Hypothermia Kills

     It doesn’t have to be winter to die of hypothermia. A person doesn’t have to be submerged in water and the temperature doesn’t even have to be below freezing.  It has even been said more people die of hypothermia in the summer than they do in the winter.  To become hypothermic all that has to happen is for your body temperature to get below 98 degrees. 

     Last night at training for the Gunflint Trail Volunteer Fire Department that includes our ambulance personnel we reviewed hypothermia.  It’s something we do each year as it is one of the emergency calls that usually happens once or more each year.  Sometimes it’s a person who has spent time in the water, other times it occurs in the winter.   It can happen to anyone almost anywhere and without knowing the facts about hypothermia it can and does result in death.

      I started to think about how easy it is to become hypothermic while I was out hiking the other day.  When we left to go hiking the temperature was very near 60 degrees and the sky did not look like it would produce rain any time soon.  I didn’t see rain in the forecast so we didn’t bother to bring along raingear.  I was dressed in layers but didn’t remove them quickly enough to prevent sweating so my base layers were wet.  My 8-year old, 70 pound Josh was wearing jeans, a t-shirt and a hooded sweatshirt.  I can’t remember the details about what Chelsea was wearing but those of you who know her know she doesn’t carry any fat on her tall slim torso.  We had been hiking for about 2 hours before it started to rain and we were at the absolute farthest point from the trailhead and had 2 hours of hiking to do in order to return to our vehicle.  

     I wasn’t worried about any of us getting hypothermic at this point in the hike.  I had my day pack along that contains a flashlight, headlamp, carabineer, pocket tool, sugar kool-aid mix, gum, toilet paper, matches, firestarter, first aid kit with an emergency blanket and my Emergency Kit that contains a compass, whistle, fire starter, duct tape, a signaling device and another space blanket.  In addition to the usual suspects in my pack I also had water, a neck gaiter, my camera and a bag of beef jerky.  We had all eaten lunch, were hydrated and none of us were fatigued.

     I really didn’t start thinking about hypothermia until I felt the temperature dropping drastically and my outer layers soaking through to my skin.  By 3:00pm the temperature had dipped to 38 degrees and we had spent an hour walking in the rain.  With an hour left to go and Josh’s jeans, shoes and sweatshirt soaked I began to get concerned.  I know from medical training the elderly and young kids can get hypothermia much quicker than a person like me.  The trail was slippery from the mud and rain and I started to think about what would happen if Josh couldn’t walk out?  I knew the trail and wasn’t going to get lost and I knew I could make it back to the trailhead even in the dark.  What I didn’t know was what would have happened if I did get lost or if we did have to spend the night in the woods. How easily would it have been for Josh to become hypothermic and would I have been able to keep him alive throughout the night?

     I’m just happy I didn’t have to find out the answers to those questions.  What was to be a short day hike could have easily turned into a disaster even though we were doing most things right.  We were protecting ourselves against hypothermia in a number of ways.

  • We dressed in loose layers(Jeans are a no-no as are tight clothing and cotton)
  • We were well hydrated(none of us had been drinking alcohol)
  • We weren’t hungry or fatigued(I could have packed more high energy snacks)
  • We had hats and hoods
  • Someone knew where we were hiking and when to expect us home.

     I hadn’t thought much about the different ways of losing body heat until last night’s training.  I was sitting on a cold metal chair that was on a cold cement floor and I was getting cold through conduction.  When the fire hall door opened I immediately became chilled through convection because the cold wind whipped against me.  I didn’t have a windproof jacket on and the warm air next to my body was replaced with the colder air.  Evaporation doesn’t only happen through sweat but also through respiration when warm moist air is expelled and cold dry air is inhaled.  Heat was radiating out of my body since my head and neck were exposed allowing thirty percent of my heat to be lost.  I wasn’t dressed in wool, didn’t have mittens on and was wearing poorly insulated footwear.  I’m also on different medications that may cause my body not to regulate my body heat properly which is another factor in hypothermia.

     Was I hypothermic at training or on my hike?  I don’t believe so but I know alot of people who have experienced it and I can recognize some of the signs of hypothermia.

  • Goose bumps
  • Shivering(keep in mind some people never shiver)
  • Stiff muscles
  • Swollen or puffy face
  • Coordination problems
  • Cold skin(especially back, belly and extremities)
  • Blue extremities
  • Confusion
  • Loss of memory
  • Slow heart rate and breathing
  • Acting strange- irritable, mean, hostile or apathetic
  • Difficulty speaking, thinking and walking
  • Irrational behavior- taking off clothing known as paradoxical undressing

     Knowing the signs of hypothermia and knowing what to do are the keys to staying alive.  Some of the suggestions of what to do sound quite obvious but may or may not be possible.  The first step is to get the person out of the cold and into someplace warm.  While this is easy if you’re outside of a building it is difficult when out in the wilderness in a blinding snowstorm.  Another key to preventing further body heat loss is removing any wet clothing.  When you’re dealing with someone’s life is not the time to be concerned with seeing a person naked or by lying next to this person in a sleeping bag naked.  It’s important to warm this person up as quickly as possible without causing further harm and skin to skin contact is the best way to do this.  The condition the person is in will help you determine what to do next but if the person is able to change into dry clothes then get them on them.  If you have a hat or can put something over the person then cover them up and get them off of the cold ground.  If they are able to drink then get them some warm liquids to drink.  Most importantly you need to use care when handling the hypothermic patient. 

     In a hypothermic person all of their warm blood will have gone to the core of their body to keep the major organs functioning.  This leaves cold blood at the extremities and if you cause this blood to go back to the core before it is warm then you could cause cardiac arrest.  Do not move or jostle the person unnecessarily, do not massage their limbs and do not attempt to use hot water, a heating pad or any other direct heat to warm them as this can not only cause tissue damage but also cardiac arrest.  A warm pack can be applied to the chest, neck or groin of a hypothermic person. 

     If you are with a person who is suffering from hypothermia then do not give up.  A person can appear dead but still have a pulse or very shallow breathing that you are not able to detect.  If you know how to do CPR or rescue breathing and can’t tell if the person is breathing any longer then go ahead and administer CPR.   In training they say a hypothermic patient is not dead until he or she is warm and dead. 

     This blog entry has gotten a bit long but I feel it is one that is valuable because it could save a life, maybe even your own. Recognizing the signs you may be able to save a person who you may just be thinking is stupid or possibly drunk.  The signs can be strikingly similar and knowing what to do in this situation may be the difference between life and death.  Hypothermia can kill but if you know how to prevent it then you’re better off than most.

Be safe out there.