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The reality of hypothermia

By definition, hypothermia is present once the body’s core temperatures drop below 95 degrees. Hypothermia is an ever-present danger – interestingly, its incidence is not limited to the wintertime. In fact, there is often a higher occurrence during the spring and fall months. The reason for this is clear – recreationists are prepared for the elements in the winter. Spring and fall outings may be plagued by unexpected inclement weather, ice and snow, frigid waters and plunging nighttime temperatures. Failure to take a few simple precautions can have devastating consequences.

The cause of hypothermia is simple.If heat loss is greater than the body’s ability to produce more heat, then the body’s core temperature will fall. Often, hypothermia is not the result of sitting for hours in a frigid tree stand, although many will argue that fact when they are perched in the treetops in December! Frequently, hypothermia can occur from a fall into the water, an unplanned night in the outdoors or if a recreationist is injured and cannot escape the elements. No matter the cause, the ambient temperature becomes cold enough that the body cannot generate enough heat to keep the core warm. Surprisingly, this can occur even at air temperatures as high as 50 degrees in certain conditions – it can be the “perfect storm.” Signs and symptoms of hypothermia can develop quickly, and if they are ignored the results can be tragic.

Hypothermia is a progressive and dynamic state. Early symptoms include chilling and uncontrolled shivering Most of us have experienced the unpleasant sensation of “the shiver.” This is actually the body’s way of trying to maintain an optimal body temperature. As the core temperature continues to drop, the body begins work to salvage the vital organs, thus blood is shunted to the core from the skin surface and the extremities. Shivering eventually stops, as the body can no longer work to provide heat. Confusion and ataxia (stumbling) ensue. Often, victims of profound hypothermia appear to be intoxicated. Eventually, as the core cools further, all organ systems are affected and ultimately shut down. Unconsciousness occurs and is soon followed by the ultimate organ system failure . . . death. I have learned over the years that when my children voice their discomfort from cold, I tell them not to complain until the shivering stops.

Combat the cold with some of the tips listed below:

  • Smart duds: Clothing is key. Base layering with a wicking fabric is most beneficial, as it will wick the moisture from the skin and dry faster. Polyester blends or lycra/wool blends are best. Eliminating moisture is critical to avoiding hypothermia. Further layering with vests and jackets is also helpful, as items may be donned or doffed according to the temperatures. Gearing up for the outdoors takes careful consideration. A cotton jacket will not be of much help. Choose a vest for an insulating layer to wear over your shirts. External shell layers should provide windstopping and/or waterproofing. Technical fabrics can provide all the necessary function without a lot of bulk. Become a careful consumer and investigate the fabrics that work best for you.
  • Don’t forget the dome. Always bring a hat, even if you never wear it. We lose the majority of our heat from our heads. I can’t tell you how long it took me to learn this lesson. A high-quality fleece or wool blend cap or beanie will help immensely.
  • Footwear is often overlooked. Wet shoes and socks not only contribute to hypothermia, they can lead to frostbite. Pay for the socks. I always recommend SmartWool, as it provides unparalleled warmth and dryness. Cotton socks are worthless. That’s why you can buy six pair for $4.99. When it comes to shoe/boot selection, look closely. Waterproofing is priceless. Numerous boot manufacturers provide high-quality footwear across varying price points.
  • The Girl Scouts had it going on when they taught us to be prepared. Always, and I mean always, carry matches in a waterproof canister. A small fire can mean the difference between life and the “ultimate organ system failure.” We don’t often plan to be out in the elements overnight, but unfortunately it happens. Fires are not just for nighttime. Should your clothing become wet, it is essential that you build a fire and dry them. Failure to dry can lead to disaster.
  • Feed the shiver . . . bring energy bars or snacks. Provide the calories you will need to sustain the increased demands of the body. It takes energy to shiver, move and maximize warmth. Feed the shiver. While we often think that high-carbohydrate and sugary options are good, they are not best. Think of it as burning a match – it’s a quick ignition but burns out quickly. Bring food with a protein and carb combination. Carbohydrates provide quick energy, while protein provides sustenance. I am a huge fan of energy bars, especially Builder’s Bars and PowerBars. Trail mix options with power-packed nuts and seeds are also good choices.
  • Avoid the water. Sound crazy? Most of the hypothermic deaths I have personally witnessed were due to submersion in cold water. Avoid swift water in the early spring, as it is downright cold. Think of it this way: it JUST melted. It’s cold. Once someone is submerged in frigid water, acute hypothermia is only minutes away, and drowning is often imminent once that happens. Coldwater lakes? Winds are common in springtime and can get dangerously gusty very quickly. Should you be on a lake in a small watercraft when Mother Nature whips up some nasty wind, get to shore immediately. Low-profile craft are quickly swamped or submerged once whitecaps are present. Even skillful swimmers who are wearing personal floatation devices cannot combat the cold water and waves.

So what if all that fails? How do you rewarm a victim of hypothermia? Here’s how:

  • Remove wet clothing. Don’t forget to get wet clothing out from beneath the victim as well. Dry him or her.
  • Elevate the head slightly.
  • Encourage warmed fluids (as long as the victim is conscious and can swallow). Broth, sugary tea or hot chocolate are good choices.
  • Warm zones. Apply warm packs to armpits, groin, head and abdomen. Ensure that hot packs do not burn the skin.
  • Keep the victim awake and moving if possible.
  • Body-to-body warmth. It’s best if this is done skin-to-skin, but hey . . . there are limits!
  • No alcohol or medications should be given – these may mask symptoms.
  • Do not shake or jostle the victim. This can actually agitate the heart in victims with severe hypothermia, sending them into cardiac arrest.

Should you find yourself in inclement weather and hopes of reaching shelter are diminishing, stay put. Find shelter out of the wind and elements. Build your Girl Scout fire. Keep dry. Feed your shiver. With a little good planning and a level head, a disastrous outcome can be avoided!

~Kirstie Pike

***Advice provided in First Aid Afield is simply suggested first aid and is not intended to replace any medical plan of care suggested by your primary care physician. Should you have any questions or concerns about an illness or injury, please contact your physician immediately.***

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1 comment

  1. Barbara Baird - August 13, 2009 7:20 pm

    Hey, Flo in the Field!

    Enlighten us and give us more advice for field first aid, would ya please? You are quite a writer and I bet your nursing skills at least match that ability and if so, I hope I get someone of your caliber if I ever have to go to the ER!
    Thanks!

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