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Paddling was fun, did slightly less than the full hour. Sunset truely beautiful above the water. F2 Assessment on Saturday [wibble] must study.
What is hypothermia:
Background
"Hypo" means under. "Therm" is a unit of heat. The normal core temperature for you body is 98.6 degrees F. "Core temperature" means the temperature of internal body organs, particularly the heart, brain, lungs, kidneys, stomach, and intestines.
An abnormally low core temperature is the condition of hypothermia. In this condition normal muscular and mental abilities are impaired. If the condition continues to deteriorate it will lead to death.
What causes hypothermia:
Hypothermia IS CAUSED by
1) sudden exposure to cold water or CAN BE CAUSED by
2) prolonged exposure to the cold conditions of temperature, water, and wind or by
3) or a very slow and prolonged period of cold conditions AND prolonged fatigue, exhaustion, and lack of food which is not uncommon among adventure racers. In this last case shivering may never be a symptom, but there will be plenty of other signs.
When heat loss exceeds heat production and heat retention; hypothermia is the result.
Heat is lost by the body to the cold conditions of the environment (temperature, water, air) by...
Radiation (cold condition - temperature of the air)
This is when the EXPOSED surface area of your skin is warmer than the surrounding air. This occurs in all air that is less than 96.8 degrees F and from all skin that is exposed.
So, wear clothes, but remember YOU will lose twice the amount of heat from your head as from the rest of your body, that is why head gear is SO important. Thus the old adage, "if your hands or feet are cold, put on a hat".
Conduction (cold conditions - temperature and water)
Heat is conducted from direct contact between your warm body and colder objects. The more dense the object the greater the ability to conduct heat. Heat is conducted from your exposed skin or through clothes; to the ground, to the air, to the kayak seat, from your feet to shoes to kayak hull, from your hands to gloves to paddles shaft, etc.
Since water is much more dense than air, heat will be conducted away from your body much faster (probably at least 5 times faster, but some sources quote the rate as 25 times faster) in water than in air. Heat is conducted from the body through WET clothes much faster than through dry clothes. That is why the statement, "to stay dry is to stay alive".
So, you must stay dry. Have the proper rain gear, storm gear, and spare dry clothes (that you do not allow to get wet).
Convection (cold condition - primarily wind)
Heat will be lost to moving mediums, the denser and faster the moving mediums the faster the heat loss. You will lose heat more quickly in fast current than in still water. You will lose heat faster the faster the air is moving, this is 'wind chill'. This is the importance of wearing something to 'break the wind', such as a paddle jacket, dry top, etc.
Evaporation
This heat loss is due to your body's processes of converting water from liquid to gas. Perspiration is the evaporative process your body uses to cool itself during exercise.
Insensible Perspiration is the evaporative process your body uses to maintain 70% humidity next to skin, which can be a lot of water particularly in a cold, dry environment. Respiration is the evaporative process that occurs when air is heated as it enters the lungs and is exhaled with moisture content from your body.
Evaporation processes are natural functions. There is nothing you can do to retain heat in regard to evaporation. But you can breath through a light covering over the nose and mouth to pre-warm the air that you are breathing.
Sidebar: Knowing about the constant loss of water due to evaporation, it is important to stay hydrated.
Preventing hypothermia:
Retaining your heat and producing heat are how you prevent hypothermia.
More on heat retention:
There are FOUR ways to increase your body's ability to retain heat while kayaking.
1) Practice being in the cold.
That's right, acclimate and become used to physical exertion in the cold. The body does a wonderful job of adapting to different conditions. If you spend all day and every day in the warm office, you are not going to be physically prepared for a vacation of long cold, wet days of kayaking.
By spending a few hours outside in the cold a few times a week, you can prepare yourself. This does not take a big science project. For instance, you'll notice when your hands, without gloves for say 20 minutes, are not as cold after several weeks of 'practice' as they were when you first started.
Adventure race team sidebar: Let's say, it is June, you are from southern California and you are going to Poland for an expedition race in the Fall. Consider training at higher elevations at night during the summer, not for the altitude (which won't hurt anyway) but for the cold. Also, consider arriving in Poland a week ahead of the race start and hanging out in shorts and short sleeves a little bit.
