Hypothermia Survival Stories
Posted: Mon Jan 21, 2013 4:58 pm
Have any of you fallen into a river/creek/lake and had to act swiftly to avoid getting
hypothermia. Ever get caught in a rain storm, gotten drenched, and felt the chill
come on suddenly. Or how but doing a sweaty hike lasting all day and then the sun
starts to set and cold wind picks up all of sudden making your core temps drop suddenly?
Have you or anyone you know been hypothermic, and what category did you/they
fall into?
Wikipedia:
Signs and symptoms
The signs and symptoms vary depending on the degree of hypothermia and may be
divided by the three stages of severity.
Mild
Symptoms of mild hypothermia may be vague with sympathetic nervous system
excitation (shivering, hypertension, tachycardia, tachypnea, and vasoconstriction).
These are all physiological responses to preserve heat. Cold diuresis, mental confusion,
as well as hepatic dysfunction may also be present. Hyperglycemia may be present, as
glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity
to insulin may be blunted. Sympathetic activation also releases glucose from the liver.
In many cases, however, especially in alcoholic patients, hypoglycemia appears to be
a more common presentation. Hypoglycemia is also found in many hypothermic patients
because hypothermia often is a result of hypoglycemia.
Moderate
Low body temperature results in shivering becoming more violent. Muscle mis-
coordination becomes apparent. Movements are slow and labored, accompanied by
a stumbling pace and mild confusion, although the victim may appear alert. Surface
blood vessels contract further as the body focuses its remaining resources on keeping
the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may
become blue.
Severe
As the temperature decreases further physiological systems falter and heart rate,
respiratory rate, and blood pressure all decreases. This results in an expected HR
in the 30s with a temperature of 28 °C (82 °F).
Difficulty in speaking, sluggish thinking, and amnesia start to appear; inability to
use hands and stumbling is also usually present. Cellular metabolic processes shut
down. Below 30 °C (86 °F), the exposed skin becomes blue and puffy, muscle
coordination becomes very poor, walking becomes almost impossible, and the
person exhibits incoherent/irrational behavior including terminal burrowing or
even a stupor. Pulse and respiration rates decrease significantly, but fast heart
rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail.
Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia,
the body will actually take longer to undergo brain death.
Paradoxical undressing
Twenty to fifty percent of hypothermia deaths are associated with paradoxical
undressing. This typically occurs during moderate to severe hypothermia, as the
person becomes disoriented, confused, and combative. They may begin discarding
their clothing, which, in turn, increases the rate of heat loss.
Rescuers who are trained in mountain survival techniques are taught to expect this;
however, some may assume incorrectly that urban victims of hypothermia have been
subjected to a sexual assault.
One explanation for the effect is a cold-induced malfunction of the hypothalamus, the
part of the brain that regulates body temperature. Another explanation is that the
muscles contracting peripheral blood vessels become exhausted (known as a loss of
vasomotor tone) and relax, leading to a sudden surge of blood (and heat) to the
extremities, fooling the person into feeling overheated.
Terminal burrowing
An apparent self-protective behaviour known as terminal burrowing, or hide-and-die syndrome,occurs in the final stages of hypothermia. The afflicted will enter small,
enclosed spaces, such as underneath beds or behind wardrobes. It is often associated
with paradoxical undressing.
Managment
Aggressiveness of treatment is matched to the degree of hypothermia. Treatment
ranges from noninvasive, passive external warming, to active external rewarming,
to active core rewarming. In severe cases resuscitation begins with simultaneous
removal from the cold environment and concurrent management of the airway,
breathing, and circulation. Rapid rewarming is then commenced. A minimum of
patient movement is recommended as aggressive handling may increase risks of
a dysrhythmia.
Hypoglycemia is a frequent complication of hypothermia, and therefore needs to
be tested for and treated. Intravenous thiamine and glucose is often recommended
as many causes of hypothermia are complicated by Wernicke's encephalopathy.
Rewarming
Rewarming can be achieved using a number of different methods including passive
external rewarming, active external rewarming, and active internal rewarming.
Passive external rewarming involves the use of a person's own heat generating
ability through the provision of properly insulated dry clothing and moving to a
warm environment.It is recommended for those with mild hypothermia. Active
external rewarming involves applying warming devices externally such as
warmed forced air (a Bair Hugger is a commonly used device). In austere
environments hypothermia can sometimes be treated by placing a hot water
bottle in both armpits and groin.It is recommended for moderate hypothermia.
Active core rewarming involves the use of intravenous warmed fluids, irrigation
of body cavities with warmed fluids (the thorax, peritoneal, stomach, or bladder),
use of warm humidified inhaled air, or use of extracorporeal rewarming such as
via a heart lung machine. Extracorporeal rewarming is the fastest method for those
with severe hypothermia.
Intravenous fluids
As most people are moderately dehydrated due to hypothermia induced cold
diuresis, intravenous fluids are often helpful (250–500 cc 5% dextrose and normal
saline warmed to a temperature of 40–45 °C is often recommended).
