>>>>Date: Tue, 10 Apr 2001 18:07:34 -0400 From: John Fereira <jaf30_at_cornell.edu> Subject: Re: [Paddlewise] rescuers die <snip> They were 400 feet offshore when they capsized into the 38 degree water. They were not dressed for immersion. <snip> Hypothermia had already started to have an effect and the twice swimmers were unable to stand after landing. ***After a hot shower***, and the rescuers gave them warm clothes and drove them home. <<<< I'm not an expert on hypothermia, but my understanding is that warming a hypothermic person too quickly (like from putting them into a hot shower) can be *fatal*. I took a class on wilderness first aid, where they told the story of a fishing boat stranded (someplace cold, I forget where) powerless and heatless with a large crew. They were "rescued" by another boat, who brought the hypothermic but still living crew into the warm cabin onboard the rescue ship, and within a short time every one of the rescued crew died. My class instructor said the best solution is to get them to a hospital immediately, but if that's not possible he preferred the put-a-cold-person-into-a-sleeping-bag-with-a-warm-person technique. Evan Woodinville, WA *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
At 10:14 AM 4/11/01 -0700, Evan Dallas wrote: > >>>>Date: Tue, 10 Apr 2001 18:07:34 -0400 >From: John Fereira <jaf30_at_cornell.edu> >Subject: Re: [Paddlewise] rescuers die > ><snip> >They were 400 feet offshore when they capsized into the 38 degree >water. They were not dressed for immersion. ><snip> >Hypothermia had already started to have an effect and the twice >swimmers were unable to stand after landing. ***After a hot shower***, >and the >rescuers gave >them warm clothes and drove them home. <<<< > >I'm not an expert on hypothermia, but my understanding is that warming a >hypothermic person too quickly (like from putting them into a hot shower) >can be >*fatal*. I took a class on wilderness first aid, where they told the >story of a >fishing boat stranded (someplace cold, I forget where) powerless and heatless >with a large crew. They were "rescued" by another boat, who brought the >hypothermic but still living crew into the warm cabin onboard the rescue ship, >and within a short time every one of the rescued crew died. My class >instructor >said the best solution is to get them to a hospital immediately, but if that's >not possible he preferred the >put-a-cold-person-into-a-sleeping-bag-with-a-warm-person technique. Obviously there are different levels of impairment or these two people would have suffered the same fate as those on that fishing boat. While they were exhibiting some of the symptoms of hypothermia, based on what I read, their exposure time in the cold water was fairly short so their body temperature probably had not dropped much. The article didn't even mention "uncontrolled shivering" or a "loss of judgement" (other than the fact that they got into those conditions in the first place). From what I've read, the reason for getting someone to a hospital as soon as possible in extreme cases is that a doctor would understand at which rate it is safe to increase the core body temperature, and the only way to get an accurate measurement of the victims core body temperature is through the use of a rectal thermometer. *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
From: "Evan Dallas" <Evan_Dallas_at_notes.ntrs.com> > I'm not an expert on hypothermia, but my understanding is that warming a > hypothermic person too quickly (like from putting them into a hot shower) can be > *fatal*. In the case of acute hypothermia, you are absolutely right. Acute hypothermia, or immersion hypothermia, occurs when the body is subject to a rapid decrease in temperature. Paddlers are likely to suffer this in cold water. The outer tissues are very cold, but the core is still relatively warm. Increasing the blood flow brings the cold to the core, which can be fatal. Rapid warming of the outside of the person can do this as well. Chronic hypothermia occurs when the body gradually looses heat. This is what can happen due to wind chill, for example. In this case, the difference in temperature between the outer layers and the core is less significant and blood flow doesn't change the temperature of the core downward as rapidly. While formal treatment of acute and chronic hypothermia are different, in the event of doubt or in an emergency away from help, treating for chronic is ok. Gradual warming (one or two healthy people in a sleeping bag with the casualty, for example) is the right thing to do. I've never suffered from acute hypothermia, but have suffered from chronic a couple of times, most recently this past winter while on a long ski tour. Fortunately there was a heated hut in the woods nearby and I was able to rest, eat and drink while rewarming. Mike *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
