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Watch out for the Umbles: Preventing and Treating Hypothermia

Watch out for the Umbles: Preventing and Treating Hypothermia

Seattle weather seems to have finally conceded that winter has arrived. This week, we’ve seen the kinds of temperatures that can easily result in hypothermia if precautions aren’t taken. In this post, we’re going to look at some of the ways you can protect yourself before venturing out, how to recognize the onset of serious cold exposure, and what first aid steps are necessary to treat hypothermia.

Avoiding hypothermia means staying warm and dry. Choice of clothing for low temperatures should include lots of layers to trap air for insulation and fabrics that retain heat when wet (i.e. wool and silk instead of cotton). Start with a wicking base layer to draw moisture away from the skin, follow with a warm layer or layers (down, wool, fleece), and finish with a breathable wind and waterproof shell.

Note that even a seemingly small drop in body temperature can have life-threatening effects; a body temperature of just 95 degrees can cause severe shivering and an irregular heartbeat to develop. When core temperature goes below 90 degrees, the victim may lose the ability to walk, can fall unconscious, and their breathing and pulse may be very difficult to detect.

Some of the common initial stages of hypothermia are often referred to as the “Umbles”. These include:

  • Stumbles – loss of control over movement, slowed motion, stiffness in extremities
  • Mumbles – slurred, slowed, or incoherent speech, sleepiness or confusion
  • Fumbles – slow reaction time, dropping objects, poor coordination
  • Grumbles – change in behavior, expressing a negative attitude

Other signs of mild hypothermia include poor judgment, apathetic behavior, increased rates of breathing and heartbeat, and cool, pale skin.

As the condition worsens, the victim may develop severe shivering (which uses up energy reserves), an inability to walk, and may have an unfocused, faraway gaze. Sever hypothermia results in a halt to shivering (as the brain is impeded from sending signals via the nerves), rigid muscles, unconsciousness, slowed or undetectable pulse and breathing, and cold and bluish skin.

If any of the above characteristics are noted, it’s time to get the patient out of the cold. Blood vessels in their extremities will be contracting and there will be a reduction in blood flow. The victim will therefore feel colder, and the drop in core temperature will be affecting brain function. Get them into a warm environment.

Wet clothing will draw heat away from the body at a very high rate. Anyone who has become wet outdoors should be considered to be at risk of developing hypothermia. This applies even in moderate temperatures of around 50 degrees. Wet clothing should be removed as quickly as possible and replaced with dry clothes. Make sure to do a thorough check, as dampness may not be immediately noted.

The human body will try to keep the heat contained in the core (where the vital organs are). Shivering is the body’s way of heating the core blood, and anyone exhibiting uncontrollable or severe shivering should be treated immediately. A condition to be aware of is re-warming shock, which can occur when a victim is not handled gently, or if a rescuer attempts to warm them through vigorous massage. This can result in the colder blood rapidly circulating back from the skin and limbs into the core, and therefore into the heart. This can also result in cardiac arrest in some cases.

All alcohol is to be avoided as it increases the chances of developing hypothermia by dilating blood vessels and reducing the body’s ability to shiver. Caffeine should also be avoided if possible, as it is a diuretic and increases dehydration. But if no other hot liquid is available, it’s better to give something caffeinated than nothing at all. For mild cases, a sweetened drink provides sugars that can increase the energy available to heat the body.

Keep in mind that hypothermia is of particular concern for elderly people who may have poor nutritional habits, are taking certain medications, and who have conditions such as arthritis, Parkinson’s disease, or stroke, which make it difficult to move around and generate body heat. Those suffering from Alzheimer’s disease or memory loss may not think to put on more clothing or set heating systems appropriately.

In the end, prevention of hypothermia is much easier than treating it. But if you think someone is suffering the effects of hypothermia, make sure to do the following:

  • Get them out of the cold and into a warm environment
  • Remove all wet clothing and wrap the victim in blankets, a sleeping bag, i.e. something dry
  • Call 911 immediately
  • Keep them as still as possible
  • If they can swallow safely, give them something warm to drink
  • If the victim stops breathing, begin the steps of CPR immediately

Above all, if you are in doubt, notify emergency medical services as soon as you can. It just might save a life.

For information on treating hypothermia in situations where emergency medical services are not available or are significantly delayed, CPR Seattle offers a Wilderness First Aid course where these practices are discussed. For details visit our website at http://www.cprseattle.com/wilderness-first-aid.


Published on December 5, 2014