SavedAdd your journal

Journals / Acta Medica Alanya / 2026 / Cilt: 10 Sayı: 3

Prehospital Assessment of Cold Exposure in Casualties Following a Chairlift Malfunction

Telesiyej Arızası Sonrası Kazazedelerin Soğuk Maruziyeti Açısından Hastane Öncesi Değerlendirilmesi

Ayça Çalbay(ATATURK UNIVERSITY)0000-0002-7031-2689
Pages
224–230
Publication Date
2026-10-20
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The study highlights the importance of rapid triage, proper thermal management, and EMS preparedness in mass cold-exposure events.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Hypothermia is a preventable condition frequently encountered in emergency medical services at high-altitude ski resorts.
📊
Key Findings & Data:Methods: In this retrospective observational study, 18 adult victims exposed to temperatures between –7°C and –24°C for 90–180 minutes at altitudes of 2.230–2.507 meters were analyzed.
💡
Conclusion & Impact:The study highlights the importance of rapid triage, proper thermal management, and EMS preparedness in mass cold-exposure events.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Kazara hipotermi · soğuğa maruz kalma · acil sağlık hizmetleri

Abstract

Aim: Hypothermia is a preventable condition frequently encountered in emergency medical services at high-altitude ski resorts. This study aimed to evaluate the demographic and clinical characteristics of patients affected during a high-altitude cable car malfunction and prehospital management priorities after cold exposure caused by a chairlift malfunction. Methods: In this retrospective observational study, 18 adult victims exposed to temperatures between –7°C and –24°C for 90–180 minutes at altitudes of 2.230–2.507 meters were analyzed. Body temperature was measured using a non-contact infrared thermometer. Patients were categorized as cold stress (35–37°C) or mild hypothermia (32–35°C). Vital signs, symptom distribution across 30-minute exposure intervals, hospital arrival times, and triage codes were statistically compared (p<0.05). Refusal of on-site medical assessment was recorded only as an operational note and was not analyzed as a clinical variable. Results: Mild hypothermia developed in 22.2% of patients and occurred exclusively in females. Cutis marmorata and facial erythema were significantly associated with lower body temperature (p<0.001). Exposure beyond 150 minutes was strongly associated with facial and extremity erythema (91.7%, p=0.004). Heart rate showed a borderline increase with longer exposure duration (p=0.085). Dyspnea peaked in the intermediate exposure group (p=0.004). Although triage codes were not statistically correlated with measured temperature, no patient classified as green had a body temperature below 35°C. Conclusion: In high-altitude prehospital settings, peripheral clinical findings may provide critical risk stratification when core temperature cannot be measured. Continuous monitoring, dynamic triage reassessment, and early external warming are essential to prevent progression toward cardiovascular and neurologic compromise. The study highlights the importance of rapid triage, proper thermal management, and EMS preparedness in mass cold-exposure events.

