Would You Recognize the Symptoms of Hypothermia in Time to Save a Life?

by JoHarrington

If you've ever dithered, teeth chattering with the cold, you've been in the onset of mild hypothermia. If it went beyond that would you know the treatment for hypothermia?

Every year, there are an average 1560 reported cases of hypothermia in the USA. Around 650 of them prove fatal.

In my native Britain, a combination of rising fuel costs and the temperature dipping very low in winter means that the figures are much higher. During 2012/13, emergency staff recorded 28,354 people needing hypothermia treatment.

It was up 25% on the previous year, which in itself was 50% higher than the year before that. But on the bright side, so many people rationing their heat meant that energy companies filed profits of over £15billion.

Assuming that you care more for lives than a corporation's bottom line, would you be able to recognize the signs of hypothermia and know how to treat it?

Hypothermia Can Be Deadly

I know all about it. It nearly killed me last week.

Image: Jack and Rose in TitanicThe sinking of the Titanic was one of the most famous disasters in history, mostly because of the James Cameron movie about it. But ask people how most of the victims died and the majority will get it wrong.

They didn't drown. Lifeboats might have been scarce but life jackets were in plentiful supply. Most Titanic passengers survived the ship's sinking, floating on the surface of icy waters.

It was hypothermia which killed them.

Nor does this have to be a thing which occurs only in freezing oceans. The military campaign of Hannibal lost over 20,000 men to the cold, as his army marched over the Alps. Even that pales into insignificance when you consider Napoleon's retreat from Russia during the winter of 1812.

Men knelt down in the snow, dying in their tens of thousands. Some curled up next to a campfire and never woke up. General Armand Augustin Louis de Caulaincourt poignantly wrote afterwards, "Sleep comes inevitably, to sleep is to die."

An estimated 300,000 members of the Napoleonic Grand Army had perished in the Russian wars. Another 70-80,000 died of starvation and hypothermia on the way home.

It is something which I can picture quite vividly, as I was recently lost in fog and rain on the summit of a mountain. It took dozens of emergency responders to remove me safely, but first they had to find me and while I waited I froze.

What is Hypothermia?

It is when the body's core temperature drops below 35.0 °C (95.0 °F), or that needed to maintain the metabolism necessary to stay alive. All physical functions begin to fail and death follows shortly on.

The Symptoms of Mild Hypothermia

Hypothermia's early stages is why so many individuals don't take this condition seriously enough. It's too commonly felt and survived.

We've probably all experienced mild hypothermia in our time. Just go outside in winter, if you're in a Northern climate, or pop into a walk-in fridge for a moment if you're not.  Diving into a cold swimming pool will do it too.

  • Shivering through to dithering
  • Rapid breathing - more than 20 breaths per minute
  • Increased heart rate - more than 100 beats per minute while resting
  • Increased blood pressure - at or above 140/90 mmHg
  • Pale skin - vasoconstriction is restricting your blood vessels
  • Wanting to urinate - on its own this isn't a biggie, we all do it every day, but in conjunction with the rest, it's not great
  • Mental confusion
  • Hyperglycemia - your body pushes all its glucose into your blood cells to fuel the tremendous push to stay warm
  • Trouble communicating
  • Loss of Energy.

After this, things are going to become quite dangerous and that can occur with surprising speed. It only takes three hours to die of hypothermia, so read on to learn how to recognize the most critical symptoms of hypothermia.

How to Treat Mild Hypothermia

  1. Remove individual from wet, windy and/or cold environment
  2. Provide shelter
  3. Remove any wet clothing
  4. Keep them warm with dry clothing and blankets - a hat is particularly important, as much body heat is lost through the head
  5. Give them high energy food (it takes a remarkable amount of energy just to keep warm)
  6. Give them warm drinks
  7. Start moving them around, as activity stimulates heat.

Learn More about Hypothermia Protocol and First Aid

The Symptoms of Moderate Hypothermia

Here is where things are starting to become quite serious. These individuals may struggle to save themselves.

  • Violent shivering
  • Lack of co-ordination
  • Pronounced confusion
  • Extreme fatigue
  • Labored, stumbling gait
  • Extreme paleness
  • Cyanosis - blue tinge to fingers, toes, lips, ears, nose and eye sockets
  • Slurred speech.

How to Treat Moderate Hypothermia

  1. Call for an ambulance - this has now become serious enough to need a physical check up by a professional
  2. Shelter the individual
  3. Remove any wet clothing, replacing them with dry clothes and blankets
  4. Cover the individual's head with something warm and dry
  5. Take steps to gradually warm the individual's core (torso, trunk):  water bottles, warm rocks, warm drinks, or your own body pressed against them to transfer heat.

NB LEAVE THE EXTREMITIES ALONE!  You can kill somebody heating up the hands, feet and limbs, while the trunk is still cold.