Mike, How do you fit three people in a sleeping bag? Jack ----- Original Message ----- <snip> > While formal treatment of acute and chronic hypothermia are different, in he event > of doubt or in an emergency away from help, treating for chronic is ok. Gradual warming > (one or two healthy people in a sleeping bag with the casualty, for example) is the > right thing to do. *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
Hi folks! Iīm not a doctor, but Iīve heard several things about the different levels of hypothermia. I remember a story a paddling friend told me 2 years ago. He was almost ready with his medicine studies and was working a few months in Narvik hospital (northern Norway), when the following incident appears. It was his last working day: In march or april (???) two colleagues from Narvik hospital were on a skiing trip nearby. It was melting time and they were crossing a frozen river (no risk no fun), when the ice breaks under the skies of the woman (surgery doctor). She was lucky, hanging with head first into the cold river and only the skies avoid that she was up an away with the river under the ice. Her colleague couldnīt get her out of the water and so he grabs the mobile Fon, with the stiff fingers he lost it to the river. The second phone got immediate contact to the next station (not normal for Norway!) and he phoned up the Narvik hospital (only few Kilometre away). The chief nurse knows what to do, press all buttons and alarms all necessary people. On that day, really everything was perfect. In Svolvaer (biggest town on lofotes) a SAR Chopper was ready to take off and got an anaesthesia assistant on board by pure chance. They start and fly to Narvik hospital, get up a doc and went to the river. Meanwhile several helpers had hurry up, gone to the river. One of the men took by a sudden idea a heavy shovel with him. This shovel should rescue the womans life. They start to make a hole in the ice behind the woman, where they thought her head had to be under the ice. Nobody could get her out through the first hole because her jacket functions as a parachute, so they pray the skies would stand the power. But the ice was so thick, they break all knife, break the skies, nothig was able to make a hole in it, only the heavy shovel was able to. By this way, they got the woman out of the river, with head first. The SAR Shopper comes an they start to get her up. The woman was about half a hour in the icecold water, so she was almost frozen. They fly direct to the next bigger hospital in Tromsö (Tromsö gots the most northern University in world). On the landing field everythng was ready, just on the field they attached a heart-lounge-machine to the woman and then went to a special room especially fitted for hypothermia cases. The body centre temperature was down to about (donīt nail me on the exact temp) 12 or 15 degree Celsius (about 285-288 degree Kelvin). She was really shock frosted and that saved her life. They place her in a special bed an start to cool her down. YES, cool down. By the helicopter transport her body temp. had get up for two degrees. And thatīs to much in such a short time. I think the lowest temp. was about 13,6 degree Celsius. Absolutely world record, until today. Next 3 days (THREE) they warm her up under controlled conditions to normal body temp. Then the woman wakes up and everybody couldnīt believe it, she was okay. The only problems she got afterwards were some diffuse irritations in the outer extremeties. Thereīs almost no feeling in the fingers. Thats all, but hard for a surgery doctor! An unbelieveable case and everything had worked great. The rescueing chain was first class. The story was publicated in late August or Septembre 99, I think. Shortly after Volker returns from Norway I ask him, if he had heard from this case. He was laughing, because heīd been almost nearby and knows everything from first hand. A extreme important part of medicine history. Just think on complicate heart operations, when they have to stop everything and cool the body down... The story was a little revolution, it was the first time a person survives such an extreme accident and they had waited with the publication, just to give the woman time to get back into live. Hope Iīve found the right words. Its a little bit complicate to explain such an incident without good english and without being eye-witness. If somebody suffers under a hard form of hypothermia it is the biggest and (mostly) the last fault just to warm the person, give something warm to drink, a hot shower or something else. By light forms its okay, but differs from case to case. A circulation collapse is everytime possible, so have an eye on such