[Clinical manifestations and diagnosis] Casualty skin was pale, cold, sometimes with edema in the face and surrounding tissues, confusion or coma, muscle rigidity, slight tremors on the electromyogram and electrocardiogram, pupillary retardation or disappearance of light, bradycardia, heart rhythm Arrhythmia, not measured in blood pressure drop, atrial fibrillation can occur and fibrillation, severe heartbeat stop. Breathing is slow and shallow, and occasionally one or two weak breaths are visible.
If there is a history of cryosurgery, as long as the measurement of rectal temperature and electrocardiogram make it possible to confirm the diagnosis. Do not make excessive tests. However, it should be noted that ordinary thermometers do not apply (only 350C can be measured). A water thermometer can be inserted into the anus for a minimum of 5 cm.
In general, the rectal temperature is above 28-300C, and it can recover more. There is a risk of death at 250C. The General Hospital of the Xinjiang Military Region saved one case of severe freezing and freezing. The rectal temperature is only 220C patients. There is also an individual case report on the recovery of the central body temperature 180C in foreign countries.
[First Aid and Treatment] The key is to quickly restore the patient's central body temperature and prevent complications.
Quickly and steadily move the patient into a warm environment, take off clothes, shoes and socks, take warm-up of the whole body, cover with a quilt or blanket, and use a hot water bottle and kettle to heat (note that it is separated by mats, clothes or blankets, not directly on the skin To prevent scalding) put down the groin and groin, conditional electric blanket wrapped body open, infrared and shortwave diathermy, etc., can also be used warm water, the patient immersed in 40 ~ 420C warm tub, water temperature from 34 ~ 350C, 5 ~ After 10 minutes raise the water temperature to 420C until the rectal temperature rises to 340C. With regular breathing into the heartbeat, stop heating.
If the patient's consciousness exists, a warm drink or small amount of wine may be given. Intravenous drip in warming 10% glucose water (infusion tubing can be lengthened to 5-6 meters, soaked in a water bath of 38-400C) will help to improve circulation. .
In addition to resurfacing the body surface, a central rewarming method can also be used, especially for those who are severely frozen. Extracorporeal circulation blood warming and peritoneal dialysis can be used. Peritoneal dialysis can be carried out in general hospitals. Dialysate which can be heated to 49-540C is suspended at a height of 3 to 4 feet. It is poured into the abdominal cavity through a catheter kept in a 430C water bath for peritoneal dialysis. 30 minutes, continuous dialysis 5 to 6 times. Each hour can increase the rectal temperature 2.9 ~ 3.60C, help to improve heart and kidney function.
Other treatments include correcting heart rhythm disorders and acidosis, and paying attention to the prevention and treatment of complications (pneumonia, heart and kidney insufficiency, brain and pulmonary edema). If there is a local frostbite, it should first be rescued and frozen, and then dealt with according to the principle of frostbite treatment.
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