Özet

Amaç: Hipotermi, yüksek irtifa kayak merkezlerinde acil tıbbi hizmetlerde sıklıkla karşılaşılan önlenebilir bir durumdur. Bu çalışma, yüksek irtifa teleferik arızası sırasında etkilenen hastaların demografik ve klinik özelliklerini ve teleferik arızası nedeniyle oluşan soğuk maruziyetinden sonra hastane öncesi yönetim önceliklerini değerlendirmeyi amaçlamıştır. Yöntem: Bu retrospektif gözlemsel çalışmada, 2230-2507 metre irtifada 90-180 dakika boyunca -7°C ile -24°C arasındaki sıcaklıklara maruz kalan 18 yetişkin hasta analiz edildi. Vücut sıcaklığı temassız kızılötesi termometre kullanılarak ölçüldü. Hastalar soğuk stresi (35-37°C) veya hafif hipotermi (32-35°C) olarak sınıflandırıldı. Yaşam belirtileri, 30 dakikalık maruz kalma aralıklarındaki semptom dağılımı, hastaneye varış süreleri ve triyaj kodları istatistiksel olarak karşılaştırıldı (p<0.05). Yerinde tıbbi değerlendirmeyi reddetme durumu yalnızca operasyonel bir not olarak kaydedildi ve klinik bir değişken olarak analiz edilmedi. Bulgular: Hastaların %22.2'sinde hafif hipotermi gelişti ve bu durum yalnızca kadınlarda görüldü. Cutis marmorata ve yüz eritemi, düşük vücut sıcaklığıyla anlamlı derecede ilişkiliydi (p<0.001). 150 dakikadan fazla maruz kalma, yüz ve ekstremite eritemiyle güçlü bir şekilde ilişkiliydi (%91.7, p=0.004). Kalp atış hızı, daha uzun maruz kalma süresiyle sınırda bir artış gösterdi (p=0.085). Nefes darlığı, orta düzeyde maruz kalma grubunda zirve yaptı (p=0.004). Triyaj kodları ölçülen sıcaklıkla istatistiksel olarak ilişkili olmasa da, yeşil olarak sınıflandırılan hiçbir hastanın vücut sıcaklığı 35°C'nin altında değildi. Sonuç: Yüksek rakımlı hastane öncesi ortamlarda, çekirdek sıcaklığı ölçülemediğinde periferik klinik bulgular kritik risk sınıflandırması sağlayabilir. Kardiyovasküler ve nörolojik bozulmaya doğru ilerlemeyi önlemek için sürekli izleme, dinamik triyaj yeniden değerlendirmesi ve erken dıştan ısıtma şarttır. Çalışma, kitlesel soğuk maruziyeti olaylarında hızlı triyajın, uygun termal yönetimin ve acil tıbbi hizmetlerin hazırlığının önemini vurgulamaktadır.

🔖

Cite This Article

Çalbay, A. (2026). Prehospital Assessment of Cold Exposure in Casualties Following a Chairlift Malfunction. Acta Medica Alanya, Cilt: 10 Sayı: 3, 224–230. https://doi.org/10.30565/medalanya.1759429

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (23)

