Bitter cold and MVA's

[scubanurse]

I've used the instant heat bags and wrapped the tubing around the IV line before....not sure how it would fair in extreme cold temps though.

[Arctickat]

We've got electric blankets in the ambulance and an extension cord. Plug it into the power inverter in the ambulance or into the FD gen set.

[AmboGuy]

As I read these wonderful answers, I worked in Queensland as a paramedic, where if it gets below 10 deg C, (50F) the poor blighters have to put on a jumper (pullover)

Now, right now, working as a rig medic (and bored shirtless) the first thing I thought about, what keeps the back of the MTC (industrial first aid unit) warm (well not frozen) so as freezables (remember guys and girls, defib pads and burn gels freeze too) don't have to be thrown away, 110v little fan heaters. If your in this situation, you should have fire on site, what does every fireie have, a generator, great, heat source, and electricity (when I get my own ambulance, I will get maybe one of those quiet Honda genny's to save a bunch of money idling all day. Anyway, back to topic, someone else said you wouldn't want them in some situations (overturned etc)

We are medics, why are we medics, we can think outside the box (unless your agency/service don't trust you and make you consult for a sneeze), we are thinkers.

We have different backgrounds or day jobs, so before you fall asleep, what about..... You all (assume) have seen the flexible foil lined hoses that vent your clothes dryer or bathroom (dunny) exhaust.... See where I am going!!

Cover the heater if outside on ground in frigid conditions (to help that air heat up) using your hose that you have modified to fit snugly over your heater, say 3m or ten odd feet, you now have a flexible heat source to leave near pt's feet, or near exposed body parts, just my trivial thought.

Guy

Oh, Queensland is in Australia, right now, northern Alberta, if you guys down south don't know where it is, go to the USA border, if you see Mexican flags, turn around

[MedicAsh]

This can be a common occurance here as well. What we do is do our best to keep the patient warm. We have wool blankets as well as regular cotton blankets. As for ourselves, we usually have the firefighter's tarp to block the wind, but usually I keep moving around. We will swap getting into the ambulance and getting things ready. This keeps us from getting too cold. We won't put warm fluids to a patient unless they are in the ambulance. We have had them freeze while outside on scene. I am lucky that I have been on few of these calls but they do happen. I like what others have said about the pocket warmers. I am going to have to do this next winter.

[island emt]

Wool is fine until it gets wet , OR you have a crew member or Patient Severely allergic to it.

Synthetic thermal blankets are much better with a wind barrier space blanket on the outside as a wrapper.

[Resqmedic]

I believe it was touched on in a earlier post, but confined space heaters are portable and actually work quite well in these conditions. You can take the propane heater a bit away and take the attached tube and run it right into the vehicle to directly heat the PTs and rescuers. Nice thing is you probably won't have to spend a dime to get one. Check out your local decon trailer, most of them have one, confined space teams will have them, and even utility companies will have them roaming around your community for under ground work. Call up the phone or power guys, I am sure they would be thrilled to help out.

[island emt]

Not something commonly found in rural areas.

Nearest decon trailer is well over an hour from us.

We don't have any manholes for the power or phone company to need heaters for.

While that will work in suburban areas ,we rural folks have to come up with our own solutions.

[WolfmanHarris]

It really comes down to two approaches: system based and on the fly.

System based would be everything your service and area has in place for these calls and can tap into and will vary so much area to area. For us, even though we have large rural areas in our catchment, we have lots of units to call upon. In a really prolonged rescue we'd utilize our Rehab/Treatment trailer, assign a Special Response Unit medic and Supervisor and likely another unit to rotate personnel. I would have fire, since there's so many of them set up tarps to block the wind. I'm also fairly certain we have heater units for our inflatable shelters which could be utilized. Prolonged extrication is also a consideration for HEMS so we'd look at getting them tiered. The bigger problem is the time it takes to get these resources in place. Getting the trailer on scene and set up is just not going to happen on most extrications and the shelters are stored in HQ not on the units.

On the fly I'd copy a lot of what's been said. Have fire tarp, tarp and tarp some more. Hopefully they have a rescue that can roll quicker than our stuff can since most trench/confined space rescue gear seems to include blowers for warm air. Raid all the heat packs and foil blankets and regular blankets from the truck and burrito that patient up. Call for a second unit for the hands, extra equipment (we don't carry dozens of heat packs) and rotating personnel as needed. Crank the heater in the truck and get the sauna going. Toss extra blankets on the seat of the truck and blast the vents on them as best you can. If done well and made a priority the patient can probably end up warmer than you.

For me I'm tossing my splash pants on and the outer layer to my coat and putting winter gloves over my nitriles and my thinner work gloves (they're oversized and cheap so they can go right in the trash after if need be), toque on under my helmet and hopefully that's enough.