2) Put on more body fat.
Body fat is insulation. Insulation will prevent conductive heat loss. Fat, by the way, is not necessarily bad for you. In fact, your body needs certain fats for health. So, be wise about your nutrition, your diet, and your training.
3) Make your rescues proficient.
Plan on being in the water! This means consider how long you might be in the water should you capsize. And do not assume that you are not going to capsize. That kind of decision is what causes hypothermia. (see my article on the wet entry)
And if you have a good kayak roll, do not assume that you will be able to roll in cold water. The effects of fatigue, exhaustion, and the shock of cold water immersion will likely cause you to miss.(cold shock from immersion coming in another chapter)
And if you are not real proficient at wet exits and re-entries practice some more. Again, the shock of cold water immersion and fatigue probably will cause a longer time than usual to sort out the rescue (getting back in the kayak). The less time in the water the less time for the rapid heat loss of cold water conduction.
4) Wear the right clothes for the water.
Which means dress for the water temperature and not the air temperature. Any water colder than 96.8 degrees F can cause hypothermia! (more on kayaking clothes for cold water coming in another chapter)
Again, plan on being in the water and do not assume you won't capsize.
And consider, given the possible conditions, how wet are you going to get while kayaking. Kayaking with a light wind is going to be a lot dryer than kayaking into 20 mph winds and the resulting waves.
But do not assume that the weather is not going to change. This is another decision which causes hypothermia.
The only way to know what clothes to wear for the water temperature is through practice. Everyone is different with different abilities to ward off the causes of hypothermia.
And there are two ways to retain heat while beached up.
1) Get in your dry non-paddling clothes (that you have brought in a dry bag). These clothes you never get wet and never paddle in.
2) Get inside your sleeping bag and use an insulating pad between your sleeping bag and the ground.
Heat production:
There are THREE ways to produce heat to prevent hypothermia.
1) Eat.
The body produces heat by the digestion and utilization of food. This is the main fuel source for the body's furnace. While in cold conditions you have got to eat to stay warm. And to digest the food you have got to stay hydrated. You can not digest food without water.
A little about food. Carbohydrates, with 5 calories/gram are quickly released into blood stream for sudden brief heat surge. Carbs are the best to use for quick energy intake especially for mild cases of hypothermia. Proteins, with 5 calories/gram are slowly digested and release heat over a longer period of time. Fats, with 9 calories/gram are slowly released but are good because they release heat over a long period, but it takes more energy and water to digest fats.
2) Exercise.
Heat is also produced during exercise, in our case paddling. But, you need to remain fueled to continue paddling Shivering is a natural mechanism that creates involuntary exercise and produces heat. But, if you are shivering, you are losing to hypothermia. You need to retain or produce more heat.
3) Warm things.
The body can also gain heat from external sources. These can include but are not limited to warm food and drink, chemical heat pads, fire, and of course the sun.
While paddling you can drink warm liquids that you have already prepared from a thermos. You can eat warm food that you have already prepared from aluminum foil or in the case of freeze dried foods, from the container they come in. Before you paddle, prepare a freeze dried meal with boiling water in its container, leave a spoon in it, and it's ready to eat and warm when you need it.
And while paddling you can utilize chemical heat pads by placing them inside your paddling jacket or pants (however, don't place them directly against the skin).
If you have beached up you can build an emergency fire, prepare warm food and drink, and use heat pads.
Stages and Signs and Results of Hypothermia:
This is about detecting hypothermia. It is not a math formula. It is the evaluation human beings and each one is different. It is also about being aware of and honest with yourself.
Mild Hypothermia - core temperature 98.6 - 96 degrees F:
1) Cold sensation begins - getting goose bumps feel cold, hands, nose, or feet are numb.
2) Shivering - not under voluntary control.
3) Can't do complex motor functions - can walk and talk but putting on a rappel harness is difficult and paddling strokes are sloppy.
These above three signs are enough for corrective action - retain or produce more heat.
Moderate Hypothermia - core temperature 95 - 93 degrees F:
1) Dazed consciousness - may at first appear alert, but mild confusion will become apparent.
