Hypothermia Treatment for Boaters
Treating Cold Injuries Using Alaska State Guidelines
Boaters should be familiar with the signs, symptoms, and treatment of hypothermia, while being proactive in its prevention
Boaters and other outdoor enthusiasts should be familiar with the care and treatment of hypothermia. Cold injuries can easily occur south of the Great Land, but people in the north need to be very familiar with the problem. The State of Alaska started what are known as the Cold Injury Guidelines in 1982 and they offer good insight for boaters on the subject. These guidelines cover hypothermia, cold water drowning, frostbite, and avalanche burial. The first topic of hypothermia is of greatest interest to boaters. While these guidelines are geared to the emergency medical service, many suggestions are provided by them for the general population.
What is Hypothermia? - A reduction of the core body temperature to less than 35°C ( 95°F) is considered hypothermia. Many factors influence the onset of the condition like age, sex, weight and physical condition. Alcohol and other medications can reduce the ability to produce heat or increase its loss. There are several avenues of heat loss that can lead to hypothermia and four stages of hypothermia.
Heat Loss Factors
- Conduction - Direct transfer of heat through a solid. Usually caused by contact with a cold surface like the ground
- Convection - Cold air or water can carry heat away from the body
- Radiation - Heat lost from the body into the cooler air
- Evaporation - The body cools itself through the vaporization of perspiration from its surface
- Respiration - Outside air is warmed during inspiration and the heat is lost on exhalation
Degrees of Hypothermia
- Impending - Core temperature is down to 36°C (96.8°F). Skin may be pale and shivering can begin
- Mild - Core temperature is down to 34°C (93.2°F). There is intense and uncontrolled shivering. Movement is less coordinated and cold is causes some pain
- Moderate - Core temperature is down to 31°C (87.7°F). Shivering can slow or stop. There is mental confusion, drowsiness, and breathing is slowed
- Severe - Core temperature is below 31°C (-87.7°F). Skin can become a blue-gray color and eyes dilated. There will be a gradual loss of consciousness, little or no breathing, and no response to stimulation
Treatment Notes for Hypothermia - There are many things that can be done to treat hypothermia. It is better to prevent it from occurring through good preparation. Here are a few hints for care of hypothermia:
- Handle those that are severely hypothermic very gently. A cold heart is prone to ventricular fibrillation
- The core body temperature is an important vital sign in hypothermia care
- A simple test for hypothermia is to place an ungloved hand against the skin of the armpit, back or chest. If the skin is warm to touch, hypothermia is probably not a concern
- A person with hypothermia can also have other injuries or illnesses. Be observant for these problems that can worsen the hypothermia
- Cold skin is easy to injure, avoid direct contact with hot objects or application of extreme pressure
- Assume those with severe hypothermia can be resuscitated regardless of their appearance
Basic Treatment for Mild Hypothemia
- Prevent further heat loss from the ground, wind or wet clothes. Insulate the patient, use a vapor barrier like a tarp and move into a warmer environment
- Activate the emergency medical response system to facilitate transportation to a medical facility
- Do not allow the patient to consume alcohol or use tobacco
- Warm sweetened drinks can be given if the patient can protect their airway
- Carefully apply heat to the underarms, groin, sides of the chest, and neck
- If the patient is alert and mobile, consider a warm bath or shower
- Place the patient in a sleeping bag with a warm person
Severe Cases - Transport Immediately Patients with moderate to severe hypothermia need to be handled carefully. Do not attempt to remove wet clothes unless they can be carefully cut off. Do not allow them to sit or stand until they are rewarmed. Prevent further heat loss. Do not give fluids or food. Check their physical status often. Check for pulse and breathing for at least 60 seconds. Conduct CPR even if the patient appears to be in poor condition.
Consider taking a first-aid class and learning more about hypothermia.
