Cold truths about hypothermia

Every Minnesotan is familiar with piling on coats, hats, mittens and other clothing to stay protected from the elements during the winter months. Hypothermia — literally meaning “low (body) temperature” —  occurs when too much heat escapes the core of the body and cannot be replaced quickly enough. It can affect someone’s mental and physical abilities and eventually be fatal if not treated. Hypothermia sets in very slowly, so those affected often do not realize they need help or medical attention. 

No one plans to become hypothermic; car trouble, walking home from a party, or a slip and fall on the ice are just a few ways people inadvertently get over-exposed to the harsh cold.

According to HCMC emergency physician and hypothermia specialist Dr. Doug Brunette, hypothermia can set in within minutes, depending on the conditions and the patient.

“Heat is lost rapidly if the patient is wet, like if they fall through the ice on a lake. And the body size of the patient matters as well. Thin patients will lose heat faster; and infants – who have a higher body surface area relative to adults – can become hypothermic in a matter of minutes if exposed to severe heat losing environmental conditions.”

We have all experienced bone-chilling cold at some time or another, but how can you tell if it’s hypothermia?

“Confusion and disorientation are telltale signs that someone may be having problems, and if someone is suspected of prolonged cold exposure and is found unconscious, he or she needs immediate medical care,” says Dr. Brunette.

Depending on the severity of hypothermia, treatment in the emergency department includes aggressive, supportive critical care that may require that the patient is placed on a ventilator. Re-warming is a key part of the medical management. This is accomplished using a variety of techniques that include both external and internal rewarming methods.

“Severe hypothermia can result in organ damage and permanent medical issues,” warns Dr. Brunette, “however, if the patient didn’t have a respiratory or cardiac arrest, there’s a good chance for complete recovery without long-term effects.”

Few would argue against the logic of staying warm and comfortable by wearing protective clothing and avoiding extreme cold temperatures; however, poor or impaired decision-making increases the chances of hypothermia and frostbite. Alcohol use, for example, impairs judgment and puts people at risk for life and limb-threatening cold exposure. It can also cause dehydration, which can accelerate symptoms of hypothermia and frostbite.

“No one plans to be stranded in the cold, but it can and does happen,” says Dr. Brunette.

Here are some reminders of what you can do to be safe:

• Wear layered – and dry – clothing and outerwear. Always wear a hat, gloves, and warm shoes or boots.
• Avoid being outdoors on those brutally cold days and nights when temperatures are low and the winds are high. Stay inside if you can!
• Anticipate problems and dress appropriately – car trouble, late buses/trains, icy/slippery conditions might have you being outside longer than planned
• Keep a winter emergency kit in your vehicle that includes a blanket, matches, candle, flashlight, snacks and other comfort items
• Share your travel plans with someone else so they’ll know when you’ll arrive at your destination
• Carry a cell phone
• Stay alert – avoid or limit alcohol use