Environmental emergencies

2012 ◽  
pp. 253-270
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
The Elderly ◽  
Cold Water Immersion ◽  
Heat Illness ◽  
Near Drowning ◽  
The Core ◽  
Conscious Level ◽  
Acute Confusion ◽  
Electrical Injuries

Hypothermia 254 Frostbite and non-freezing cold injury 257 Drowning and near drowning 258 Diving emergencies 260 Heat illness 264 Electrical injuries 266 Radiation incidents 268 Hypothermia exists when the core temperature (T°)<35°C. Infants and the elderly are at particular risk. In young adults hypothermia is usually due to environmental exposure (eg hill-walking or cold water immersion), or to immobility and impaired conscious level from alcohol or drugs. In the elderly, it is more often a prolonged state of multifactorial origin: common precipitants include unsatisfactory housing, poverty, immobility, lack of cold awareness (autonomic neuropathy, dementia), drugs (sedatives, antidepressants), alcohol, acute confusion, hypothyroidism and infections....

Heat balance precedes stabilization of body temperatures during cold water immersion

2003 ◽  
Vol 95 (1) ◽  
pp. 89-96 ◽  
Author(s):  
Peter Tikuisis
Keyword(s):  
Heat Balance ◽  
Cold Water ◽  
Water Immersion ◽  
Heat Content ◽  
Cold Water Immersion ◽  
The Body ◽  
Body Temperatures ◽  
Mean Body Temperature ◽  
The Core ◽  
Region Temperature

Certain previous studies suggest, as hypothesized herein, that heat balance (i.e., when heat loss is matched by heat production) is attained before stabilization of body temperatures during cold exposure. This phenomenon is explained through a theoretical analysis of heat distribution in the body applied to an experiment involving cold water immersion. Six healthy and fit men (mean ± SD of age = 37.5 ± 6.5 yr, height = 1.79 ± 0.07 m, mass = 81.8 ± 9.5 kg, body fat = 17.3 ± 4.2%, maximal O2 uptake = 46.9 ± 5.5 l/min) were immersed in water ranging from 16.4 to 24.1°C for up to 10 h. Core temperature (Tco) underwent an insignificant transient rise during the first hour of immersion, then declined steadily for several hours, although no subject's Tco reached 35°C. Despite the continued decrease in Tco, shivering had reached a steady state of ∼2 × resting metabolism. Heat debt peaked at 932 ± 334 kJ after 2 h of immersion, indicating the attainment of heat balance, but unexpectedly proceeded to decline at ∼48 kJ/h, indicating a recovery of mean body temperature. These observations were rationalized by introducing a third compartment of the body, comprising fat, connective tissue, muscle, and bone, between the core (viscera and vessels) and skin. Temperature change in this “mid region” can account for the incongruity between the body's heat debt and the changes in only the core and skin temperatures. The mid region temperature decreased by 3.7 ± 1.1°C at maximal heat debt and increased slowly thereafter. The reversal in heat debt might help explain why shivering drive failed to respond to a continued decrease in Tco, as shivering drive might be modulated by changes in body heat content.

Near-Drowning: Fresh, Salt, and Cold Water Immersion

1986 ◽  
Vol 5 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Ashok P. Sarnaik ◽  
Meena P. Vohra
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Near Drowning

scholarly journals Exertional Rhabdomyolysis in a Collegiate American Football Player After Preventive Cold-Water Immersion: A Case Report

2012 ◽  
Vol 47 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Leamor Kahanov ◽  
Lindsey E. Eberman ◽  
Mitchell Wasik ◽  
Thurman Alvey
Keyword(s):  
Athletic Training ◽  
Cold Water ◽  
Water Immersion ◽  
Football Player ◽  
Cold Water Immersion ◽  
American Football ◽  
Heat Illness ◽  
Normal Range ◽  
Exertional Rhabdomyolysis ◽  
American Football Player

Objective: To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive cold-water immersion. Background: A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated post-practice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45–260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal &lt; 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%– 30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids. Differential Diagnosis: Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis. Treatment: The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L). Uniqueness: The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis. Conclusions: In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after exercise should be monitored by the athletic training staff and may not be appropriate to prevent muscle damage, given the lack of supporting evidence.

