Stormwind Medical Handbook: Temperature Related Illness

Stormwind
Medical Handbook
1. Medical Theory & Anatomy
2. Medical Duties
3. Soft Tissue Wounds
4. Bone Fractures
5. Head & Eye Injuries
6. Chest & Abdominal Injuries
7. Shock
8. **Temperature Related Illness**
9. Toxins & Poisons
10. Magical Wounds

The **Temperature Related Illness** chapter of the Stormwind Medical Handbook covers the terminology and treatment of common illnesses brought upon by extreme temperatures. All medical staff should be able to identify and treat these illnesses and determine triage based on the severity.

It is recommended that all medical personnel read and comprehend the Medical Theory & Anatomy and Soft Tissue Wounds chapters of this handbook before attempting any treatment outlined in this chapter.

**Disclaimer:** The information edited here has been adjusted to suit the lore of World of Warcraft, and is not meant to be used as real-life saving techniques. Techniques utilized, and information contained in this document may not be best practice.

## Terminology

Common **Temperature Related Illness Terminology** will be defined and explained below.

### Burns

Partial-thickness skin burns are sometimes called first-degree burns. A superficial burn looks like a sunburn; pink to red, and painful. The skin may be cooled with water initially, though ointments consisting of egg, honey, vinegar, mint, and other herbs may be applied to the skin to alleviate pain and aid with healing.

A burn that affects the skin and causes blisters is called a second degree superficial burn. A severe sunburn can be a superficial partial-thickness burn. Superficial, partial-thickness burns are associated with painful blisters and red or pink skin. The burnt area will exude moisture as sweat, so efforts should be made to keep the patient’s humours balanced with plenty to drink. Ointments consisting of egg, honey, vinegar, mint, and other herbs may be applied to the skin to alleviate pain and aid with healing.

A deep tissue third degree burn is one which affects the skin and underlying fat. They are typically characterized by large, thick-walled blisters or, red exposed skin. Sensation is still present in the tissue and it will be sensitive to cold. Ointments consisting of egg, honey, vinegar, mint, and other herbs may be applied to the skin to alleviate pain and aid with healing. The burnt area should be wrapped in dry cloth bandages. Deep tissue burns are extremely painful and may send the victim into shock. If so, the patient should be provided with ample fluids to drink in order to balance their humours.

A full thickness fourth degree burn involves the skin and underlying tissues, including fat, muscles, and bone. Full-thickness burn typically appear dry, feel leathery, and may be red, white, brown, or even charred black. The burned tissue usually lacks sensation. Amputation is the only option for tissue burnt this severely. If a significant amount of flesh has sustained fourth degree burns, the patient may experience shock and require emergency fluid replacement and magical healing to balance their humours.

### Frostbite

Frostbite is the condition in which bodily tissue freezes beyond the body’s ability to rewarm it. Blood vessels in the skin and extremities constrict when exposed to extreme cold. If tissue is not rewarmed, blood clots form and circulation to the affected area decreases. First degree frostbite is superficial surface skin damage that is usually not permanent. The primary symptoms include a loss of feeling in the skin, numbness, and skin that is swollen with a reddening border. If continued frostbite occurs, the affected skin can slough off.

Second degree frostbite usually develops clear blisters early on in addition to flesh hardening. This stage is marked by an imbalance of humors in the affected areas, and tissue may corrupt and die. There tends to be an increased sensitivity to the cold at this stage. In the weeks following second degree frostbite, the hardened, blistered skin dries, blackens, and peels off.

Third degree frostbite affects the deeper layers of tissue and can cause permanent damage to the skin itself. The victim often experiences numbness, loss of sensation of cold, pain, or discomfort. Joint and muscle function may be compromised as this point. Large blisters may form and the affected area may become blackened and necrotic. In severe cases, the blood vessels themselves freeze and the affected area becomes unsalvageable without healing magic.

