How to Identify and Treat Hypothermia

Cold environments present a real hazard to workers. Just being in the cold can limit a person’s range of motion, creating a possible workplace hazard. Illnesses caused by the cold include trench foot, frostbite and hypothermia. The most serious of the cold stress illnesses is hypothermia, a condition in which core body temperature drops below the required temperature for normal metabolism and body functions. Symptoms of hypothermia vary depending on the level of hypothermia: mild, moderate, severe and critical. To ensure a safe winter workforce, you must be able to identify the symptoms of hypothermia and treat them.

Mild Hypothermia

When a person’s body begins to cool, the body’s natural reaction is to shiver to create internal heat. As the body cools, surface blood vessels begin to shut down to prevent the further loss of heat through the skin. Numbness to the extremities occurs, resulting in a loss of dexterity. Although the victim will be alert, other symptoms of mild hypothermia include a body temperature of 97 to 93 F and pain from the cold.

Moderate Hypothermia

As the victim’s body temperature decreases, shivering will become more violent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim still may appear alert. Surface blood vessels contract further as the body focuses on keeping the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may be blue. His or her body temperature now is around 93 to 90 F.

Severe Hypothermia

The victim now is showing obvious signs of the cold. Less blood flow causes confusion. Other symptoms include:

  • A body temperature of 90 to 82 F.
  • Shivering has decreased or stopped.
  • Confusion and loss of reasoning.
  • Slurred speech.
  • Semi-conscious to unconscious.
  • Muscular rigidity.

Critical Hypothermia

This is a life-threatening condition. The victim will die if not treated. Symptoms include:

  • A body temperature of less than 82 F.
  • Unconscious and may appear dead.
  • Little breathing.
  • Slow pulse.
  • Dilated eyes.
  • Rigid body.

Treating Hypothermia

The basic principles of rewarming a hypothermic victim are to conserve the heat he or she has and replace the body fuel he or she is burning to generate heat.

Victims of mild to moderate hypothermia are still conscious and can be treated without medical attention. Follow these guidelines:

  • Handle the victim gently and minimize his or her exertion.
  • Remove wet clothing and get the victim into warm, dry clothes. Wrap the victim in warm blankets, ensuring his or her head is covered. Place something warm and dry under the victim. Move him or her to a warm environment. Do not make the victim exercise to warm up.
  • Do not suppress shivering, even if violent. Shivering is the most effective way to generate body heat.
  • Do not massage the extremities (hands, arms, legs, feet, etc.) or the trunk.
  • Do not place the victim in a warm bath or shower.

Victims of moderate to severe hypothermia have an altered level of consciousness and fluctuating changes to their heart and respiratory rate. They may be shivering and their core body temperature is usually below 91.4 F. If someone is suffering from critical hypothermia, dial 911 immediately. Then follow these steps:

  • Handle the victim gently. Rough handling can cause heartbeat irregularities and death.
  • Check for airway obstructions and breathing or circulation problems and take appropriate action if there are any abnormalities. Initiate CPR only if no pulse is present after a one-minute assessment.
  • If CPR is necessary, assist breathing at 10 to 12 breaths per minute. Do not start cardiac massage unless it can be continued effectively without a break. It is more dangerous to start, stop and restart CPR rather than to wait until proper care is available.
  • Remove all wet clothing and replace with dry, warm blankets or a sleeping bag. If this is not possible, cover the victim with warm dry clothing, ensuring his or her head is covered. Place something warm and dry under the victim.
  • Move the victim to a warm, dry environment.
  • Do not suppress shivering, even if it is violent. Shivering generates body heat.
  • Do not give anything by mouth because of the high risk of vomiting.
  • Do not massage the trunk or extremities of the victim.
  • Do not place the victim in a hot bath or shower.
  • If available, heated, humidified air or oxygen should be administered.
  • Continue first-aid treatment even if the victim appears lifeless. The body can sometimes survive for hours at very low body temperatures without signs of life.
  • Arrange rapid transport to the nearest medical facility.

Hypothermia Prevention

Hypothermia can happen on a mild winter’s day or damp day in fall or spring. The basic principle for preventing hypothermia is to stay warm and dry and be prepared for a sudden emergency. You must know how to assess hypothermia and give help when it is needed, even if the victim resists help. He or she may be confused and unaware of what is happening, so it is up to you to recognize the signs of hypothermia and administer treatment.

