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Hypothermia… In August?

5 comments

Called at 0700 for a a Man Down. As we near the scene the update indicates it is a 93 year old woman in her driveway, confused and cold. I honestly expected the typical fall, and, it being 60 degrees out, she was likely a bit chilly….

What I FOUND was actually much more serious. We found a woman, lying on the driveway, wet clothes, and COLD. Very cold. No longer shivering cold. Cardiac dysrhythmia cold. She could tell me her name, and that was it. Neighbors had found her while out walking, and told me she lived alone in this huge old house in the old money neighborhood of little big town.

She was cold. Seriously cold. It is August, we’re not supposed to have hypothermia cases… but a few things left her little chance… She weighed… soaking wet, might you say… 80 pounds. I suspect that even without the dampness she would be damn cold. I suspect she has been down a long time. She has abrasions on her hips and shoulders from dong what some call the “crappie flop”. Further, at 0700, it is rare to find an elderly fall victim fully dressed. She had jeans, blouse, and shoes on. Most of our early morning fall victims have their pajamas on still.

What got me was that she was wet. Not damp, but soaked. No sprinklers near, no pool. I KNEW she had been out since 10pm last night… in the middle of a 3/4 inch downpoor. Poor thing had laid in her driveway, alone and affraid in the middle of a god damn thunderstorm. Then laid out all night, till a passerby noticed her–and I don’t know how they did! She lives on a secluded street up a bendy driveway. Lucky, if you can call her that.

In the field we can do little for cases like this. Warmed IV fluid, blankets, and heat packs in the arm pits is all I had. Fortunately it is a short jaunt to the ED.

Guess her core temp….

84.7 degrees. Yup. Thats cold. Beyond Stage 3 hypothermia. She was in V-Tach(which we did NOT treat due to temp), respiration of 9, but her eyes were open, almost as if they were trying to say something to me….

I’m not sure if she survived. Often times Stage 3 Hypothermia ends in Organ Failure and cell death. This call just goes to show you that you can’t walk into a call close minded. It is flipping August and I just ran a severe hypothermia call.

Posted by on August 4, 2009 • Filed under: Crazy Calls, medic, Wow. • Tagged: , ,
  • EMT Tim

    Wow. That's not something you see every day.

    Do you actually warm the IV fluid, or I would assume air-temp is warm for her?

    They learnt us in skool that you need to be careful with hypothermia pt's, rough movement can send the heart into a lethal rhythm. Guess she was already there…

  • Medic(three)

    We have 3 bags of fluid that sit on a heating pad year round. We often use them in the winter for anyone that was outside. We rarely use them in the summer with the exception being (near)drownings.

    With hypothermic patients it is always a good idea to put them on a monitor prior to moving them(30 seconds will not kill someone who was outside for 12 hours. I had put hot packs in her armpits prior to moving as well.

  • Woodymedic

    Definitely not your typical summertime call. We had a "Unconcious" this winter during a 38F day. Pt was found by her landlord inside her cottage, naked on the floor. When we arrived, as usual, there was approx. a foot of work space around her. She appeared to be laying urine, cold and doughy to the touch. Only other clues we had nearby was a glucometer on the counter and a bottle of Tequila, 3/4 empty under her bed. I was able to elicit a moan, but not much more. BP was in the high 80's,RR 22 (Kussmal), HR 70's, Sinus arrythmia on the monitor, CBG was 400mg/dl. So, I was assuming a combination of ETOH abuse and her diabetes not agreeing with the winter weather. Started O2,and a quick IV with dashboard warmed fluid. Then, my challenge was attempting to maneuver her 300lbs out of her cramped cottage around all her furniture and piles of things safely without throwing her into cardiac mischief. Fortunately, Sinus rhythm prevailed. Code 3 to the hospital, 6 min transport time, 10 min on scene time. Arrived to the hospital to find out the ER no longer warms IV bags, and their Bair Hugger was missing. They found her core temp to be 86.4F. They sent her to CT to check for CVA, then directly to ICU where she coded and died after one hour of attempted resus. I was surprised by the ER's lack of preparation for the cold weather, and CT before warming?? Not sure about that either. Frustrating and unfortunate.

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