Tuesday, November 02, 2021
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Hypothermia Signs & Treatment Skills to Know in the Field

by Derek Benoit September 29th, 2021

ALWAYS consult your physician, specialist, or appropriate exercise professional before beginning ANY exercise or treatment plan. This content is for INFORMATIONAL PURPOSES ONLY AND DOES NOT CONSTITUTE MEDICAL ADVICE. By accessing this content, you agree to hold harmless the-outdoor-phoenix-community.com and Benoit Outdoor Media LLC for any injury, death, or damage to private property that results from performing any exercise, therapeutic exercise, or in receiving medical treatment.

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Formula for degrees Fahrenheit to Celsius conversion

Hypothermia signs & treatment skills to know in the field will save lives. Such knowledge allow you to react to such possibilities, and also prevent such. Hypothermia is possible, but avoidable, any time of year. Critically, layer for heat management based upon activity level as well as environmental condition. Specifically, moisture-wicking base layers, including wool-based ones, dry quickly and provide warmth even if wet. Critically important is to avoid cotton next to skin. Once wet, it tends to stay wet. As a result of this, it increases body heat dispersion, dropping body temperature (Curtis 2009, 2010; Jones 2016).

Hypothermia Prevention Begins Prior to Going Afield

It is absolutely critical to know conditions in which hypothermia is most likely. Cool or cold air temperatures, combined with wind, wetness, and of course, cold water. Additionally, brisk activity with too heavy of clothing can lead to excessive sweat, soaking clothes from the inside out. Use that layering system to manage your body heat, too! (Curtis 2009, 2010).

Dryness is Priority Numero Uno

Stay as dry as possible. Always have a backup set of socks, clothes etc. Even if it takes up more room in your pack and adds a couple of pounds your life is worth it. Should you become wet, it is critical that you change out of wet clothes and begin the warming process as quickly as possible. Any available blankets, towels, heat blankest, etc. apply here. Never shrug off early stage symptoms of hypothermia like shivering. Once hypothermia sets it, it can progress rapidly (Curtis 2009, 2010; Jones 2016). Emergency kits, fist aid kits, all are basic requirements for any trip.

Plan for your Activities AND your Methods of Access

Hunting or fishing, it matters not. Cold water is prevalent early and late in the seasons. The same rules for preparation apply, especially with safety gear. Always use the buddy system, whenever possible. Critically, assume changes in weather WILL occur. This is true for a day of fishing or  quick access  to a choice location via waterway. Additionally, having a PFD that is properly rated, sized correctly, as well as a safety kit, is advised. Be sure to know and adhere to state and local requirements for gear, including Coast Guard regulations.

Thoughts on Training

First aid training, included basic life support is always a valuable skill for anyone to have. It is strongly suggested that assessment and treatment be performed by a person with such training, if available. For training, please checkout my friend and certified instructor October Blair at https://survival1cpr.training/

Hypothermia Assessment

Hypothermia begins as soon as body temperature drops below 37 degrees Celsius. It spirals quickly downhill if not dealt with immediately! (Curtis 2009, 2010; Jones 2016)

1st Stage AKA Mild Hypothermia

  • Shivering-can  be significant
  • Difficulty coordinating or using hands, fingers
  • Extremities can become numb (Curtis 2009, 2010; Jones 2016)

Treatment:

  • Find or create shelter from wind/cold/moisture
  • Get victim out of wet clothes and into dry ones if available
  • If still mobile, movement will help with rewarming (Curtis 2009, 2010; Jones 2016)

PLEASE NOTE: IF MODERATE OR WORSE HYPOTHERMIA IS SUSPECTED, MEDICAL EVAC IS STRONGLY RECOMMENDED WHENEVER POSSIBLE

Internal rewarming in an ER setting is best in such cases

(Giesbrecht, 2001; Jones, 2016)

2nd Stage AKA Moderate Hypothermia

  • Victim acts increasingly uncoordinated, but can still talk, walk
  • Difficulty using hands
  • Speech becomes slurred
  • Confusion, difficulty thinking (counting down, etc.)
  • Starts to become irrational, may become violent
  • Apathy
  • Victim gets very quiet, not interacting with others
  • Severe shivering
  • Some victims actually strip down in hallucination
  • VICTIM STOPS SHIVERING! (Curtis 2009, 2010; Jones 2016)

