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HIPOTERMIA (Physical and Biological Hazards of The Workplace 2nd.

Edition, 2002, Peter


H Wald)
Riwayat penyakit yang tepat, pemeriksaan badan & temperature rectal sebagai sarana
membuat diagnosis.
Tanda & gejala hipotermia mulai muncul pada suhu tubuh 36,1 OC. Menggigil terjadi pada
suhu tubuh 35OC, terus menurunnya suhu inti tubuh sebabkan respon kebingungan,
tingkah laku tidak biasa, koordinasi melemah, bicara tdk jelas, mengantuk, lesu,
lemah, disorientasi, ketidaksadaran. Akan ada penurunan kecepatan detak jantung,
dan RR. Denyut nadi melemah dan tensi menurun. Pergerakan melambat, menurun reflex
tendon.
Suhu 32,2 sampai 35OC, vasokontriksi peripheral dan menggigil terjadi. 25-32,2 OC
menggigil berkurang dan vasokonstriksi perifer akan hilang. < 25 OC aka nada gangguan
pada sistem pengaturan panas & mekanisme pertahanan panas tubuh. 30 32 OC terjadi
hilang kesadaran. Hilangnya fungsi SSP dan koma terjadi di <28 OC. Apnea <27OC, asistol
<22OC.
Perawatan
Hanya hipotermia ringan dalam keadaan sadar (> 32,2 OC) yang harus dihangatkan di
tempat. Suhu tubuh inti harus diukur & cegah kehilangan panas berlebih hangatkan
dengan penghangat pasif external (tempatkan dlm sleeping bag, selimut tertutup,
dekatkan dgn sumber panas)
Tingkatkan panas tubuh = menggigil + aktivitas fisik lain (berjalan), minum hangat non
kafein, minuman hangat non alkohol
Hipotermia sedang (< 32,2OC) dalam keadaan tidak sadar hati-hati diisolasi beri IV
line 5% dekstrosa + bawa ke instansi medis pemantauan fisiologis & pengawasan
penghangatan tubuh
Hipotermia berat (< 25-26OC) miokardium sgt mudah teriritasi, resiko tinggi fibrilasi
ventricular. Tidak dapat lakukan tindakan resusitasi (penghangatan aktif eksternal, RJP)
kecuali jika ada alat monitoring jantung tersedia. Segera mungkin bawa pasien ke
instalasi medis. Jika RJP sudah dilakukan, harus terus dilakukan hingga suhu pasien capai
36OC

Frostbite (CDC)
Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of
feeling and color in the affected areas. It most often affects the nose, ears, cheeks, chin,
fingers, or toes. Frostbite can permanently damage body tissues, and severe cases can
lead to amputation. In extremely cold temperatures, the risk of frostbite is increased in
workers with reduced blood circulation and among workers who are not dressed properly.
Symptoms
Symptoms of frostbite include:

Reduced blood flow to hands and feet (fingers or toes can freeze)

Numbness

Tingling or stinging

Aching

Bluish or pail, waxy skin

First Aid
Workers suffering from frostbite should:

Get into a warm room as soon as possible.

Unless absolutely necessary, do not walk on frostbitten feet or toes-this increases


the damage.

Immerse the affected area in warm-not hot-water (the temperature should be


comfortable to the touch for unaffected parts of the body).

Warm the affected area using body heat; for example, the heat of an armpit can
be used to warm frostbitten fingers.

Do not rub or massage the frostbitten area; doing so may cause more damage.

Do not use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator
for warming. Affected areas are numb and can be easily burned.

Trench Foot
Trench foot, also known as immersion foot, is an injury of the feet resulting from prolonged
exposure to wet and cold conditions. Trench foot can occur at temperatures as high as 60
degrees F if the feet are constantly wet. Injury occurs because wet feet lose heat 25-times
faster than dry feet. Therefore, to prevent heat loss, the body constricts blood vessels to
shut down circulation in the feet. Skin tissue begins to die because of lack of oxygen and
nutrients and due to the buildup of toxic product
If a Natural Disaster Occurs (CDC)

Follow instructions provided by local emergency and public health authorities. US


travelers visiting other countries can also seek advice from the nearest US
embassy.

Be aware of your surroundings and avoid hazards:


o

Be aware of the risks for injury during and after a natural disaster. After a
natural disaster, deaths are most often due to blunt trauma, crush-related
injuries, or drowning.

Be careful during clean-up. Avoid downed power lines, electrical outlets that
have been exposed to water, and interrupted gas lines.

Eat and drink only safe food and water.

Stay away from wild or stray animals.

Dont use electric tools or appliances while standing in water.

Avoid swiftly moving water during floods.

To prevent carbon monoxide poisoning, only use generators or other


gasoline-, propane-, natural gas-, or charcoal-burning devices outside and
away from open windows, doors, and air vents.

Be informed, make a plan, make a kit:


o

Be informed: know what type of emergencies happen in the area where you
are traveling.

Make a plan: have safe places identified for your family to meet if
separated, have a list of emergency contacts, and make sure you know how
to let your family know you are okay.

Make a kit: your travel health kit should include first-aid supplies and copies
of important documents (such as passport or prescriptions).

Seek medical care if you are injured, sick, or having trouble coping with stress.