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August 2014 Issue
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How to spot and treat hypothermia

Hypothermia is best treated by finding shelter, changing into dry clothes and getting warm. Photo: Paul King

Knowing how to spot and treat this condition could save lives, says Dr Craig Ellis

Hypothermia occurs when the core body temperature drops below 35°C – or when the body is cooling down and is unable to stop the process with its usual compensatory mechanisms such as shivering. The onset of hypothermia is more rapid if the person is immersed in water or is soaking wet.

Recognition

It is much easier to recognise hypothermia in others than in yourself, though early self-recognition is possible. You might feel cold and start shivering. More importantly, you may have problems finding and formulating words and you may start to feel poorly coordinated. A good test is to rapidly tap the tip of your thumb against the tips of your fingers on the same hand as fast as you can; an inability to do this can be a sign you are developing hypothermia.

Symptoms you may notice in others:

  • Shivering (often quite violently)
  • Complaining of unreasonable tiredness
  • Slow to respond to questions
  • Increasingly uncoordinated, clumsy and may appear drunk
  • Irrational behaviour and may be resistant to help

Treatment

If the patient is awake, orientated and able to obey commands but is thinking and acting slowly, they are usually at the mild end of the hypothermia spectrum. If the patient has stopped shivering and is very confused or unconscious, they are at the severe end. No matter how severe, do the following:

Get shelter – getting out of the wind and rain is the single most important action you can take
Get dry – once you have some degree of shelter, you need to change into warm dry clothes
Get warm – taking shelter and getting dry may be enough, but passively warming a hypothermic patient by placing them in a sleeping bag or blankets is also important along with warming the shelter if possible. It is a widespread belief that getting into the sleeping bag with the patient, skin to skin, also helps, but realistically it adds little if you have taken these three actions.

If the patient is wide awake, warm drinks or soups are also useful and if you can achieve all of the above, they will usually recover quickly.

If they are drowsy, confused or unconscious you must do all of the above but also get help. Activate your PLB or, if it is safe, send for help. If they are deeply unconscious and show no signs of life, consider CPR and continue for as long as you physically can without compromising your own safety.

– Dr Craig Ellis is the St John Deputy Medical Director and a Specialist Emergency Physician at Hawkes Bay Regional Hospital

 

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