The Lethal Triad
Hypothermia, acidosis, and coagulopathy reinforce one another in trauma. A cold patient cannot clot effectively, which worsens bleeding. Preventing heat loss is a treatment priority from the first contact.
Stages of Hypothermia
Mild hypothermia causes shivering and clumsiness, moderate causes confusion and loss of shivering, and severe causes bradycardia, coma, and arrhythmias. Handle severely hypothermic patients gently because rough movement may trigger ventricular fibrillation. Remove wet clothing and insulate the patient from the ground.
Frostbite
Frostbitten tissue appears white, waxy, and numb. Do not rub the area or rewarm it if there is a chance of refreezing. Cover with dry dressings and transport for definitive rewarming.