1. Lesson 12: Hypothermia

2. Objectives Describe mechanisms of heat loss Define hypothermia
List signs and symptoms
Demonstrate emergency treatment for mild to severe hypothermia
Describe situations requiring evacuation
Describe methods for prevention

3. Myth or Reality? True or False? 70F or below describes “cold” water
A living body always produces heat
Hypothermia is contagious, if one person has it, all should be treated
A patient with severe hypothermia complains of being cold
Wet clothing from rain/sweat can contribute to hypothermia

4. Key Points Humans maintain normal temperature by: Heat is shed by
Heat generated by metabolism
Heat gained by outside source (fire/sun)
Muscular activity, shivering/exercise
Heat is shed by
Radiation from skin
Conduction via contact with cold surfaces
Convection: movement of air over skin
Evaporation of moisture from skin
respiration

5. Key Points Normal core temperature is 98.6F
Hypothermia occurs if core drops to point where muscle or brain function impaired
Hypothermia may be mild to severe
Does not have to be “cold” to become hypothermic

6. Signs/Symptoms for Mild Hypothermia
Shivering
“umbles”
Inability to perform tasks: “fumbles”
Confusion, apathy, sluggish, “grumbles”
Slurred speech, “mumbles”
Altered gait, “stumbles”

7. Signs/Symptoms for Moderate Hypothermia
Worsening of the “umbles”
Uncontrollable or violent shivering
Confusion or unusual behavior
Impaired judgment

8. Care for Mild to Moderate Hypothermia
Ways to warm up someone
Change environment
Replace wet clothes
Move out of wind and cold into a sheltered area
Cover all exposed skin
Drink/eat simple carbohydrates. Digestion produces internal heat. Do not driver caffeine/alcohol
Insulate from ground

9. Care for Mild to Moderate Hypothermia
Bundle in dry insulation
Snuggle with warm person
Place hot water bottle or chemical heat packs near patients heart and in armpits
If patient can exercise, encourage it to produce heat
Fluids are more important than solids
Warm sweet drink best
Even cold drinks better than no fluids

10. Care for Mild to Moderate Hypothermia
If patient goes to sleep, wake periodically to check condition
Patient with moderate hypothermia may “think” they are not cold. Watch for altered mental state/judgment
If patient can still move adequately, may resume activities after initial care
Wait until patient returns to normal perform preceeding

11. Signs/Symptoms of Severe Hypthermia
Shivering stops
Muscle rigidity increases
Mental state worsens, stupor to coma
State of awareness: semi-conscious to unconscious
Pulse and respiration rate decrease, may be difficult to detect
Complaining stops

12. Care for Severe Hypothermia
Handle gently, roughness can overload cold heart and stop it
If not breathing, perform rescue breathing (CPR) for at least 3 min prior to moving
Start to warm patient, same as mild to moderate hypothermia
Warming too quickly/too much movement may cause cold blood from extremities to rush to heart and stop it

13. Care for Severe Hypothermia
Use hypothermia wrap, vapor barrier to trap any heat inside
Wrap patient in tent fly, sheet of plastic, etc
Leave face exposed and monitor airway/breathing
Do not force food/liquids
Care for patient even if they appear dead
Call for help immediately, do not evac unless it can be done gently

14. Guidelines for Evacuation
Mild and Moderate cases likely will recover and may remain in the field
GO FAST for severe cases. Evacuate with extreme care to not jostle the patient

15. Preventing Hypothermia
Far easier to maintain core temp than to regain it
Prevent heat loss
Terminate exposure
Detect early warning signs and treat early
Replace wet clothes quickly
What you wear has major effect on preventing hypothermia

16. Preventing Hypothermia
Types of Clothing for Preventing Hypothermia
silk, wool, and synthetics designed to wick moisture away
Layers of clothing help you stay dry
Layers help regulate temperature better
Hats prevent heat loss through head (major source of loss)
If feet cold, put on a hat
Protect hands and feet, change socks often
Rain gear/water proof boots

17. Preventing Hypothermia
Avoid Cotton, traps moisture
Maintain hydration
Avoid alcohol and caffeine
Eat regularly, especially carbs
Stay active but don’t over exert
Know the weather, be prepared for changing conditions

18. Preventing Hypothermia
Terminate exposure early
If you can’t stay warm/dry, get out of wind and rain
Set up camp early, before you are exhausted
Early Detection
Watch yourself and others for behavior or exposure that can lead to hypothermia
Care for signs early, monitor others if one has symptoms
Being cold affects judgment, believe signs not patient