2) Uncoordinated movements - the stumbles, walking isn't easy.
3) Slurred speech - the mumbles, or isn't talking at all because of the effort to speak correctly.
4) Loss of fine motor coordination - particularly in the hands, can't zip up parka.
4) Mild depression - may appear withdrawn, gets the "I don't care attitude".
5) Irrational behavior - may appear alert and "with it" but starts behavior that is not goal oriented.
6) Violent shivering - shivering has increased in duration.
If you have missed the signs before, NOW with any of the above signs, it is time to take ACTION.
Severe Hypothermia - core temperature 92 - 86 degrees and below:
Now the situation is immediately life threatening.
1) Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases
2) Person falls to the ground, can't walk, curls up into a fetal position to conserve heat
3) Skin is pale
4) Pupils dilate
5) Pulse rate decreases
6) At 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate. May be unconscious.
7) At 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.
The signs above indicate conditions that will soon lead to death if not quickly treated. At this point your paddle friend or adventure team mate has just become a patient. Seek medical help.
Critical Hypothermia - 85 degrees and under:
1) Unconscious - may appear dead.
2) Little or no apparent breathing or pulse.
3) Skin is cold - may be bluish and gray.
4) Muscular rigidity - very rigid
Assume the patient is still revivable, don't give up. Medical help is imperative. Look, listen, and feel for breathing and pulse every 2 minutes.
Treatment of Hypothermia:
The basic principle of rewarming a hypothermia victim (the victim could very well be yourself) is to conserve the heat they have (heat retention) and warm the victim (heat production), getting them back to normal.
In general...
1) Get the victim dry and out of the wind.
2) Gently remove all wet clothes (get dry).
3) Insulate the body, including head and neck (heat retention).
4) Apply mild heat to body core and rewarm gradually (heat production).
5) Handle gently.
Afterdrop: Is a situation in which the core temperature actually decreases during rewarming. This is caused by peripheral vessels in the arms and legs dilating if they are rewarmed. This dilation sends this very cold, stagnate blood from the periphery to the core further decreasing core temperature which can lead to death. Afterdrop can best be avoided by not rewarming the periphery. Rewarm the core only! Do not expose a severe hypothermia victim to extremes of heat.
Sudden drops in blood pressure from sudden or quick movements can also lead to afterdrop.Leave the victim horizontal because vertical position changes can also lead to afterdrop.
Mild to Moderate Hypothermia Treatment:
1) Reduce heat loss - getting the victim dry, out of the cold, and out of the wind (shelter).
2) Increase heat retention - additional layers of dry clothing OR sleeping bag
3) Increase heat production by physical activity and / or food and water intake:
3) Increase heat production by warm (not hot) liquids. Give warm sweet (carbs) drinks. DO NOT give alcohol (opens the capillaries and will increase peripheral heat loss), caffeine (causes water loss), or tobacco (closes capillaries and will increase risk of frostbite).
4) Increase heat production with external sources. These can include fire, chemical heat pads, or from body to body contact with a warm person. The best method for body to body contact warming is in a sleeping bag with both victim and warmth giver dry and both in light clothing.
Sidebar to adventure racers: If you have a team mate (or you yourself) that is hypothermic, giving the care and allowing the victim to properly warm up and rest for a couple hours is your ONLY course of action. You know yourself, that if you are in a race that is cold and wet, many teams will not finish.
But, if your team hypothermia protocol is in play... Your team will finish.
I was in the Adrenaline Rush '03 and witnessed the lead team, with more than 2 hours lead drop out from hypothermia... Bad hypothermia protocol.
Severe Hypothermia Treatment:
Same general principles apply but extra effort must be given to heat retention. And special care must be given to food and liquids.
1) Shelter: Warm - Dry - Out of the Wind
To reduce heat loss and increase heat retention get the victim in a Hypothermia Wrap:
The idea is to provide a shell of total insulation for the patient. No matter how cold, patients can still internally rewarm themselves much more efficiently than any external rewarming.
Make sure the patient is dry, and has a polypropylene layer to minimize sweating on the skin.
Get the victim in a sleeping bag and further insulate the sleeping bag. Pay particular attention to getting insulation between the victim and the ground. Include an aluminium "space" blanket to help prevent radiant heat loss.
