My Page for Hypothermia Fundamentals...


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Chuck Sutherland has a fantastic Coldwater page as well.
Fern Usen compiled this page of information from various sources and courteously supplied the text.

PREVENTION:

AVOID EXPOSURE

  1.   STAY DRY.   When clothes get wet, they lose about ninety percent of their insulating value. Wool loses less as does many of the new synthetics. Cotton and wet down are worthless.
  2.   BEWARE OF THE WIND.   A slight breeze carries heat away from bare skin much faster than still air. Wind drives cold air under and through clothing. Wind refrigerates wet clothes by evaporating moisture from the surface.
    WIND MULTIPLIES THE PROBLEMS OF STAYING DRY. If you have been in the water and you are wearing a T-shirt that is wet remove it and you will retain more heat. Direct sunlight on the skin helps in the warming process.
  3.   UNDERSTANDING COLD.   Most hypothermia cases develop in air temperatures between 30 and 50 degrees. Most outdoor enthusiast simply can't believe such temperatures can be dangerous. They fatally underestimate the danger of being wet at such temperatures. Fifty degree water is unbearably cold. The cold that kills is cold water running down your neck and legs, and cold water removing body heat from the surface of your clothes.

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TERMINATE EXPOSURE

If you can not stay dry and warm under existing weather conditions, using the clothes you have with you, do whatever is necessary to be less exposed.
  1.   BE SMART ENOUGH TO GIVE UP REACHING THE DESTINATION, OR WHATEVER YOU HAD IN MIND.
  2.   Get out of the wind and rain. Build a fire. Concentrate on making your camp or bivouac as secure and comfortable as possible.

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NEVER IGNORE SHIVERING

Persistent or violent shivering is a clear warning that you are on the verge of hypothermia.
GET OUT OF WATER & WIND AND BACK TO YOUR VEHICLE.

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BEWARE OF EXHAUSTION

Make camp while you still have a reserve of energy. Allow for the fact that exposure greatly reduces your normal endurance. You may think you are doing fine when the fact that you are exercising is the only thing preventing your going into hypothermia. If exhaustion forces you to stop, however brief:
  1. Your rate of body heat production instantly drops by fifty percent or more.
  2. Violent, incapacitating shivering may begin immediately.
  3. You may slip into hypothermia in a matter of minutes.

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DETECT HYPOTHERMIA

If your group is exposed to WIND, COLD, OR WET, think hypothermia. Watch yourself and others for the symptoms:
  1. Uncontrollable fits of shivering.
  2. Vague, slow, slurred speech.
  3. Memory lapses, or incoherence.
  4. Immobile, fumbling hands.
  5. Frequent stumbling.
  6. Drowsiness (to sleep is to die.)
  7. Apparent exhaustion. Inability to get up after a rest.
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BE PREPARED

Pack a VHF radio and know how to use the emergency Channel 16 to call for help.
Carry chemical hot packs and a thermometer in your first aid kit.
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TREATMENT

The victim may deny he/she is in trouble. Believe the symptoms, not the person. Even mild symptoms demand immediate treatment.
  1. Get the victim out of the wind and rain.
  2. Strip off all wet clothes.
  3. If the victim is only mildly impaired:
  4. If the patient is semi-conscious or worse:
  5. Warm the torso only. Not extremities.
  6. Transport the victim as soon as possible to the closest hospital for monitoring. It takes a very long time to warm the inner core and only a rectal hypothermia thermometer is long enough to find out what the inner core temperature really is. DON'T DELAY!
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HYPOTHERMIA IN WATER

Loss of body heat to the water, is a major cause of deaths in boating accidents. Often the cause of death is listed as drowning; but, often the primary cause is hypothermia. It should also be noted that alcohol lowers the body temperature around two to three degrees by dilating the blood vessels. Do not drink alcohol around cold water. The following chart shows the effects of hypothermia in water:

WATER TEMPERATURE EXHAUSTION SURVIVAL TIME
32.5 degrees Under 15 min Under 15 to 45 min.
32.5 to 40 15 to 30 min 30 to 90 min.
40 to 50 30 to 60 min 1 to 3 hrs.
50 to 60 1 to 2 hrs 1 to 6 hrs.
60 to 70 2 to 7 hrs 2 to 40 hrs.
70 to 80 3 to 12 hrs 3 hrs. to indefinite
Over 80 Indefinite Indefinite

NOTE:  THIS MEANS THAT NOW, WITH WATER TEMPS AROUND 50f, YOU HAVE BETWEEN 30 MINUTES & 3 HOURS SURVIVAL TIME. SCARED? YOU SHOULD BE.

