscious and unresponsive, CPR should be started which includes opening an airway and cardiac massage at a rate of 100 per minute, and if possible use a semi-automatic defibrillator.

In the hospital, the treatment focuses on advanced heating of the patient through warm infusions, and in severe cases even washing the stomach with warm solutions. At the same time, injuries to the body’s organs are treated, drugs are given to correct arrhythmias, and the patient is connected to a ventilator. In particularly difficult situations, connection to an ECMO heart-lung machine is required. A severe cold injury also affects the blood acidity balance, the patient’s condition with dedicated infusions, and sometimes kidney failure develops which requires dialysis.

Beyond the danger of the cold itself, winter brings with it another danger, carbon monoxide poisoning. This is a deadly gas, colorless and odorless, that may be emitted from gas stoves and fireplaces that operate on coals. Since its existence cannot be felt until symptoms appear, ensuring adequate ventilation and proper maintenance of the heating systems is essential. The signs of poisoning include dizziness, nausea, vomiting, weakness and fatigue, and in severe cases also loss of consciousness. When these signs appear, immediately turn off the heating source, ventilate the house and call MDA by calling 101.

During the cold days it is important to keep the body heat of the elderly, babies and bedridden patients. It is recommended to dress them in light layers that allow movement, cover them with a light blanket and maintain a room temperature of about 24 degrees. Be especially careful with babies, and avoid excessive covering or heavy blankets that can cause suffocation. Signs of hypothermia in these groups include decreased function, confusion, lack of eating and drinking, and sleepiness, and when they appear, you should act immediately and seek medical help.

And what is expected in the coming days? On Tuesday the weather will be partly cloudy with local rains and thunderstorms mainly in the south. On Wednesday the cold wave will start, the temperatures will drop and it will be colder than usual for the season. On the night between Wednesday and Thursday, the cold will intensify, and in the Jerusalem area, temperatures are expected to drop to about 4 degrees.