2) Add Fuel & Fluids:
Warm Sugar Water - for people in severe hypothermia, the stomach has shut down and will not digest solid food but can absorb water and sugars. Give a dilute mixture of warm water with sugar every 15 minutes (sugar source should be simple carbs).
Urination - people will have to urinate from cold diuresis. Vasoconstriction creates greater volume pressure in the blood stream. The kidneys pull off excess fluid to reduce the pressure. A full bladder results in body heat being used to keep urine warm rather than vital organs. Once the person has urinated, precious body heat will be used to maintain the temperature of vital organs. So in the end urinating will help conserve heat. You will need to help the person urinate. Open up the Hypothermia Wrap enough to do this and then cover them back up.
3) Add Heat:
Heat can be applied to transfer heat to major arteries - at the neck, at the armpits, at the groin, and at the palms of the hands. Use chemical heat pads, warm water bottles, warm rocks, towels, or compresses
Rescue breathing can increase oxygen and provide internal heat.
4) Get medical attention.
Dehydration: Causes, Symptoms, Effects, Treatment
Causes: Not drinking water and drinking diuretics instead of water (coffee or other drinks with caffeine). Kayakers often find themselves dehydrated because they are paddling, paddling, paddling and their water bottle is...somewhere. To use their bottle they have to stop paddling to drink and often when they do stop to drink they don't drink enough.
A little coffee is fine before paddling, but you probably don't need to do what I do and take a thermos of coffee with you while paddling in the summer.
Symptoms: These are the signs of dehydration.
If you are paddling alone just pay attention to yourself. If you a kayaking with others, give a little attention to your mates. Make sure they and you are drinking water, sweating, peeing, and getting enough rest.
If you or your friends are light headed, dizzy, or confused you have gone too far without caring for yourselves.
1) thirst
2) less-frequent urination
3) dry skin
4) fatigue
5) light headedness
6) dizziness
7) confusion
8) dry mouth and mucous membranes
9) increased heart rate and breathing
Effects: Basically if you have let yourself become dehydrated you will not have the fluids in your body to produce sweat, the body's wonderful evaporation process. So, you won't cool off and can likely spiral down into the next level of heat injury, heat exhaustion.
Treatment:
Have water in your bladder/bottle, and drink it occasionally. Most athletes
during strenuous activity need about 16oz to 28oz per hour. This of coarse will vary with the individual and with the heat and humidity. But, more than a quart per hour every hour for an extended period could lead you to OVER-HYDRATION, which is just as dangerous. Replace electrolytes.
What is hypothermia:
Background
"Hypo" means under. "Therm" is a unit of heat. The normal core temperature for you body is 98.6 degrees F. "Core temperature" means the temperature of internal body organs, particularly the heart, brain, lungs, kidneys, stomach, and intestines.
An abnormally low core temperature is the condition of hypothermia. In this condition normal muscular and mental abilities are impaired. If the condition continues to deteriorate it will lead to death.
What causes hypothermia:
Hypothermia IS CAUSED by
1) sudden exposure to cold water or CAN BE CAUSED by
2) prolonged exposure to the cold conditions of temperature, water, and wind or by
3) or a very slow and prolonged period of cold conditions AND prolonged fatigue, exhaustion, and lack of food which is not uncommon among adventure racers. In this last case shivering may never be a symptom, but there will be plenty of other signs.
When heat loss exceeds heat production and heat retention; hypothermia is the result.
Heat is lost by the body to the cold conditions of the environment (temperature, water, air) by...
Radiation (cold condition - temperature of the air)
This is when the EXPOSED surface area of your skin is warmer than the surrounding air. This occurs in all air that is less than 96.8 degrees F and from all skin that is exposed.
So, wear clothes, but remember YOU will lose twice the amount of heat from your head as from the rest of your body, that is why head gear is SO important. Thus the old adage, "if your hands or feet are cold, put on a hat".
Conduction (cold conditions - temperature and water)
Heat is conducted from direct contact between your warm body and colder objects. The more dense the object the greater the ability to conduct heat. Heat is conducted from your exposed skin or through clothes; to the ground, to the air, to the kayak seat, from your feet to shoes to kayak hull, from your hands to gloves to paddles shaft, etc.
