Cold Weather Considerations

1 Hypothermia — The Silent Threat

• “Stable” patient can crash without warning
• Use Heat/Blizzard Blanket immediately
• Insulate underneath — ground steals heat fastest
• Limit exposure to cold wind and ground
• Seconds matter — every moment exposed is heat lost

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2 Hemorrhage Control Challenges

• You lose dexterity — TQs slip more in cold
• Cold, blanched skin mimics inadequate perfusion
• Blood clots slower when limb is frozen
• Hemostatic agents work slower in cold
• Practice TQ application with gloves

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3 Airway & Respiration

• Cold air triggers bronchospasm
• BVM valves stiffen — may malfunction
• Fogging kills visibility
• Respiratory fatigue happens faster
• Secretions thicken, harder to clear

Adapt: Keep BVM/airway equipment warm inside clothing layer

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4 Wound Care

• Open wounds freeze → additional tissue damage
• Dressings harden, lose conformability
• Tape and adhesives fail in cold
• Irrigation becomes dangerous — can cause cold injury
• Perfusion slows → slower clot formation
• Cold increases infection risk

Adapt: Cover wounds immediately. Warm dressings against body before applying.

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5 Gear & Evacuation

Problem	Items Affected
Lose stretch/adhesion	Elastics, tape, chest seals
Die faster	Batteries (2-3x faster drain)
Crack/break	Plastics, litters
Freeze shut	Zippers, IV tubing
Stick to skin	Metal tools

Evac Reality:

• Ropes and straps freeze stiff
• Radio batteries fail
• Ground movement 2-4x slower
• Helicopter ops may be limited
• Plan for extended timelines

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Cold Weather MARCH Quick Adjust

Step	Cold Addition
M	TQs harder, clotting impaired
A	Bronchospasm, equipment stiffens
R	BVM fails, seals lose adhesion
C	Skin color unreliable, IVs freeze
H	Already happening — act immediately