Also see any items from treating mild hypothermia and introduce those as your freezing individual begins to warm up. But hopefully the ambulance will have arrived by then and paramedics will deal with all that.

Image: Hypothermia
Image: Hypothermia

The Symptoms of Severe Hypothermia

If it reaches this stage, you should be seeking out emergency medical treatment from professionals. This individual is close to dying.

  • Shivering stops
  • Profound cyanosis
  • Drowsiness, need to sleep immediately
  • Risk-taking/apparently suicidal behavior - due to impaired rationality
  • Hallucinations
  • Slow, shallow breathing
  • Weak pulse
  • No longer caring about physical condition, nor anything really
  • Unable to think
  • Inability to co-ordinate limbs
  • Paradoxical undressing - where the individual, beyond all reason, suddenly begins to take off their clothes
  • Terminal burrowing - the individual may try to dig a hole and get into it, but without much co-ordination nor energy, that is doomed to failure. More likely they will crawl under a bed or into a cupboard anywhere small and hidden.

How to Treat Severe Hypothermia

  1. Call the emergency services NOW! No-one gets saved if that ambulance isn't on the way, so make it your first priority
  2. Erect a shelter around them
  3. SLOWLY remove any wet clothing. Sudden movements might jar the system into shock and/or a heart attack. Try not to move the extremities any more than strictly necessary
  4. Replace with dry, warm clothing
  5. Place a hat on them, or anything else which may cover the head and reduce heat loss
  6. Use your own body heat to regulate their own - cuddling is better here than ever it was before
  7. If conscious, give them a room temperature beverage - not hot, not even all that warm, just room temperature
  8. Refresh your memory about CPR, it may become necessary to know that if the ambulance doesn't hurry up.

Supplies to Help Combat Hypothermia

Hypothermia Cap

Fits the contour of the head to give heat transfer uniformly over the whole area.

View on Amazon

Survival Wrap 5-Pack

Big insurance in a small package, this 52" x 84" heat-reflective survival wrap can make a difference when it really counts. Also useful as an emergency reflector, signaling devi...

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Veridian 08-308 V Temp 10-second Hypothermia Digital Thermometer

Wide-range measurements: 78.0°f – 111.9°f (26.0°c – 43.9°c). backlit display. professional accuracy to 2/10ths of a degree f. peak temperature tone and last-reading memory recal...

View on Amazon

Updated: 11/12/2014, JoHarrington
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JoHarrington on 12/01/2014

LOL I like you. I'm keeping you. <3

frankbeswick on 12/01/2014

You are, of course, ageless, Jo. When did you discover the elixir of youth?

JoHarrington on 12/01/2014

Frank - All fabulous advice! Thank you very much.

I particularly like the bit about knowing our limitations and accepting that we're no longer in our twenties (excepting those who are!).

JoHarrington on 12/01/2014

Sheilamarie - I can concur with you there.

frankbeswick on 11/28/2014

Prevention is better than cure. Firstly, avoid conditions that might be overmuch for you. Avoid very strong winds, which sap energy. We must all accept our limitations. Secondly, if you are out in cold conditions, ensure that you have as much body coverage as possible. This means gloves, not those with finger tips cut off, and a suitable hat, preferably a balaclava. A spare sweater and waterproofs are important in winter. A flask of hot drink is important, as is sugary food, such as chocolate or Kendal mint cake. A bivvy bag to nestle in is a great safety device.

One problem that some of us here might face is a failure to realize that we are no longer in our twenties, and we cope with cold less well as we age, especially as we pass sixty. As a male, I am constitutionally prone to this delusion, but when working alongside my thirty three year old son, I am reminded very forcefully of the passage of time. Your limbs lose flexibility as you age, so your passage over rough mountain ground will be slower than it once was. allow for this slowing factor if you are walking in mountains, because you might be caught out in cold and dark. The fact that I am now in receipt of U.K. government winter fuel allowance [for people over sixty] reminds me that if I walk in winter hills I have to be more careful.

sheilamarie on 11/27/2014

I've had my experiences of this, too. Not fun.

JoHarrington on 11/17/2014

Me too! Absolutely me too! I meant to look up the psychology being paradoxical undressing, but I haven't been there yet.

JoHarrington on 10/23/2014

WordChazer - If it's getting the word out, then I'm giving blanket permission for anyone to spin anything off these articles. Have you got Mountain Rescue mates then?

JoHarrington on 10/23/2014

cmoneyspinner - Thank you so much. And yes, it's quite horrific to read about those Napoleonic soldiers and what they witnessed on the way back.

Guest on 10/23/2014

Great timely article. I have contacts asking me to share as much as you write about this, so with your permission there may be a spin off on that this weekend. As we live in a house without heating I know a fair bit about low level hypothermia and regularly wrap up in layers as a result.

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