Field Treatment of Hypothermia is Vital—Intervention ASAP.
By Bill Kane, The Kane School
Hypothermia is the simple process of the body’s core losing heat faster than it can be produced. As warm-blooded humans, our body runs at about 98 degrees, plus or minus just a couple of degrees. We rely on food, water, and our metabolism to produce the energy to allow us to move, think, and always produce heat. In warmer climates, we wear less clothing to allow heat to escape, and in colder weather, we wear more clothing … it seems so simple. Field treatment of hypothermia is vital—intervention as soon as possible, the willingness to stop and treat, and then head to shelter, home, or a medical facility (depending on the severity).
Unfortunately, the history of exploring the outdoors in any number of pursuits has too often found fit, smart, motivated outdoors folks who find themselves unaware that they are slowly being injured. The cold is affecting their awareness, reasoning, speech, strength, coordination, and most tragically, the failure of the survival instinct.
Usually when a person is “injured,” they know it. Bumps, bruises, cuts, sprains, and fractures, are abrupt and painful, and a person is usually very aware and will respond to the injury. This protective response in our brain is called a medically sympathetic response, but more commonly known as the “fight or flight response.”
This adrenal surge can be triggered prior to injury when the person is about to try something difficult, daring, or threatening. The fight or flight response keeps us aware, focused, and usually compels a person to help themselves or call for help.
Hypothermia, unlike other injuries, quiets the fight or flight response, sometimes with tragic results, as the Mountain Rescue Service of NH found out in the winter of 1994.
Two ice climbers became lost in brutal weather in late February on Mount Washington. Monroe Cooper, 40, and Erik Lattey, 28, had been to Washington before, but on this climb, they had gotten partway up the trail on Huntington Ravine when they realized they’d forgotten rope. They ran down, got it, and began to push hard to get up into the ravine to complete the climb.
That’s when things went very wrong and MRS was dispatched the following day to start searching. “Unfortunately, with the arctic cold and winds at 125 miles per hour, we couldn’t get to them that day, so we began again early the next morning. When we got to the top of Huntington Ravine, my teammates and I saw something we hadn’t seen in 20 years of mountain rescue. One subject sitting up with his back against the rock looking into a pack. He was frozen solid, still in his climbing harness with the rope still tied in. We couldn’t see anyone else, but we picked up the rope and started pulling in out of the snow till we came to a snow covered lump that we realized was the second climber who likely crawled a short way to find more shelter, he was frozen as well. We loaded the two men into litters and took them down the mountain.”
These two men pushed themselves, probably not eating or drinking much, and climbed the route despite the weather. Though no one knew exactly what happened, it was agreed they had gotten to the top and into the teeth of the wind and cold. They sat down in what little shelter from the weather they could find to “rest” for a little while. This is the insidious nature of hypothermia. These two men were healthy, likely experienced, and committed, with no other injury, and kept climbing. Once they got to the top, their brains were so cold, there was no recognition of the threat.
Treating hypothermia means acting early, before the problem becomes more difficult to fix.
The signs and symptoms of cold follow a progression—and you don’t want to let anyone in your party (or yourself) get too cold. When you think your friend is becoming hypothermic, remember not to judge, diagnose, or preach to them about it. Despite the fact they are showing some signs/symptoms, their brain can still hear what sounds like criticism.
Classic Progression of Worsening Hypothermia Signs and Symptoms
- Quiet, but responsive
- Responds, but won’t carry a conversation
- Less eye contact
- They don’t drink or eat often enough
- Minimal layers
- Shivers, can start as light and intermittent, but progress to steady, maybe severe
- Slowing down
- Speech is slow, even slurred
- After these assessments, this cold person will just continue to get colder without help or intervention.
As you notice the possible signs of hypothermia start this process:
Suggest they eat some of your yummy snacks (sugar-based), then offer some water. If they refuse, beg them to try your awesome snacks with, “Please, please, please eat my chocolate.” It may be annoying to them, but they may take some food and drink just to shut you up.
Then suggest you help them put on another layer or two and a hat, gently help them put the extra layers on even if they resist. If you’re in an exposed place, try to find shelter or more layers.
It may take a while to warm them up enough to continue, which means going home. If they are too exhausted and you are without any more resources, then keep them as warm as possible where they are and call for the SAR team to help bring them home.