D257. Severe winter weather
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D257. Severe winter weather
Q
With forecasts showing that a severe winter may be on the way, what are the symptoms of hypothermia, how can you treat it and how do you reduce risks for service users?
A
Hypothermia is a very real risk for older people, especially those with medical conditions that make them vulnerable to the cold. Care homes should ensure that all of their staff are trained to recognise the signs and symptoms of hypothermia and know what to do if they suspect a resident may be suffering from it.
Hypothermia is a reaction of the body to intense cold. It occurs when a person’s body temperature drops below 35°C. Symptoms include shivering, tiredness, fast breathing and cold or pale skin. In more severe cases, where the body drops below 32°C, a person may be unable to think straight. He or she may become confused and may have difficulty moving about. The speech may become slurred, and the breathing may shallow. People with a body temperature of 32°C or lower will usually stop shivering completely. With a body temperature below 28°C, they may lose consciousness and appear to be dead.
Hypothermia is a medical emergency, and an ambulance should be called immediately. While waiting for help to arrive, staff should keep the service user as warm as possible by covering with blankets and moving in from the cold and perform cardiopulmonary resuscitation (CPR) if he or she shows no sign of life.
Older people can be vulnerable to the cold and every year many older people die from living in cold conditions in the community. Deaths have even happened in care homes.
Older people generally move about less and therefore do not generate heat. In addition, they may have medical conditions, such as heart or circulatory problems, which render them vulnerable to the cold.
To lessen the risks of hypothermia, care staff should identify residents who might be at risk and take action to protect them. Any required actions should be agreed with the resident concerned, and with their relatives or carers, and added to their plan of care. Where a service user is transferred from hospital after a period of illness he or she should be reassessed, and the plan of care reviewed and adjusted. Medication may also need to be reviewed as some drugs interfere with the body’s ability to regulate temperature.
Managers should make sure that heating systems are working effectively before winter conditions start. Boilers and heating systems should be properly maintained and serviced by appropriately trained and qualified engineers. Thermostats and radiators in service users’ rooms should be checked. Service users should all have effective heating systems in their rooms and in communal areas. To protect service users against power cuts and system failures, managers should keep a current list of emergency contact phone numbers for electricity, gas and water suppliers. Contingency plans should be in place. These should include emergency back-up heating as well as a supply of spare blankets.
When going outside in the cold, residents should be encouraged to dress warmly. Managers should monitor weather alerts and take appropriate action if seriously cold weather is forecast. They should monitor the temperatures in residents’ rooms and ensure that regular checks are made on residents who may be at risk. Care staff should ensure that they are dressed warmly. Hot food and regular hot drinks should be provided. Caffeine and alcohol should be avoided.
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