persons! By hard hypothermia you have to avoid EVERYTHING which could restart the body circulatory in the extremeties. If you do so, the cold blood comes to the slightly warm inner body and a total circulatory collapse will happen and the person will die immediately. Many hypothermia suffering persons die, when the rescuers hold them on their legs. Collapse! You have to keep the person flat, flat, falt and rewarm the body as slow as possible. There ist a new system. USA and Canada use it for several years and the DGzRS (german sea rescue squad) got it also on every ship. It had saved many lifes, yet. The persons are given heated air. Over the lounge the body is warmed directly over the blood. If you drink a warm tea, the body would need blood for the stomage and get it from the extremeties. I think it would be better to ask a specialised medicine to get more exact information on all forms of hypothermia. This aspect should also be part of every good seakayak teaching book, I think. Biggest enemy isnīt the water, it is the cold or everyone to themself... Maybe my text is understandable enough for you. best regards Jochen Grikschat *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. 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[839 lines of unedited post removed by the moderator] went to a lecture on hypothermia, which was presented by a doctor who was a noted expert on the topic. This was given to paramedics for re-certification credit. He mentioned a case where an officer responded to look for two fishermen who capsized their boat mid-winter. He found one by the stream at the bottom of a steep embankment. He evaluated this man who was alert and oriented and not shivering. He decided to help him up the embankment, since he didn't seem too bad. After reaching the road, the man suddenly died of cardiac arrest. The doctor speculated that his core temperature was only moderately low prior to the climb. Exercising resulted in a sudden temperature drop when the cooler blood from the extremities reached the heart. This man was in his sixties, I believe. Bill >He made it back into his condo, but was >found a few days later, still in some wet cloths, on his bed, dead. The >family was told he died of hypothermia. I'd never heard of such a thing. >Anyway, I shut up for the rest of the meal. > >Doug Lloyd *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
From: "Jack Fu" <SeaDogJack_at_cablespeed.com> > Mike, > How do you fit three people in a sleeping bag? > Jack With great difficulty! Actually two is a possibility if you have a rectangular bag, but a mummy is awkward. If two bags zip together (more common today than twenty years ago) do that. Spreading an open sleeping bag over the casualty and rescuers with thermal sleeping pads underneath will work. Wrapping the whole affair with an aluminized mylar blanket (emergency "space" blanket), tarp, tent or other windproofing is a useful addition. Like all serious first aid in the wilderness, you have to improvise. If a person is shivering, they won't need this treatment. If they are practically an iceberg, the treatment that Matt suggested is probably advised. This falls somewhere in-between. I described the worst I've been through personally - that just required "fuel", a drink and a bit of warming. The worst I've ever had to treat was a kayaker that overturned in icy water, losing his paddle and means of reentry in the process. We got to him after he had been in the water for about five minutes. He was wearing cotton sweat pants and -shirt, windbreaker & PFD (air temp just above freezing, wind chill below freezing). We did an assisted rescue to get him in the kayak and, while I kept him steady, the other rescuer towed us to an island. We rafted over the shore-bound ice and got him to shore. Between the two of us, we rescuers were able to give him a complete change of clothes - including _extra_ insulation (and this was a day paddle!). We wrapped him in a aluminized tarp and fed him hot tea. He was shaking so bad he spilled half the tea. An ice canoe was launched from shore to rescue him. Seeing an ice canoe seal land on the ice and come right to shore was something! I hope I never have to deal with anything that serious or more again! Mike *************************************************************************** PaddleWise Paddling Mailing List - Any opinions or suggestions expressed here are solely those of the writer(s). You must assume the entire responsibility for reliance upon them. All postings copyright the author. Submissions: PaddleWise_at_PaddleWise.net Subscriptions: PaddleWise-request_at_PaddleWise.net Website: http://www.paddlewise.net/ ***************************************************************************
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