Lesson 12:
Hypothermia
Emergency Reference Guide p. 62-63
Does it Have to be Cold to Get
Hypothermia?
Objectives
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Describe mechanisms of heat loss
Define hypothermia
List signs & symptoms
Demonstrate emergency treatment for
mild to severe hypothermia
• Describe situations requiring evacuation
• Describe methods for prevention
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
Key Points
• Humans maintain normal temperature by:
– Heat generated by metabolism
– Heat gained by outside source (i.e. fire/sun)
– Muscular activity, shivering/exercise
• Heat is shed by:
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Radiation from skin
Conduction via contact with cold surfaces
Convection: movement of air over skin
Evaporation of moisture from skin
Respiration
Key Points (cont’d.)
• Normal core temperature is 98.6F
• Hypothermia occurs when 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
Signs/Symptoms for Mild
Hypothermia
• Shivering
• “umbles”
– Inability to perform tasks: “fumbles”
– Confusion, apathy, sluggish, “grumbles”
– Slurred speech, “mumbles”
– Altered gait, “stumbles”
Signs/Symptoms for Moderate
Hypothermia
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Worsening of the “umbles”
Uncontrollable or violent shivering
Confusion or unusual behavior
Impaired judgment
Care for Mild to Moderate
Hypothermia
• Ways to warm up someone:
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Change environment
Replace wet clothes
Move out of wind /cold into a sheltered area
Cover all exposed skin
Drink/eat simple carbohydrates. Digestion
produces internal heat. Do not drink
caffeine/alcohol
– Insulate from ground
Care for Mild to Moderate
Hypothermia (cont’d.)
– 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
Care for Mild to Moderate
Hypothermia (cont’d.)
• 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
preceding
Signs/Symptoms of Severe
Hypothermia
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Shivering stops
Muscle rigidity increases
Mental state worsens, stupor to coma
State of awareness: semi-conscious to
unconscious
• Pulse & respiration rate decrease, may be
difficult to detect
• Complaining stops
Care for Severe Hypothermia
• Handle gently, roughness can overload cold
heart & 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 & stop it
Care for Severe Hypothermia (cont’d.)
• Use hypothermia wrap, vapor barrier to trap any
heat inside:
– Wrap patient in tent fly, sheet of plastic, etc.
– Leave face exposed & monitor airway/breathing
• Do not force food/liquids
• Care for patient even, if they appear dead
• Call for help immediately, do not evacuate,
unless it can be done gently
Guidelines for Evacuation
• Mild & Moderate cases will likely recover,
may remain in the field
• GO FAST for severe cases. Evacuate with
extreme care. Do not jostle the patient
Preventing Hypothermia
• Far easier to maintain core temp than to
regain it:
– Prevent heat loss
– Terminate exposure
– Detect early warning signs & treat early
– Replace wet clothes quickly
• What you wear has major effect on
preventing hypothermia
Preventing Hypothermia (cont’d.)
• Types of Clothing for Preventing Hypothermia
– Silk, wool & 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 are cold, put on a hat
– Protect hands & feet, change socks often
– Rain gear/water proof boots
Preventing Hypothermia (cont’d.)
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Avoid Cotton (traps moisture)
Maintain hydration
Avoid alcohol & caffeine
Eat regularly, especially carbohydrates
Stay active, but don’t over exert
Know the weather, be prepared for
changing conditions
Preventing Hypothermia (cont’d.)
• Terminate exposure early:
– If you can’t stay warm/dry, get out of wind & rain
– Set up camp early, before you are exhausted
• Early Detection:
– Watch yourself & others for behavior /exposure
that can lead to hypothermia
– Care for signs early, monitor others, if one has
symptoms
– Being cold affects judgment, believe the signs
not the patient
Questions???
What else could you add to your
First Aid Kit?