Impacts of Substance Abuse

Studies show an estimated 10 percent of U.S. employees have a chemical dependency, costing employers upwards of $100 billion each year. The most basic losses are attributed to the fact that, on average, an employee who partakes in substance abuse provides approximately two-thirds of the productivity of a sober employee.

Look at it this way: A worker’s salary is the price a business pays for the worker’s contribution to the company. If his or her salary is, for example, $60,000 per year but he or she is only contributing two-thirds of what the employer is paying because of the impacts of substance abuse, the company is looking at a loss of $20,000 each year for a single employee.

In addition, the on-the-job productivity losses don’t include extended behaviors. Other statistics show employees with substance-abuse issues:

  • Leave work early twice as often
  • Are absent from work twice as often and are tardy three times as often
  • File workers’ comp claims five times as often
  • Have an increased likelihood of being the root cause of workplace accidents
  • Have an increased likelihood of stealing or damaging company property

Employees with chemical dependencies also affect their coworkers. One in five employees has had to work harder, redo finished work or has been injured (or nearly injured) as a result of the behavior of a coworker who is under the influence.

Workplace substance abuse can have a stronger impact on small businesses that may not have the written policies or financial means to address accidents, injuries, and loss or damage of company property.

Spotting Substance Abuse

The signs of substance abuse range from vague to completely obvious and depend greatly on the degree to which an employee uses (from casually to compulsively). It is important supervisors are well-versed in recognizing signs so they can address the matter. Some signs to look for may include:

  • Perpetual tardiness or early departure
  • Unknown whereabouts in the middle of the day, doesn’t return after lunch
  • Constant complaints regarding health
  • Complaints from other employees regarding the abuser’s behavior
  • Irrational responses to constructive criticism, ranging from irritation to belligerence or aggression
  • Clear decrease in efficiency or a fluctuating level of performance
  • Repeated injuries on and off the worksite
  • Obvious financial problems (wage garnishment, loss of vehicle, borrowing money from coworkers)
  • Obvious alcohol or illegal drug odors

Keep in mind: Short of actually witnessing an employee drinking or using drugs at work, many of these signs could be attributed to problems that have nothing to do with substance abuse. Certain medications, for example, may present odors that are similar to that of alcohol. It’s vital to never use these signs to jump to conclusions because they’re merely a starting point from which to begin addressing a problem.

Pages: 1 2

OSHA’s Pending IIPP Standard

The Washington, D.C.-based Occupational Safety and Health Administration is directing its efforts toward enforcing a standard in which employers nationwide will be required to establish a thorough, written Injury and Illness Prevention Program (IIPP).

OSHA’s Assistant Secretary of Labor David Michaels calls the IIPP the organization’s highest priority and said it could go into effect in the next one to two years. Its goal is to reduce injuries and the associated costs to business. In fact, California, which implemented the requirement in 1991, has experienced overwhelmingly positive results from it.

What’s Involved

IIPPs aren’t a new idea; most companies already have a program in place designed to reduce or eliminate worksite health and safety hazards. OSHA’s standard, however, will make it a requirement and will set guidelines for what must be included in the program. OSHA is accepting input during the drafting phase but has officially stated the following will be required IIPP inclusions:

Hazard Identification/Assessment: A written process by which hazards will be identified. This will include investigating incidents, inspecting the workplace for hazards, and identifying new hazards created by worksite changes or emergencies.

Hazard Prevention/Control: Control methods by which hazards will be isolated or eliminated. This portion of the IIPP also will require documentation of the control methods and their determined effectiveness.

Management: This will cover a company’s chain of command, including managerial duties, resource distribution and allocation, and the proper network for employee communication.

Education and Training: Training requirements, such as specific hazard training, control methods and timetables, will be required. In addition, incidents would dictate the need for residual or refresher training.

Employee Involvement: This will ensure employees participate in creating and maintaining the IIPP. It provides employees with access to important safety information and sets guidelines for employee involvement in risk assessments and incident investigations.

Program Evaluation and Improvement: Employer IIPPs will need to be considered a living document, constantly being evaluated and updated. These evaluations will include performance monitoring and using incident investigations to identify and correct program deficiencies.

Why?

OSHA’s goal in making its IIPP standard a federal requirement is to encourage employers to implement clear directives for reducing health and safety hazards in the workplace. By mitigating hazards and reducing safety incidents in this way, employers should expect to see an overall improvement in workplace health conditions.

The standard will also allow OSHA to look more deeply at an employer’s systems and efforts to reduce workplace hazards. By making safety at work more transparent, OSHA will be able to get more involved in evaluation and risk reduction.

Pages: 1 2