Rewarming collapse
Rewarming collapse (or rewarming shock) is a sudden drop in blood pressure in
combination with a low cardiac output which may occur during active treatment
of a severely hypothermic person. There is theoretical concern that external
rewarming rather than internal rewarming may increase the risk. However, recent
studies have not supported these concerns
hypothermia. Ever get caught in a rain storm, gotten drenched, and felt the chill
come on suddenly. Or how but doing a sweaty hike lasting all day and then the sun
starts to set and cold wind picks up all of sudden making your core temps drop suddenly?
Have you or anyone you know been hypothermic, and what category did you/they
fall into?
Wikipedia:
Signs and symptoms
The signs and symptoms vary depending on the degree of hypothermia and may be
divided by the three stages of severity.
Mild
Symptoms of mild hypothermia may be vague with sympathetic nervous system
excitation (shivering, hypertension, tachycardia, tachypnea, and vasoconstriction).
These are all physiological responses to preserve heat. Cold diuresis, mental confusion,
as well as hepatic dysfunction may also be present. Hyperglycemia may be present, as
glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity
to insulin may be blunted. Sympathetic activation also releases glucose from the liver.
In many cases, however, especially in alcoholic patients, hypoglycemia appears to be
a more common presentation. Hypoglycemia is also found in many hypothermic patients
because hypothermia often is a result of hypoglycemia.
Moderate
Low body temperature results in shivering becoming more violent. Muscle mis-
coordination becomes apparent. Movements are slow and labored, accompanied by
a stumbling pace and mild confusion, although the victim may appear alert. Surface
blood vessels contract further as the body focuses its remaining resources on keeping
the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may
become blue.
Severe
As the temperature decreases further physiological systems falter and heart rate,
respiratory rate, and blood pressure all decreases. This results in an expected HR
in the 30s with a temperature of 28 °C (82 °F).
Difficulty in speaking, sluggish thinking, and amnesia start to appear; inability to
use hands and stumbling is also usually present. Cellular metabolic processes shut
down. Below 30 °C (86 °F), the exposed skin becomes blue and puffy, muscle
coordination becomes very poor, walking becomes almost impossible, and the
person exhibits incoherent/irrational behavior including terminal burrowing or
even a stupor. Pulse and respiration rates decrease significantly, but fast heart
rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail.
Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia,
the body will actually take longer to undergo brain death.
Paradoxical undressing
Twenty to fifty percent of hypothermia deaths are associated with paradoxical
undressing. This typically occurs during moderate to severe hypothermia, as the
person becomes disoriented, confused, and combative. They may begin discarding
their clothing, which, in turn, increases the rate of heat loss.
Rescuers who are trained in mountain survival techniques are taught to expect this;
however, some may assume incorrectly that urban victims of hypothermia have been
subjected to a sexual assault.
One explanation for the effect is a cold-induced malfunction of the hypothalamus, the
part of the brain that regulates body temperature. Another explanation is that the
muscles contracting peripheral blood vessels become exhausted (known as a loss of
vasomotor tone) and relax, leading to a sudden surge of blood (and heat) to the
extremities, fooling the person into feeling overheated.
Terminal burrowing
An apparent self-protective behaviour known as terminal burrowing, or hide-and-die syndrome,occurs in the final stages of hypothermia. The afflicted will enter small,
enclosed spaces, such as underneath beds or behind wardrobes. It is often associated
with paradoxical undressing.
Managment
Aggressiveness of treatment is matched to the degree of hypothermia. Treatment
ranges from noninvasive, passive external warming, to active external rewarming,
to active core rewarming. In severe cases resuscitation begins with simultaneous
removal from the cold environment and concurrent management of the airway,
breathing, and circulation. Rapid rewarming is then commenced. A minimum of
patient movement is recommended as aggressive handling may increase risks of
a dysrhythmia.
Hypoglycemia is a frequent complication of hypothermia, and therefore needs to
be tested for and treated. Intravenous thiamine and glucose is often recommended
as many causes of hypothermia are complicated by Wernicke's encephalopathy.
Rewarming
Rewarming can be achieved using a number of different methods including passive
external rewarming, active external rewarming, and active internal rewarming.
Passive external rewarming involves the use of a person's own heat generating
ability through the provision of properly insulated dry clothing and moving to a
warm environment.It is recommended for those with mild hypothermia. Active
external rewarming involves applying warming devices externally such as
warmed forced air (a Bair Hugger is a commonly used device). In austere
environments hypothermia can sometimes be treated by placing a hot water
bottle in both armpits and groin.It is recommended for moderate hypothermia.
Active core rewarming involves the use of intravenous warmed fluids, irrigation
of body cavities with warmed fluids (the thorax, peritoneal, stomach, or bladder),
use of warm humidified inhaled air, or use of extracorporeal rewarming such as
via a heart lung machine. Extracorporeal rewarming is the fastest method for those
with severe hypothermia.
Intravenous fluids
As most people are moderately dehydrated due to hypothermia induced cold
diuresis, intravenous fluids are often helpful (250–500 cc 5% dextrose and normal
saline warmed to a temperature of 40–45 °C is often recommended).
Rewarming collapse
Rewarming collapse (or rewarming shock) is a sudden drop in blood pressure in
combination with a low cardiac output which may occur during active treatment
of a severely hypothermic person. There is theoretical concern that external
rewarming rather than internal rewarming may increase the risk. However, recent
studies have not supported these concerns