Dead Cold: Hypothermia 101

Dead Cold: Hypothermia 101

Human beings live in a delicate temperature balance. It may seem like we’re pretty tolerant of changing temperatures because we can be comfortable on a hot summer day and also enjoy winter sports, but our core body temperature always stays about the same – the trusty old 98.6 (F). If we deviate from that by more than a few degrees up or down it’s extremely dangerous. This is why fevers, heatstroke and hypothermia are all potential killers.

Hypothermia happens when your body cannot maintain a normal temperature around your organs. In a low-temperature setting you must be able to keep warm. Humans generate heat by burning food calories or we absorb heat, typically from an outside source such as the sun or a fire. The trick is, you have to create or absorb heat faster than your body loses that heat. So when you are wet or exposed to wind those conditions make your heat loss accelerate because of evaporative cooling.

IDENTIFYING HYPOTHERMIA

You can tell when you’re getting close to hypothermia when your teeth are chattering and you’re shivering. Shivering is simply your body actuating your muscles to try to generate some heat by burning sugar. If your body temperature gets below about 90 degrees, your brain will start functioning erratically. You may find yourself disoriented, dulled and uncoordinated. By the time your core body temperature dips below 85 degrees you’re likely to lose consciousness and slip into a comatose state that is very difficult to treat. Death follows soon after.

Because low body temperature starts affecting your cognition very quickly, it may be easier to identify hypothermia in others than to diagnose it in yourself. But most people have experienced some degree of hypothermia at some point – it’s not pleasant.

TREATING HYPOTHERMIA

To treat hypothermia in its early stages, you can simply apply external warming in the form of clothing, blankets and warm compresses around the neck. If possible, try to get the hypothermia sufferer to drink warm sweet liquids. These drinks are especially effective because they both warm the body core from the inside and deliver rapid-response sugar fuel to the body. That’s why hot apple cider and hot chocolate are so good in the winter! A hot shower or warm bath can also help raise core body temperature.

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Obviously, if a person is disoriented or losing consciousness, they may be unable to swallow or be safe in water. Also, be aware that warming someone too quickly from outside the body can induce shock, fainting, or cause a heart attack, so be careful with the hot showers.

For more severe cases of hypothermia, you will likely need professional medical help. Hospitals can administer warm intravenous fluids in addition to external warming. When in doubt, do what you can for the victim but head for the hospital.

WHAT ABOUT FROSTBITE?

The rules for dealing with frostbite or freezing are quite different than when dealing with hypothermia. Frostbite is when skin and flesh have actually frozen. Human bodies are mostly made of water, and we freeze just as easily as a pork chop. But freezing living flesh has nasty consequences.

First, when flesh is frozen, blood is not getting through to deliver life-sustaining oxygen and sugars, so the frozen area is likely to become necrotic when it thaws. Second, when the water in your cells freezes, it expands and the cellular structure may be physically damaged. Think about leaving a can of soda in the freezer too long – the can becomes bloated and usually ruptures. That’s what happens to frozen cells.

HOW TO SPOT FROSTBITE

Extremities are the most likely places for frostbite. They’re far away from the heat engine of your torso and they have lots of surface area to shed heat. Fingers and toes, plus your nose, cheeks and ears are prime targets for frostbite. Flesh that is frostbitten may look gray or yellowed, and it will feel very cold and hard to the touch. Typically smooth areas like fingerprints may develop bumps or ridges. The victim will probably know the areas have gone numb.

“FLESH THAT IS FROSTBITTEN MAY LOOK GRAY OR YELLOWED, AND IT WILL FEEL VERY COLD AND HARD TO THE TOUCH.”

To spot frostbite in yourself, know that as frostbite begins, it’s painful. Your extremity is losing circulation, and so it’s likely to cramp up and hurt. But once the real freezing happens, the nerves are deadened and the extremity feels numb. That’s when the worst damage is occurring. Unless the body part is thawed and warmed right away there will likely be tissue necrosis leading to gangrene or death. Often, amputation is the only solution for dead fingers and toes.

TREATING FROSTBITE

To treat frostbite the best thing is to bring the whole person somewhere warm, such as the inside of a car with the heater on. You may also want to immerse the affected extremities in warm body-temperature water or hold the frozen parts in warm hands or under an armpit to help them absorb heat. Resist the urge to rub frostbitten parts or handle them roughly – this can cause further cell damage.

As the body part thaws and circulation is restored you can expect pain, swelling, and redness. There has been substantial insult to the capillaries, muscles, and tissues, and they will be complaining. Wrap and insulate the damaged parts and protect them against further exposure. If they freeze a second time, you’re pretty much guaranteed to lose the flesh.

“RESIST THE URGE TO RUB FROSTBITTEN PARTS OR HANDLE THEM ROUGHLY – THIS CAN CAUSE FURTHER CELL DAMAGE.”

The worst case is the flesh turns black when thawed. Now you’ve got real problems and you need to get the frostbite victim to a hospital right away before gangrene develops.

PREVENTING HYPOTHERMIA AND FROSTBITE

Keeping hypothermia and frostbite at bay is mostly a matter of common sense. If you have a choice, never go out in freezing weather without appropriate gear including insulated gloves, heavy socks, waterproof shoes, and warm layered clothing. When it’s below freezing, try to stay dry. Mylar “space blankets” are great for this purpose. They are compact, light, reflect heat back to your body, and are wind- and waterproof all at the same time.

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High-calorie foods and drinks should also be in your cold weather kit. Keep drinks close to your body to keep them warm to avoid introducing cold into your core. High-carb cereal bars and runner’s snacks such as gummy bears and chocolate bars are great. Longer-acting foods such as proteins are less helpful. You need sugar to burn for heat right now.

If you do find yourself outdoors and unprepared for inclement conditions, keep your hands in your pockets or up in your armpits, and seek the nearest warm shelter you can find. Your life could depend on it.

TIP: Newspaper has excellent insulation qualities and wind does not penetrate it. It’s an old Hobo trick to line your pant legs and shirt with a few layers of newspaper to cut down on heat loss.

Editors Note: A version of this article first appeared in the March 2015 print issue of American Survival Guide.