Treatment & Prevention Tips for ACCIDENTAL HYPOTHERMIA

Treatment for HYPOTHERMIA:
If a member of the group becomes hypothermic, the expedition should be stopped and shelter found. .Attempts should be made to prevent further heat loss from the victim's body and to provide external heat. The victim should be insulated from the ground. Wet clothes can be removed but only if there is adequate shelter. The victim's body should be dried and put in a dry sleeping bag or "space blanket" with his head slightly lower than his body. If available, a synthetic body bag can be used for further insulation.

Additional heat can be provided by the "buddy" technique or by using wrapped, heated stones, taking care not to bum the victim. With the "buddy" technique, one or two companions supply external heat by skin-to-skin contact. Heat transfer will be more rapid with maximum contact of bare skin. The victim and his "buddies" should be-naked or nearly so and hugging tightly in­side the sleeping bag. Active rewarming with hot baths is discussed in the section on immersion hypothermia.

If the victim is unconscious and shows no pulse, he should be given mouth-to-mouth resuscitation, but at half the normal rate of twelve to fifteen times per minute. The victim must be evacuated by stretcher, even if he seems fully recovered and protests such measures. The insulation must be kept in place during the evacuation and a member of the team who is not a stretcher-bearer should watch the victim carefully because of the possibility of vomiting.

Prevention Tips for ACCIDENTAL HYPOTHERMIA:
The predisposing factors mentioned above should be eliminated. Persons who are unhealthy, on medications, in poor physical condition, elderly, or otherwise likely to have difficulty should forego activities that could lead to hypothermia. Close attention must be paid to weather forecasts before hiking, mountain climb­ing, camping, skiing, or similar outings.

During World War II the U. S. Army used the mnemonic COLD to help train men in the proper use of clothing. This mnemonic is remembered as follows:

C - Keep your clothing Clean. Dirty, greasy clothing may become matted down and lose insulating properties.

O - Before becoming overheated, Open your clothing to prevent sweating (sweat condensation).

L - Wear your clothing Loosely and in Layers.

D - Keep your clothing Dry.

Hikers, walkers, and climbers should carry food and water to provide energy and prevent dehydration. Undue fatigue should be avoided. A good pair of boots or shoes is very important, and clothing must be adequate for the worst conditions that could possibly be encountered. Clothing should be worn in layers because trapped air between the layers of garments is excellent insulation. Cotton underwear, preferably fishnet or waffle-weave, is preferable for the same reason. Outer garments must be resistant to rain and wind, a nylon shell, for example. Nylon keeps out wind better than wool. Jeans and corduroy are inadequate. Head­ gear, gloves, and extra clothing for emergencies should be included. If possible, a sleeping bag and camping material should be carried. A large bag such as a plastic garbage bag will afford protection from rain or wind during stays in emergency bivouacs.

As discussed above, the ideal garment is insulating and water resistant, but allows water vapor produced by the body to escape through it. Down and dacron fibers are very insulating and the latter provides some insulation when wet. When wet, wool is a superior insulator. Similar inner garments of nylon and wool pile are equally effective as insulators. Also, there is no difference in their ability to allow the escape of water vapor created by sweat­ing.

All parts of the body should be well-protected and insulated with clothing. Large amounts of heat can be 10stJrom the legs or head (30-40% from the head alone), especially if these areas are wet and inadequately shielded from the wind. Persons with more subcutaneous fat are less likely to succumb to hypothermia; in several instances women have survived while their male companions have perished, presumably because of their thicker layers of fat.

Alcohol must be avoided entirely. It may be quite harmful, both by increasing the likelihood of hypothermia and as a detri­ment in the treatment of victims. Alcohol dilates the blood vessels of the skin, but not the muscles. It decreases shivering and increases heat loss. Alcohol may also cause a significant drop in blood sugar. Alcohol does not act as "antifreeze" in the bloodstream. If one's body temperature is so low that he needs alcohol to keep his blood from freezing, he has been dead from hypothermia for awhile, for about 300C or so. Alcohol may obviously affect judgment adversely.

Hypothermia can occur during any season, including summer. Ambient temperatures may be in the 400 to 500F range. This is a crucial point. The air temperature is no more important than several other factors discussed above. Many hypothermia victims have started their jaunts comfortably clad in pleasant weather. They overlook the possibility of sudden weather changes as well as the falling temperatures and increasing winds encountered at higher altitudes. Abrupt changes in weather can be lethal for the unprepared. Getting lost, especially overnight, may mean death. The hiker or climber must plan carefully for expected as well as unlikely events. If you are not experienced, then go with someone who is.