Cold Water Immersion and Near Drowning

2008 ◽  
pp. 625-627
Author(s):  
Paul S. Auerbach ◽  
Howard J. Donner ◽  
Eric A. Weiss
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Near Drowning

Patient Involvement in Treatment Decision Making Can Help or Hinder Placebo Analgesia

2014 ◽  
Vol 222 (3) ◽  
pp. 165-170 ◽  
Author(s):  
Andrew L. Geers ◽  
Jason P. Rose ◽  
Stephanie L. Fowler ◽  
Jill A. Brown
Keyword(s):  
Patient Involvement ◽  
Cold Water ◽  
Prior Experience ◽  
Water Immersion ◽  
Treatment Decision ◽  
Cold Water Immersion ◽  
Not Given ◽  
Placebo Analgesia ◽  
Treatment Decision Making ◽  
Immersion Experience

Experiments have found that choosing between placebo analgesics can reduce pain more than being assigned a placebo analgesic. Because earlier research has shown prior experience moderates choice effects in other contexts, we tested whether prior experience with a pain stimulus moderates this placebo-choice association. Before a cold water pain task, participants were either told that an inert cream would reduce their pain or they were not told this information. Additionally, participants chose between one of two inert creams for the task or they were not given choice. Importantly, we also measured prior experience with cold water immersion. Individuals with prior cold water immersion experience tended to display greater placebo analgesia when given choice, whereas participants without this experience tended to display greater placebo analgesia without choice. Prior stimulus experience appears to moderate the effect of choice on placebo analgesia.

Thermoregulatory responses to cold water at different times of day

1999 ◽  
Vol 87 (1) ◽  
pp. 243-246 ◽  
Author(s):  
John W. Castellani ◽  
Andrew J. Young ◽  
James E. Kain ◽  
Michael N. Sawka
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
Early Morning ◽  
Cold Water Immersion ◽  
Time Of Day ◽  
Mean Skin Temperature ◽  
Mean Body Temperature ◽  
Metabolic Heat ◽  
Body Temperature Change ◽  
The Mean

This study examined how time of day affects thermoregulation during cold-water immersion (CWI). It was hypothesized that the shivering and vasoconstrictor responses to CWI would differ at 0700 vs. 1500 because of lower initial core temperatures (Tcore) at 0700. Nine men were immersed (20°C, 2 h) at 0700 and 1500 on 2 days. No differences ( P > 0.05) between times were observed for metabolic heat production (M˙, 150 W ⋅ m−2), heat flow (250 W ⋅ m−2), mean skin temperature (T sk, 21°C), and the mean body temperature-change in M˙(ΔM˙) relationship. Rectal temperature (Tre) was higher ( P < 0.05) before (Δ = 0.4°C) and throughout CWI during 1500. The change in Tre was greater ( P < 0.05) at 1500 (−1.4°C) vs. 0700 (−1.2°C), likely because of the higher Tre-T skgradient (0.3°C) at 1500. These data indicate that shivering and vasoconstriction are not affected by time of day. These observations raise the possibility that CWI may increase the risk of hypothermia in the early morning because of a lower initial Tcore.

scholarly journals Recovery strategies implemented by sport support staff of elite rugby players in South Africa

2009 ◽  
Vol 65 (1) ◽  
Author(s):  
D.V. Van Wyk ◽  
M.I. Lambert
Keyword(s):  
Cold Water ◽  
Water Immersion ◽  
Total Duration ◽  
Cold Water Immersion ◽  
Support Staff ◽  
Medical Support ◽  
Cross Sectional ◽  
Study Results ◽  
Recovery Strategies ◽  
Rugby Players

Objective: The main aim of this study was to determine strategies used toaccelerate recovery of elite rugby players after training and matches, asused by medical support staff of rugby teams in South A frica. A  secondaryaim was to focus on specifics of implementing ice/cold water immersion asrecovery strategy. Design: A  Questionnaire-based cross sectional descriptive survey was used.Setting and Participants: Most (n=58) of the medical support staff ofrugby teams (doctors, physiotherapists, biokineticists and fitness trainers)who attended the inaugural Rugby Medical A ssociation conference linked to the South A frican Sports MedicineA ssociation Conference in Pretoria (14-16th November, 2007) participated in the study. Results: Recovery strategies were utilized mostly after matches. Stretching and ice/cold water immersion were utilized the most (83%). More biokineticists and fitness trainers advocated the usage of stretching than their counter-parts (medical doctors and physiotherapists). Ice/Cold water immersion and A ctive Recovery were the top two ratedstrategies. A  summary of the details around implementation of ice/cold water therapy is shown (mean) as utilized bythe subjects: (i) The time to immersion after matches was 12±9 min; (ii) The total duration of one immersion sessionwas 6±6 min; (iii) 3 immersion sessions per average training week was utilized by subjects; (iv) The average water temperature was 10±3 ºC.; (v) Ice cubes were used most frequently to cool water for immersion sessions, and(vi) plastic drums were mostly used as the container for water. Conclusion: In this survey the representative group of support staff provided insight to which strategies are utilizedin South A frican elite rugby teams to accelerate recovery of players after training and/or matches.

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