Hypothermia - first actions?

[Digby]

Another in our regular series to help you brush up on your first aid skills:

In a case of obvious hypothermia during an outdoor activity, which of the following is the most appropriate course of action?
a. Give the patient brandy?
b. Get him/her to hospital quickly?
c. Heat the patient up as quickly as possible?
d. Slow down or reduce the leavel of activity?
e. Get the whole party into shelter and give warm sweet drinks to the patient?

:confused:

Choose your answer then scroll down to see what other people say. This forum is no substitute for professional first aid training - so get yourself off and get trained!

[Marmot]

if a person is violently shaking, complaining of being cold and is having muscle contractions would u say that this person is in a state of hypothermia?
cause thats what i thought, but the young lady in question was in a sleeping bag, wearing jeans and a t shirt and indoors, in a largish room, but with other bodies present, could she still get hypothermia? and would the fact tat she'd taken alcohol have any affect?

[ChamberlainPC]

Hmmmmm Interesting Selection of Answers

Now the answer depends on the cause of the cooling, without wishing to go into too much detail if you are outside and you fall into water say, your body is cooled rapidly and therefore the re-warming should be rapid. If your core cooloing is slow and prolonged then the re-warming should be carried out slower. It's all to do with blood pressure, fluid volume and peeing!

[Emanresu]

Sounds interesting. What has peeing got to do with hypothermia?

[jbgraham]

Well, the brandy certainly would only serve to make the patient worse. I would say the last answer might be closest to being correct, except that if shelter is not immediately available, one would have to begin making efforts to warm in the field. Warm, sweet drinks are good, but they should only be mildly sweet, too sweet and they will cause the patient to lose fluid in digesting the sugars. Coffee or tea are also not great, as they are diuretic and will make dehydration worse. Dehydration is one of the major contributing factors in hypothermia. I do like the last answer because it stresses taking care of the entire party, if one member is developing obvious signs of hypothermia, the chances are good that others might be in the early stages.

A lot is going to depend on the degree of hypothermia and the situation. I have been above treeline in a howling blizzard where we could do nothing but frog march the victim down out of the killing wind. In that case my big failure was not diagnosing the early signs in my eagerness to summit. It is recognizing these early signs, the stumbles mumbles and grumbles, that offers the best chance for successful treatment.

Generally speaking, in cases of mild or moderate hypothermia, stopping to warm the patient with extra clothes and high energy food and warm drinks is advisable, but if the hypothermia advances to the point where shivering stops, you have a dying patient and it is too late for food or drink. In such an instance, immediate evacuation on a litter to a medical facility is the only hope for survival, and heart failure is a real possibility. Due to the fact that the metabolism is shutting down, heat packs may offer the only way of retaining body heat, but rewarming of the patient should only be attempted in hospital.

[WooleySheep]

What would you say is the best method of re-heating a minor case of hypothermia, in the field?

[timmygowalkies]

Hot sweet drinks, sleeping bag, inside a survival bag. Roll mat underneath. Protect them from the elements. It depends what you class minor hypothermia as. When you feel cold inside your house etc that is a case of very minor hypothermia.

[Emanresu]

I am still keen to hear PC's comments about it all being related to peeing.

[Jake D]

I was chatting to a bloke who served on a mountain rescue team once and he said it was not unusual to find hypothermia victims with extra clothing and high calorie food still stuck in their rucksacks. I would have thought that the first thing you should do would be to go through everything you have with you to see what will help the situation.

[ken_nerve]

Alcohol will make the casualty feel warm only because it makes the blood flow towards the surface of the skin(and away from the vital organs). Which is bad.
A warm drink is good as it warms the body from the inside. No coffee or tea as they dehydrate the casualty.
If the casualties extremities are feeling cold, do not put the hot water bottle on their hands or feet, instead, put it on their chest. It might seem strange, but by warming the hands and feet, you're making blood flow away from the vital organs. So warm the chest and stomach area and the extremities will warm up too in time.

[David]

Good advice; you can also try putting your hands under your armpits, especially if the case is quite serious. Putting your hands (or feet) into hot water, or very rapidly increaing temperature any other way and making the surface blood vessels dilate, can cause tissue death if the hands are very cold, so this is a bad idea even if you are generally warm and feel well.