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

The 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.

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.

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.

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.

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.

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.

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.

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.