# Whos more susceptible to the cold? Infants or elderly people?



## CobraIV (Oct 27, 2011)

My friend is in nursing school to be an RN. We were talking and got on the topic of hypothermia. I remember from my emt class both infants and elderly have a tendency to be susceptible to the cold. I thought infrants have more of a chance to have hypothermia since they take up less space with there small bodies. She started telling me elderly are more susceptible to hypothermia since some elderly folks are on coumadin that thin out there blood. Regardless of what I know she claims shes right. My question is whos more susceptible to the cold? Infants or Elderly people?

Thanks


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## STXmedic (Oct 27, 2011)

CobraIV said:


> She started telling me elderly are more susceptible to hypothermia since some elderly folks are on coumadin that thin out there blood.



LOL! How far into nursing school is your friend?!


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## CobraIV (Oct 27, 2011)

far enough to think she knows it all, i take that back shes really not my friend shes my friends girlfriend.


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## DV_EMT (Oct 27, 2011)

My 2 cents....

Old people shouldn't get the cold more often because they've been around for a long time (though their systems may be weakened because of their age)

Infants put everything in their mouths and god knows where its been...

I'd put my money on infants... but I wouldn't put elderly behind by much


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## JPINFV (Oct 27, 2011)

CobraIV said:


> She started telling me elderly are more susceptible to hypothermia since some elderly folks are on coumadin that thin out there blood.









Anticoagulants don't work like that.

In terms of thermoregulation, infants sleep more and have a larger surface area to mass ratio, whereas elderly patients tend to lose body mass and have thinner skin.

In terms of the common cold, both have immune function issues (which, for infants, is one of the benefits of breast milk over formula). 

For either thermoregulation or the common cold, I'm not sure which population as a whole is affected more.


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## medichopeful (Oct 28, 2011)

CobraIV said:


> She started telling me elderly are more susceptible to hypothermia since some elderly folks are on coumadin that thin out there blood.



Ahh yes, the relatively unknown side effect of blood thinners! :rofl:


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## mycrofft (Oct 28, 2011)

*"IF a lion an a alligator got in a fight who'd win?"*

Babies are potentially more susceptible to cold because to the surface area versus cubic volume laws, but you have to treat each individual separately because of individual responses to cold.

It isn't anti-coagulation but anemia/iron deficiency that make one feel colder.


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## Yarbo (Oct 29, 2011)

I'd go with infants no question in my opinion.


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## Handsome Robb (Oct 29, 2011)

Lil guys. Surface area vs mass like other people have said.

Old people aren't far behind.

Both are more susceptible to illness than adults.


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## BrushBunny91 (Oct 29, 2011)

My experience tells me infants cause old people can put a sweater on, or ask someone to help them put one on. Throw a couple of warming pads in there too.


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## Underoath87 (Oct 29, 2011)

Depends on the individual patient and the situation.  
But the elderly are more likley to suffer from urban hypothermia without realizing it (where they slip into hyperthermia-induced lethargy while sitting in their own unheated living room).
Kids have a properly functioning nervous system and will recognize that they are cold, so hypothermia would likely only be an issue if they have no clothing to put on or are too young to care for themselves.


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## firetender (Oct 29, 2011)

...so we put a baby and an old guy into a freezer and start the clock...

what would be the selection criteria?


I suspect there are just too many variables to make a general call on this.


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## JPINFV (Oct 29, 2011)

firetender said:


> ...so we put a baby and an old guy into a freezer and start the clock...
> 
> what would be the selection criteria?



The selection criteria would be the IRB.


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## medicnick83 (Nov 17, 2011)

I find that young children and the elderly suffer the most.


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## STXmedic (Nov 17, 2011)

medicnick83 said:


> I find that young children and the elderly suffer the most.



Uhh... I think that's what the title of the thread is getting at...


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## lawndartcatcher (Nov 18, 2011)

firetender said:


> ...so we put a baby and an old guy into a freezer and start the clock...
> 
> what would be the selection criteria?
> 
> ...



http://www.fanpop.com/images/polls/25499_15_full.jpg

Sorry...couldn't resist.


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## WTEngel (Nov 18, 2011)

From a logical stand point, infants are at more risk, for the simple fact that they can not voice that they are cold, whereas that is sometimes the ONLY complaint the elderly voice (and voice often...)

Now when you start talking about dementia and Alzheimer's, and other degenerative conditions of the brain, I would put them at about the same level as infants, or even potentially more at risk, because the general instinct is to cover and wrap infants (too much sometimes), whereas the elderly are often left to their own devices. It is not unlikely, in fact maybe even a commonality, to find an elderly person with dementia who has wandered out into the cold without a coat, or falls on the way to the mailbox, only to be discovered hours later.

Just from a patho stand point though, infants have a higher risk for hypothermia. As has already been pointed out, they have a higher BSA to mass ration, and lose heat almost insensibly when left uncovered. The nervous systems of infants are less developed too, making their ability to shiver or use other muscular methods of generating heat minimal.

I have been to referrals to transfer infants who have been left exposed on a hospital bed or in an ohio warmer that was not turned on, and witnessed core temps of 95 or 96 before. It is not that hard to do. Keep those babies covered! Unless they have a fever, in which case, a normal layer of clothing appropriate for the season is good enough.