Treatment:

  • Wrap them in towels, survival blanket, or sleeping bag-as much insulation as possible
  • Another person may join victim in sleeping bag/other covering to share warmth
  • If available, cover the whole package in a waterproof covering
  • Use whatever you can to further pad/insulate patient from the cold ground (Curtis 2009, 2010)

3rd Stage AKA Severe Hypothermia

  • Muscles are rigid, movement/walking is difficult
  • Patient starts acting combatively, or altered personality
  • May become semiconscious-looks drowsy and difficult to “snap them out of it”
  • Pulse and breathing decrease significantly
  • VICTIM BECOMES ENTIRELY UNCONSCIOUS (Curtis 2009, 2010; Jones 2016)

Treatment:

  • Wrap them in towels, survival blanket, or sleeping bag-as much insulation as possible
  • Instead of another person joining the victim in the bag, use as many heating packs as possible, if available
  • Apply heat packs to neck, arm pits, and groin ONLY-NOT EXTREMETIES
  • If available, cover the whole package in a waterproof covering
  • Use whatever you can to further pad/insulate patient from the cold ground (Curtis 2009, 2010; Jones 2016)

Extreme Hypothermia

  • Breathing and heartbeat are inconsistent, variable
  • You may not even be able to detect a pulse
  • Breathing may stop entirely
  • Cardiac arrest
  • Victim may appear dead but still be alive (Curtis 2009, 2010) (Curtis 2009, 2010; Jones 2016)

Treatment:

  • Wrap them in towels, survival blanket, or sleeping bag-as much insulation as possible
  • Instead of another person joining the victim in the bag, use as many heating packs as possible, if available
  • Apply heat packs to neck, arm pits, and groin ONLY-NOT EXTREMETIES
  • If available, cover the whole package in a waterproof covering
  • Use whatever you can to further pad/insulate patient from the cold ground (Curtis 2009, 2010; Jones 2016)

UNLESS YOU ARE CERTAIN NO BREATHING OR HEARTBEAT IS PRESENT

  • Check pulse at neck for at least 1 full minute!
  • Do NOT administer CPR unless you are absolutely sure there is no breathing and no heartbeat
  • CPR before this could cause more heart problems, possibly even cardiac arrest (Curtis, 2009)

IF NO BREATING DETECTED, OKAY TO PERFORM RESCUE BREATING

(Curtis, 2009, 2010)

  • Rescue breathing will allow SOME degree of inhalation warming
  • It won’t be much, but it’s better than nothing (Giesbrecht, 2001)

DO NOT APPLY HEAT PACKS DIRECTLY TO EXTREMETIES OR MASSAGE/RUB EXTREMITIES

  • SLOW, gradual warming is the goal
  • Body will naturally experience a secondary drop in core temp, as cold peripheral blood begins to recirculate within the core
  • Accelerating cold peripheral blood could cause cardiac arrest
  • Warming extremities prematurely could accelerate mixing of peripheral/core blood (Curtis 2009, 2010; Jones 2016)

ONCE VICTIM REGAINS CONSCIOUSNESS, BEGIN REWARMING AS FOR SEVERE HYPOTHERMIA

(Curtis, 2009, 2010)

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References:

Curtis, R. (12/28/2009). Hypothermia: field assessment and Treatment.  Reproduced author’s permission from The Backpacker’s Field Manual, Chapter 9 by Rick Curtis. Copyright Random House Publishing.  https://www.outdoored.com/articles/hypothermia-field-assessment-and-treatment

Curtis, R. (2010). Outdoor action guide to hypothermia and cold weather Injuries. The Trustees of Princeton University. Princeton, NJ. https://www.princeton.edu/~oa/safety/hypocold.shtml New Outdoor Action site: https://outdooraction.princeton.edu/

Giesbrecht, G. Prehospital Treatment of Hypothermia. Clinical Updates in Wilderness Medicine. Volume 12, Issue 1, P24-31, March 1st, 2001. DOI: https://doi.org/10.1580/1080-6032(2001)012[0024:PTOH]2.0.CO;2https://www.wemjournal.org/article/S1080-6032(01)70677-1/fulltext

Jones, J. (2016). The dangers of heat and cold: Hypothermia. Wilderness USA. Learn. Health and Safety. Hypothermia. http://wildernessusa.com/learn/health-and-safety/hypothermia/

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