Bitter cold and MVA's

[island emt]

My thinsulate duck hunting bibs are much warmer than my turnout pants and coat. Pus they are much more flexible and easy to don. they have zippers up the side all the way up to mid thigh, you can put them on without taking your winter boots off.. Turnout boots do not really keep your feet warm with steel sole plates and arch supports.

Our uniform parkas have both the BBP lining and a removable inner fleece inner liner under the high vis dayglow lime ANSI 3 outer shell. A FF balaclava is a good idea for head and face protection from severe cold & wind. Until it ices up from exhaling through it

As far as limiting time outside in Extreme conditions, You sometimes don't have the resources available to make that happen. In rural areas, The next due service could be 30 minutes to an hour away.

[ClutzyEMT]

I am the proud new owner of a pair of thinsulate lined "Hunting" bibs... of course they are about eight inches too long, but I'm sure I can walk that off in a few years...LOL...plus they give me room to grow in the belly region just in case winter lasts too long. The Large in the youth was a bit snug so had to go with the XSmall in the 'grown up' section. (after searching several stores for an XS) I was fortunate that I had both a hoodie and a turtleneck on as well as my polar cap so my face stayed protected pretty well but I've always had trouble keeping my hands and feet warm and I'm sure this experience will not help in the future.

Today was in the 20's so I'm hoping the bitter cold snap is over for this winter. Usually when we have a bad accident in this area we can call in resources from 15 to 30 miles away, but due to the weather and blizzard conditions we did not have that luxury this time. I will be putting into place an SOP that will include a "calling tree" for back up during storm conditions as well as HP or LE to transport them to the scene if need be. The back up personnel will be notified during stormy weather that they need to prepare to possibly be called out to a scene should we have something like this in the future and there will be another crew left in town to cover that as well.

Fire/Extrication has also been putting their heads together and trying to come up with some portable heat that could be transported in one of their units as well. Everyone was affected by that call, not so much by the nature of the call, but the complete inability to provide basic heat for the patients in such dire circumstances....

[island emt]

I can build you a rack to stretch you clutzy. Ought to be able to get you to 5'4" in a few days.

[Bernhard]

One trick I heard of but never used myself yet: mobile halogen floodlights of FD could be used as local heat supply. Mountain rescue around here uses special blankets and i.v.-warmers, due to their usual scenes they're limited in weight & space, to carry much more high tech equipment. In ground EMS we have a storage comparzment for warmed iv's. But not much more beside blankets. Allthough I'm looking for solutions since years... On our mass casualty trucks we carry oil heaters, warming up a tent in minutes. We didn't use that yet for still entrapped patients, maybe a possibility. For providers good and dry clothes are essential. Everyone of my response group has a clothing set fitting local climate more or less appropriate. We additionally can set up a heated tent (see MCI truck above) and may offer hot tea if there is enough time (and no need to treat multiple patients). Mostly used on fire scenes or SAR scenarios.

[ClutzyEMT]

Only if I get to come and use the rack there my friend.

Are you hiring dinosaurs??

I like the idea of Halogen floodlights...could work dual capacity with them..

[paramedicmike]

Do your fire guys carry portable heaters for rehab tents in cold weather? Some of the local departments here carry them in the winter time. How about setting those up and direct the warm air flow to the patients?

[mikeymedic1984]

Just a side note, do you yankees keep your backboards inside the truck during conditions such as these, so that they will be warm(er) ? Nothing like being naked on a 20 degree backboard ?

[Bernhard]

Do your fire guys carry portable heaters for rehab tents in cold weather? Some of the local departments here carry them in the winter time. How about setting those up and direct the warm air flow to the patients?

We carry this in our MCI truck. Heats up a tent in minutes:

Meanwhile there are much smaller units, could be stored in a small compartment, needs just to be fueled from a diesel canister, just like this one:

Both of them could be used to heat up locally, even outside, when ouput flow is somewhat directed. Disadvantage would be operating them in hazardous or explosive environments...(as a flipped over car could provide)...

[Richard B the EMT]

The long spine boards are usually in an unheated outside compartment, so we use, minimally, a sheet as an insulation between the board and patient, preferably a blanket.

I have to ask, but...IV bag heaters are a good idea, but what about the fluid actually in the IV line? Doesn't the possibility of the fluid freezing, between the bag/bottle, and the needle in the patient exist?

Edited February 26, 2013 by Richard B the EMT

[Bernhard]

We once had an excercise where the fluid actually froze in the line. But this was most probably due to the fact, that we didn't used i.v. bag heaters AND the lines weren't running (after all, it just was an excercise - cannulas were applied and connected just for fake). And it was a cold november wind blowing over a large airfield. It never occured to me since then. I think, a steadily running fluid is not very likely to freeze - above a certain temperature...

Could be tested easily, though.

BTW: a lot of the "victims" were sick afterwards. They were from army and federal police and those tagged black were ordered to "play death" in very loud voice by their superiors allthough shivering from cold. We even weren't allowed to give the "death bodies" blankets...