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## jjesusfreak01 (Nov 21, 2011)

Infants for sure. They lack adequate thermoregulation and cannot communicate to others their discomfort. Also, infants have a much smaller temp range before they start becoming symptomatic.


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## Rural EMT (Nov 30, 2011)

Would also go with infants/Neonates as having the higher risk factor, as said previously they are unable to adequately self regulate body temperature (by means of philoerection/shivering/voicing there discomfort etc.) The larger head to body ratio in comparison to that of an adult is also a factor that may rapidly lead to Hypothermia.

With all this said and done i would not discount the seriousnes of a hypothermic geriatric patient (other med Hx aside) . 

I'm interested to know of your treatment plan for a Hypothermic patient? 
Do you also use warm ( use that word hesitantly ) fluids to centrally warm or just blankets and other warming products?

Here in SA things seem bit different to the rest of the world!


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## usafmedic45 (Nov 30, 2011)

> She started telling me elderly are more susceptible to hypothermia since some elderly folks are on coumadin that thin out there blood







Please don't assist her in breeding.  We have enough morons on this planet as it is.  In fact, you get the chloroform, I'll bring my pocketknife and some sterilized fishing line and we'll tie her tubes.  

To actually answer the question, it would depend on the makeup of each person (BMI, body fat percentage, etc), their given metabolic condition and any underlying medical conditions that might be present.  You really can't say that one is more prone to hypothermia, just that both groups are prone more so than an average middle-aged person.


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## usafmedic45 (Nov 30, 2011)

JPINFV said:


> The selection criteria would be the IRB.









There are times where I would like to go take a dump on the grave of Sigmund Rascher.  This is one of them. LOL


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## mycrofft (Nov 30, 2011)

*Oh, come on!*

Quit telling me this can't be cook booked, that flies in the face of thirty years of  Highway Traffic Adminstration's emergency medical practice!
(Build an overpass, correct a metabolic imbalance...shoot,  how different can those really get, huh?).


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## bigbaldguy (Nov 30, 2011)

Lets take away all variables and assume your dealing with two big peices of tofu. One is 20 pounds one is 120 pounds, both are 98.8 degrees, you put both in the freezer for one hour. Which is colder? Of course then you add back in all the variables like metabolic rate, Ect and it gets complicated. I still think that everything being equal a 20 pound infant will go hypothermic faster than a 120 pound old man.


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## JPINFV (Nov 30, 2011)

The problem is the metabolic and skin thickness issues. The infant is going to have a lot more brown fat than the elderly man.


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## bigbaldguy (Nov 30, 2011)

JPINFV said:


> The problem is the metabolic and skin thickness issues. The infant is going to have a lot more brown fat than the elderly man.



Had to google brown fat. For those too lazy to do so.

Brown adipose tissue (BAT) or brown fat is one of two types of fat or adipose tissue (the other being white adipose tissue) found in mammals.
It is especially abundant in newborns and in hibernating mammals.[1] Its primary function is to generate body heat in animals or newborns that do not shiver. In contrast to white adipocytes (fat cells), which contain a single lipid droplet, brown adipocytes contain numerous smaller droplets and a much higher number of mitochondria, which contain iron and make it brown.[2] Brown fat also contains more capillaries than white fat, since it has a greater need for oxygen than most tissues.

I learn new things every day


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## mycrofft (Nov 30, 2011)

*If it means anything*

...after earthquakes and landslides, more often infants are found alive than the elderly. Maybe because they fit into voids better.


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## bigbaldguy (Nov 30, 2011)

mycrofft said:


> ...after earthquakes and landslides, more often infants are found alive than the elderly. Maybe because they fit into voids better.



They also bounce....or at least ive been told the boys do. I imagine that would be a useful ability in a lane slide.

So if I'm reading the info on brown fat correctly, and I'm probably not since I'm having to google every third word. Babies because of their high brown fat content are metabolically similar to bears in their ability to produce body heat without shivering. Adults compensate for this loss of brown fat by shivering to create body neat. Old folks tend to shiver less effectively than younger adults and at the same time lack the brown fat as well so are effectively unable to compensate for cold. 

Does this sound about right?


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## Dwindlin (Nov 30, 2011)

bigbaldguy said:


> They also bounce....or at least ive been told the boys do. I imagine that would be a useful ability in a lane slide.
> 
> So if I'm reading the info on brown fat correctly, and I'm probably not since I'm having to google every third word. Babies because of their high brown fat content are metabolically similar to bears in their ability to produce body heat without shivering. Adults compensate for this loss of brown fat by shivering to create body neat. Old folks tend to shiver less effectively than younger adults and at the same time lack the brown fat as well so are effectively unable to compensate for cold.
> 
> Does this sound about right?



Yes.  Brown fat is a very potent source of heat generation for newborns, and should give them an edge over the elderly who both have no brown fat and have likely a decreased ability to generate heat by shivering.


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## usafmedic45 (Nov 30, 2011)

> They also bounce....or at least ive been told the boys do. I imagine that would be a useful ability in a lane slide.



It has its benefits and drawbacks just like anything else.


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