PFD's (personal flotation devices / better known as life jackets) can increase survival time because of the insulating value they provide. In water less than 50 degrees you should wear a wet suit or dry suit to protect more of the body.

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SOME POINTS TO REMEMBER:

  1. While in the water , do not attempt to swim unless to reach nearby safety. Unnecessary swimming increases the rate of body heat loss. Keep your head out of the water. This will increase your survival time.
  2. Keep a positive attitude about your rescue. This will increase your chances of survival.
  3. If there is more than one person in the water, huddling is recommended.
  4. Always wear your PFD. It won't help if you don't have it on.
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BODY HEAT LOSS

The body loses heat in five ways: Respiration, Evaporation, Conduction, Radiation and Convection. The body cools up to 25 times faster in water than in air.

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COLD WATER KILLS

Safety experts estimate that half of all drowning victims actually die from the fatal effects of cold water, or hypothermia, and not from water filled lungs. Loss of body heat is one of the greatest hazards to survival when you fall overboard, capsize, or jump into the water. Cold water robs the body of heat 25-30 times faster than air. When you lose enough body heat to make your temperature subnormal, you become hypothermic.

Sudden immersion in cold water cools your skin and outer tissues very quickly . Within 10 or 15 minutes, your core body temperature (brain, spinal cord, heart, and lungs) begins to drop. your arms and legs become numb and completely useless.

You may lose consciousness and drown before your core temperature drops low enough to cause death.
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RULES OF 50

  1. - An average adult person has a 50/50 chance of surviving a 50 yard swim in 50 degree F. water.
  2. - A 50 year old person in 50 degree F water has a 50/50 chance of surviving for 50 minutes

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BODY HOT SPOTS

Certain areas of your body are "hot spots" that lose large amounts of heat faster than other areas. These "hot spots" need special protection against heat loss to avoid hypothermia. The head and neck are the most critical areas. The sides of the chest, where there is little fat or muscle, are major areas of heat loss from the warm chest cavity. The groin region also loses large amounts of heat because major blood vessels are near the surface.
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HOW COLD IS "COLD WATER"?

Cold water does not have to be icy... it just has to be colder than you are to set water hypothermia in motion. A person who is wet, improperly dressed and intoxicated can become hypothermic in 70 degree F weather. The rate of body heat loss depends on water temperature, the protective clothing worn, percent body fat and other physical factors, and most importantly the way you conduct yourself in the water.

Note: Much of Alaska's waters are Very cold! Many of the larger bodies of water, rivers, and all marine waters are in the low 40s (Fahrenheit). Without a survival suit a person loses functional use of their limbs within minutes. Unconsciousness soon follows.

Different activities in the water consume varying amounts of body heat. The more energy (heat) you expend, the quicker your body temperature drops, reducing your survival time. As shown below wearing a life jacket (PFD) can add hours to your survival time.

Predicted Survival Time
(average adult in 50 degree F (10 C) water)
*Drown Proofing 1 1/2 hours
Swimming slowly 2 hours
Treading water 2 hours
Holding still 2 3/4 hours
**H.E.L.P. position 4 hours
Huddle 4 hours
Wearing a PFD 7 hours

*drown proofing is a warm water survival technique: to conserve energy you relax in the water and allow your head to submerge between breaths. This technique is NOT recommended in cold water, since about 50 % of heat loss is from the head.

(huddle)
**Heat Escape Lessening Position:
  • arms folded across the chest
  • ankles crossed
  • thighs close together
  • knees bent.

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HOW TO SURVIVE IN COLD WATER

If you suddenly find yourself in the water don't panic! Calmly follow the procedure below to increase your survival time.

