Managing Hypothermia and Serious Cold Exposure

Introduction

This Straight, No Chaser post discussing managing hypothermia and serious cold exposure.

Is this the most famous illustration of frostbite? Do you remember the movie reference?

I’ll admit that my orientation is different than yours. I’ll argue that your orientation should be closer to mine. What’s the difference, you may ask? I’ve actually seen the consequences of your unfortunate actions, and these consequences occur with a much greater frequency than you may imagine. “An ounce of prevention is worth a pound of cure” isn’t just a catchy quote from Ben Franklin. It’s an “Oops, I should’ve had a V-8 moment” when you’re in front of me, my nurses and big invasive medical treatment options in an emergency room.

Cold exposure is a good example of this. We’ve previously discussed frostbite, but there must be more to the story than frostbite. Frostbite is not a necessary pit stop on the way to very bad things happening due to cold exposure. More importantly, for as bad as frostbite is, there are worse things that can happen to you from cold exposure. This is a relatively important conversation. You need more tools at your disposal than “Just bundle up.” We’ll explore these tools in two parts: basic care and emergency care.

The Basics – Prevention

Layers of loose clothing are better. Wear more than one pair of socks, at least until you’re back indoors.
Use a hat that actually covers your scalp. (Major heat loss occurs through the scalp.)
Use a hat that covers your ears and a scarf that covers your nose. (These areas are prone to frostbite.)
Wear mittens. They are better for protecting your fingers than gloves.
People greatly underestimate the effect of the combinations of being cold and wet or being exposed to cold and windy conditions. If you have water-resistant, wind-proof options, use them.
If you know you’re going to be exposed to the cold for a significant period of time, eat up and rest up beforehand. Avoid alcohol and cigarettes prior to and during such journeys.

Treatment You Can Do If Exposed

Know what symptoms could be a result of hypothermia. Check previous posts for a refresher.
Your first step is to call 911, especially if any mental status changes (e.g., confusion) are present. Time is of the essence.
Do you know CPR? Refer here for a very easy refresher (you’ll commit it to memory in 2 minutes) of when to use it and how to perform it.
Can you get inside? Cover yourself with warm blankets and drink warm (nonalcoholic) fluids if possible. Remove wet and tight clothing (and cover back up with dry ones if possible).
You’re stuck outside? You should be thinking about reducing exposure to the cold, the wind and any wetness as much as possible. Don’t forget to provide a layer between the backside and the ground. Prioritize covering the scalp.
Think about giving or receiving a hug as a means of warmth. If you have access to warm compresses or towels, preferentially apply to the armpits, groin, neck and chest.

Your take home message is death from hypothermia can be avoided with the knowledge and application of basic fundamental considerations. Even better, you can usually choose to avoid exposure to bitterly cold conditions. I hope you find this information useful and never need to use it.
This is part of a series on medical conditions resulting from cold exposure.

Click here for a discussion of frostbite.
Click here for a discussion of the symptoms of and risks for hypothermia

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