Page 210 - ATP-P 11th Ed

h. If refreezing likely:
i. Do not attempt to thaw frostbitten tissue.
ii. Protect tissue from further injury by wrapping with dry Kerlix .
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(a) Separate digits with dressing.
i. Refreezing not likely:
i. Superficial
(a) Warm water immersion
(b) Warm extremity in axilla or groin.
(c) Drainage of clear blisters may be considered.
SECTION 2 ii. Deep ®
(d) Apply soft Kerlix type dressing.

(a) Warm water immersion 104–108° F (40–42° C) until tissue is soft (ap-
proximately 30 minutes).
(b) Apply loose dry dressing prior to transport.
(c) Pain Management per Pain Management Protocol.
(d) Do not drain hemorrhagic blisters.
3. Hypothermia
a. Move to warm environment, remove any wet clothing; and replace it with dry cover-
ings that will reducing further heat loss from evaporation, radiation, conduction, or
convection (e.g., HPMK , Blizzard Blanket , sleeping blanket with Mylar blan-
™
™
™
ket, etc.).
b. Do not put a cold patient in a shower or bath. A warm bath increases afterdrop.
Vasodilation and increased afterdrop could provoke cardiovascular collapse or ven-
tricular fibrillation.
c. Shield from wind.
c. If able to tolerate PO, provide food and hydrate patient.
d. Mild: exercise in place.
e. Moderate/Severe:
i. Do not exercise patient. Maintain supine position on insulation.
ii. Do not give patients food or oral fluids.
iii. If IV fluids are indicated, administer glucose-containing IV fluids warmed to
104° F (40° C) or 1 amp of D50.
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iv. Begin active rewarming (e.g., with heat source (e.g., Ready-Heat blanket, hot
water bottles, chemical packs, etc.)
v. If unconscious:
(a) Avoid sudden movements and rough handling due to increased ventricular
fibrillation risk.
(b) Assure airway patency.
(c) Check for 60 seconds for pulse and respirations due to bradycardia.

200 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 201