Minimize body heat loss. This is the single most important thing you should do. Take the following steps:


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FIRST AID FOR HYPOTHERMIA

Any person pulled from cold water should be treated for hypothermia..

Your goal in treating hypothermia is to prevent further body cooling. Severe cases call for rewarming by trained medical personnel. In all cases, arrange to have the victim transported to a medical facility immediately.

What To Do:


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COLD WATER DROWNING

Some apparent drowning victims may look dead, but may actually still be alive! A phenomenon called the "mammalian diving reflex" can be triggered by cold water. This reflex, common to whales, porpoises and seals, shuts off blood circulation to most parts of the body except the heart, lungs and brain and slows the metabolic rate. What little oxygen remains in the blood is circulated where it is needed most. Do not assume that a person who is cyanotic and who has no detectable pulse or breathing is dead. Administer CPR and transport the victim to a medical facility as quickly as possible for specialized rewarming and revival techniques. Most the waters of Alaska are cold enough at any time of year to trigger this reflex. People have been revived after having been submerged for extended periods, some in excess of 45 minutes! So don't give up.

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THE WARNING SIGNS OF HYPOTHERMIA

These are some of the symptoms of hypothermia. A person who is suffering from exposure (or extreme low temperatures) may demonstrate some or all of these symptoms:
  1. Shivering (an early warning sign of hypothermia), which means the body is trying to warm itself.
  2. Increased heart rate and faster breathing.
  3. Cold white hands and feet, which means that the body is diverting blood from the person's extremities to try to keep the internal organs warm.
  4. Irritable, irrational, and/or confused behavior. It is usually hard for people who are suffering from these symptoms to recognize their own condition, so you might have to spot it for them.
  5. Blue colored lips or skin (an indication the hypothermia is getting severe.)
  6. Sometimes people with hypothermia will feel hot, and start removing their protective clothing. (Don't let them do it.)
  7. Eventual unconsciousness.

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SEVERE HYPOTHERMIA

  1. A victim of advanced hypothermia must be treated as a medical emergency. If the victim is getting stiff and is either unconscious or showing signs of clouded consciousness such as slurred speech or severe loss of coordination, transport the patient to a medical facility where aggressive re-warming can be safely initiated, or radio for help.
  2. Ordinarily, let the hospital re-warm a severely hypothermic person due to physiological complications. However, on a trip, you will not likely have immediate access to medical facilities. Wrap the person warmly and transport to safety. Carry the victim as gently as possible, perhaps in the kayak or canoe, to shelter. Jostling the patient may cause cardiac arrest.
  3. Remove wet clothing. Place in a dry sleeping bag and join him or her to maximize heat generation. Once shivering has stopped, the patient has lost the ability to generate heat, so simply wrapping in a cold bag will not help. He or she needs a gentle source of heat, like another human body. Apply hot packs to the neck, armpits, sides, chest and groin. Keep the head covered. Warm the victim's lungs by mouth-to-mouth breathing.
  4. Do not warm, rub or stimulate the severely hypothermic patient's extremities. This may bring cold, stagnant blood from the body surface to the body core, resulting in cardiac arrest. Hot drinks are also dangerous as they draw warm blood away from vital organs. Nearly 3 gallons would be needed to raise core body temp 1 degrees C.
  5. Things to look out for as you re-warm a severely hypothermic person include a condition called temperature afterdrop which occurs as the body is re-warmed and cold blood from the extremities returns to the body core, resulting in another 1-2 degrees C core temperature drop.

    Acidosis occurs as the acid waste products from cell metabolism in the extremities is returned to the heart, which may result in re-warming shock. Both afterdrop and acidosis may precipitate cardiac arrest.

  6. Bystanders may be tempted to start CPR on a severe case as it is very difficult in the field to distinguish between severe hypothermia and cardiac arrest. But chest compressions or any other rough handling of a severely hypothermic person are particularly likely to convert a slow, low output heart rhythm into ventricular fibrillation, a form of heart attack. Check for any body movement or respiratory effort, both of which are lacking in a heart attack victim, and feel for a carotid pulse (in the neck, to the side of the windpipe) for a full minute before initiating CPR.

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