Re: [Paddlewise] hypothermia treatment

On 20 Nov 2003 at 22:58, eric eason wrote:

>   just a lurker on this forum but i understood the
> best treatment for hypothermia was to put the patient
> into a warm, not hot, bath with arms and legs out

For immersion or acute hypothermia, that is correct.  However, it 
must be administered correctly - meaning it's not something you 
should try without appropriate training.

>   i know this not likely to be possible in most cases
> when treatment is needed

If in doubt or if you can't get a patient to a hospital, treat as for 
chronic hypothermia - that is, move the patient as little as possible 
and keep them very warm.  That means removing wet clothing and 
getting them dry.  Build a fire if possible.  Keep them out of the 
wind.  If they are well on, get them into a sleeping bag with a 
couple of people that are warm with minimal clothing so that heat is 
readily transferred to the cold person.  

For this reason, I like to keep my tent or tarp right next to the 
hatch cover - it's the first thing, along with first aid kit, I can 
grab (oh,yeah, also the toilet paper :-).  One tarp I always have, 
even on hot summer day paddles, is an aluminized tarp - like a heavy 
space blanket with grommets around the sides.

It is important to recognize the difference between chronic and acute 
hypothermia.  

Chronic is caused by gradual cooling of the body - not wearing enough 
clothing while paddling, for example.  In this case, the body 
temperature at the core is not greatly different than at the surface. 
The paddler should be warmed.  Also, it is important to note that 
they may not have the ability to generate enough heat so external 
heat should, if the patient is sufficiently aware, be supplimented 
with energy intake - i.e. food.  Warm, sweet drinks can also be used. 
 
Acute hypothermia (aka immersion due to it's common cause) results 
from a sudden and rapid cooling of the body - as when a paddler swims 
in cold water.  In this case, the core can still be warm even though 
the surface of the body is quite cold.  Circulation of blood will 
bring the cold to the core quickly - that's what causes heart or 
other organ failure.  Hence the patient should not be moved so as to 
minimize circulation.  Ideally, immersion in water to stabilize 
temperature is called for, but leave that for the pros.

In my decades of cross-country skiing, I've probably seen more cases 
of hypothermia than all other injuries combined.  It's happened to me 
a couple of times and the first time was the most severe.  
Fortunately, I recognized the symptoms and treated myself as far as 
possible.  The second time, I picked up on it earlier and headed to a 
warm-up hut.  Energy bars and sports drinks, along with the hut's 
wood stove, got me back on skis and home.

It probably strikes more paddlers than we are aware of.  Unless it 
gets to a critical stage, most folks would probably be unaware of it. 
I wouldn't be surprised to find it kills more paddlers than drowning.

Mike
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