  1. Lott C, Truhlář A, Alfonzo A, Barelli A, González-Salvado V, et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation. 2021;161:152-219. doi: 10.1016/j.resuscitation.2021.02.011. Erratum in: Resuscitation. 2021;167:91-92. doi: 10.1016/j.resuscitation.2021.08.012.
  2. Kantar Y, Baykan N, İpekten F, İmamoğlu M. Comparison of Pre-Hospital Preliminary Diagnosis and Definitive Diagnosis in Emergency Department. Acta Med Alanya 2024;8(1):37-42 doi: 10.30565/medalanya.1443645
  3. Dow J, Giesbrecht GG, Danzl DF, Brugger H, Sagalyn EB, et al. Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update. Wilderness Environ Med. 2019;30(4S):S47-S69. doi: 10.1016/j.wem.2019.10.002.
  4. Acosta FM, Martinez-Tellez B, Sanchez-Delgado G, Alcantara JMA, Acosta-Manzano P, et al. Physiological responses to acute cold exposure in young lean men. PLoS One. 2018;13(5):e0196543. doi: 10.1371/journal.pone.0196543.
  5. Foltýnová HB, Vejchodská E, Rybová K, Květoň V. Sustainable urban mobility: one definition, different stakeholders’ opinions. Transp Res D Transp Environ. 2020;87:102465 doi: 10.1016/J.TRD. 2020.102465.
  6. Escobar GDA, Sarache W, Jiménez-Riaño E. The impact of a new aerial cable-car project on accessibility and CO2 emissions considering socio economic stratum. A case study in Colombia. J Clean Prod. 2022;340:130802. doi: 10.1016/J.JCLEPRO.2022.130802.
  7. Olgun A, Mazlum U. Recommendations on cable car accident, licensing andmaintenance. New Era International J Interdisciplinary Social Res. 2024;9(24):43–53. doi: 10.5281/zenodo.12535260
  8. Ersunan G, Bılır O, Balık MS. Primitive cable car “varangel” accidents in the Black Sea region of Rize in Turkey. J Exp Clin Med. 2016;33(2). doi: 10.5835/jecm.omu.33.02.003.
  9. Usta G, Torpuş K, Gündüz F, Atalay E. Evaluation of cable car accidents and rescue operations. Disaster Med Public Health Prep. 2024:18:e319. doi: 10.1017/dmp.2024.322.
  10. Toner, M. M, and W. D McArdle. “Human Thermoregulatory Responses to Acute Cold Stress with Special Reference to Water Immersion.” In Fregly MJ, Blatteis CM, Eds. Environmental Physiology, Vol. 1. New York: Published for the American Physiological Society by Oxford University Press, 1996.
  11. Glickman-Weiss EL, Cheatham C, Caine N, Blegen M, Marcinkiewicz J, Mittleman KD. The influence of gender and menstrual phase on thermosensitivity during cold water immersion. Aviat Space Environ Med. 2000;71(7):715-22. PMID: 10902935
  12. McArdle WD, Magel JR, Gergley TJ, Spina RJ, Toner MM. Thermal adjustment to cold-water exposure in resting men and women. J Appl Physiol Respir Environ Exerc Physiol. 1984;56(6):1565-71. doi: 10.1152/jappl.1984.56.6.1565.
  13. McArdle WD, Magel JR, Spina RJ, Gergley TJ, Toner MM. Thermal adjustment to cold-water exposure in exercising men and women. J Appl Physiol Respir Environ Exerc Physiol. 1984;56(6):1572-7. doi: 10.1152/jappl.1984.56.6.1572.
  14. Durrer B, Brugger H, Syme D, and the International Commission for Mountain Emergency Medicine. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendationHigh Alt Med Biol. 2003;4(1):99-103. doi: 10.1089/152702903321489031.
  15. Jolly BT, Ghezzi KT. Accidental hypothermia Emerg Med Clin North Am. 1992;10(2):311-27. PMID: 1559471
  16. Veicsteinas A, Ferretti G, Rennie DW. Superficial Shell insulation in resting and exercising men in cold water. J Appl Physiol. 1982;52(6):1557–64. doi: 10.1152/jappl.1982.52.6.1557.
  17. Kozyreva T. Neurophysiological aspects of the long-term adaptation to cold in mammals: the role of central and peripheral thermoreceptors. J Therm Biol. 2006;31(1–2):105–114. doi: 10.1016/j.jtherbio.2005.11.003.
  18. Charkoudian N. Mechanisms and modifiers of reflex induced cutaneous vasodilation and vasoconstriction in humans. J Appl Physiol (1985). 2010;109(4):1221-8. doi: 10.1152/japplphysiol.00298.2010.
  19. Stephens DP, Saad AR, Bennett LA, Kosiba WA, Johnson JM. Neuropeptide Y antagonism reduces reflex cutaneous vasoconstriction in humans. Am J Physiol Heart Circ Physiol. 2004;287(3):H1404-9. doi: 10.1152/ajpheart.00061.2004.
  20. Castellani JW, Young AJ. Human physiological responses to cold exposure: Acute responses and acclimatization to prolonged exposure. Auton Neurosci. 2016;196:63-74. doi: 10.1016/j.autneu.2016.02.009.
  21. Young AJ, Castellani JW, O'Brien C, Shippee RL, Tikuisis P, et al. Exertional fatigue, sleep loss, and negative energy balance increase susceptibility to hypothermia. J Appl Physiol (1985). 1998;85(4):1210-7. doi: 10.1152/jappl.1998.85.4.1210.
  22. Pasquier M, Cools E, Zafren K, Carron PN, Frochaux V, Rousson V. Vital Signs in Accidental Hypothermia. High Alt Med Biol. 2021;22(2):142-7. doi: 10.1089/ham.2020.0179.
  23. Castellani JW, Tipton MJ. Cold Stress Effects on Exposure Tolerance and Exercise Performance. Compr Physiol. 2015 Dec 15;6(1):443-69. doi: 10.1002/cphy.c140081.