### Hypothermia

Hypothermia, as opposed to 'hyperthermia', is caused by the core temperature of the body dropping below normal operating levels. Hypothermia displays symptoms in a rapidly progressive nature. Mild hypothermia symptoms will generally be displayed as a gradual increase in the rate and force of shivering. Moderate hypothermia will often be characterized by violent shivering, loss of motor/coordination skills, mild confusion, and the lips, ears, nose, and fingertips may take on a blue or purple coloration. Severe Hypothermia victims will exhibit delirium, slurred speech, mild amnesia, labored stumbling, and an inability to utilize hands and feet. Shivering stops, skin becomes puffy and blue in appearance, loss of consciousness is common, and burrowing is a clear prelude to imminent death.

### Hyperthermia

Hyperthermia occurs when the body is unable to regulate heat, usually due to dehydration, an adverse reaction to potions and medicines, or dangerously high temperatures. If left unchecked, hyperthermia is fatal. Unlike hypothermia, hyperthermia does not give the beneficial warning of progressive stages. Symptoms include swollen eyes, lips, nose, and ears, absence of perspiration, unreasonably hot skin, nausea, dizziness, fainting, rapid breathing, or discolored skin.

## Treatment

Common **Treatment Methods** for temperature related illnesses shall be defined and explained below.

### Burn Treatment

Burn treatment is intended to promote healing, prevent infection, control heat loss, retain function and minimize disfigurement. Burn wounds may be treated by the open or closed method. The method of wound care depends on the state of the wound. The open method involves the usage of salves of egg, honey, vinegar, mint, and other herbs spread over the burned tissue with no bandaging or dressing. Open care is less restrictive and simpler than closed care, but provides increased opportunity for loss of fluid and heat through the open tissue. Closed care uses topical ointments covered by bandages or dressings. Because some areas may be burnt deeper than other areas, it is not unusual to see open care for some of a patient’s burns and closed care for others.

### Frostbite Treatment

The first step in treating frostbite should be to prevent further exposure to extreme cold. The patient should be taken indoors, and if such is not possible, given additional clothing to protect the affected areas. Once indoors, the affected area should be soaked in a warm water bath to gradually rewarm the tissue. As tissue is rewarmed, the patient may experience extreme pain in the areas that have succumbed to necrosis and damage from freezing. Medical personnel may dispense healing potions to frostbite victims if they are readily available to dull the pain. In severe cases of frostbite, tissue or limbs may be removed or amputated if they do not return to function after thawing.

### Hypothermia Treatment

In the case of mild hypothermia, passive rewarming can be administered using another person's body heat, proper insulating clothing, and a warmer environment. When faced with moderate hypothermia, external warming devices are required, such as placing skins full of hot water in the armpits and groin. The victim should be given plenty of fluids to drink in order to rebalance their humours. Under severe hypothermia, there is little that can be done in the field. If a soldier contracts severe hypothermia, and full medical care cannot be given, the soldier should be given merciful death to end his or her suffering.

### Hyperthermia Treatment

Depending on the cause and severity, the treatments for hyperthermia can be many and varied. In simple exertion based cases, such as hard labor on a hot day, soldiers should be given plenty of water and a cool, shaded place to rest. In cases caused by medicines or potions, cessation of those medicines or potions and close observation for the next few hours should be the immediate step.

In significant cases, afflicted soldiers can be treated with immediate techniques such as being moved to a cool, shaded place, removal of clothing, and dabbing of the head, chest, and armpits with damp rags. Submersion in a body of cold water is also an effective way of removing a large amount of excess body heat in a short time. Severe cases of hyperthermia where the casualty has passed through the most serious stages can only be treated by fully trained medical staff. Often, severe cases require advanced cooling methods, such as mild frost magics or cooling potions that are often only found in field hospitals. When faced with severe hyperthermia, if the casualty cannot be brought to a field hospital swiftly, it is better to end their suffering with death.