Since water is much more dense than air, heat will be conducted away from your body much faster (probably at least 5 times faster, but some sources quote the rate as 25 times faster) in water than in air. Heat is conducted from the body through WET clothes much faster than through dry clothes. That is why the statement, "to stay dry is to stay alive".
So, you must stay dry. Have the proper rain gear, storm gear, and spare dry clothes (that you do not allow to get wet).
Convection (cold condition - primarily wind)
Heat will be lost to moving mediums, the denser and faster the moving mediums the faster the heat loss. You will lose heat more quickly in fast current than in still water. You will lose heat faster the faster the air is moving, this is 'wind chill'. This is the importance of wearing something to 'break the wind', such as a paddle jacket, dry top, etc.
Evaporation
This heat loss is due to your body's processes of converting water from liquid to gas. Perspiration is the evaporative process your body uses to cool itself during exercise.
Insensible Perspiration is the evaporative process your body uses to maintain 70% humidity next to skin, which can be a lot of water particularly in a cold, dry environment. Respiration is the evaporative process that occurs when air is heated as it enters the lungs and is exhaled with moisture content from your body.
Evaporation processes are natural functions. There is nothing you can do to retain heat in regard to evaporation. But you can breath through a light covering over the nose and mouth to pre-warm the air that you are breathing.
Sidebar: Knowing about the constant loss of water due to evaporation, it is important to stay hydrated.
Preventing hypothermia:
Retaining your heat and producing heat are how you prevent hypothermia.
More on heat retention:
There are FOUR ways to increase your body's ability to retain heat while kayaking.
1) Practice being in the cold.
That's right, acclimate and become used to physical exertion in the cold. The body does a wonderful job of adapting to different conditions. If you spend all day and every day in the warm office, you are not going to be physically prepared for a vacation of long cold, wet days of kayaking.
By spending a few hours outside in the cold a few times a week, you can prepare yourself. This does not take a big science project. For instance, you'll notice when your hands, without gloves for say 20 minutes, are not as cold after several weeks of 'practice' as they were when you first started.
Adventure race team sidebar: Let's say, it is June, you are from southern California and you are going to Poland for an expedition race in the Fall. Consider training at higher elevations at night during the summer, not for the altitude (which won't hurt anyway) but for the cold. Also, consider arriving in Poland a week ahead of the race start and hanging out in shorts and short sleeves a little bit.
2) Put on more body fat.
Body fat is insulation. Insulation will prevent conductive heat loss. Fat, by the way, is not necessarily bad for you. In fact, your body needs certain fats for health. So, be wise about your nutrition, your diet, and your training.
3) Make your rescues proficient.
Plan on being in the water! This means consider how long you might be in the water should you capsize. And do not assume that you are not going to capsize. That kind of decision is what causes hypothermia. (see my article on the wet entry)
And if you have a good kayak roll, do not assume that you will be able to roll in cold water. The effects of fatigue, exhaustion, and the shock of cold water immersion will likely cause you to miss.(cold shock from immersion coming in another chapter)
And if you are not real proficient at wet exits and re-entries practice some more. Again, the shock of cold water immersion and fatigue probably will cause a longer time than usual to sort out the rescue (getting back in the kayak). The less time in the water the less time for the rapid heat loss of cold water conduction.
4) Wear the right clothes for the water.
Which means dress for the water temperature and not the air temperature. Any water colder than 96.8 degrees F can cause hypothermia! (more on kayaking clothes for cold water coming in another chapter)
Again, plan on being in the water and do not assume you won't capsize.
And consider, given the possible conditions, how wet are you going to get while kayaking. Kayaking with a light wind is going to be a lot dryer than kayaking into 20 mph winds and the resulting waves.
But do not assume that the weather is not going to change. This is another decision which causes hypothermia.
The only way to know what clothes to wear for the water temperature is through practice. Everyone is different with different abilities to ward off the causes of hypothermia.
And there are two ways to retain heat while beached up.
1) Get in your dry non-paddling clothes (that you have brought in a dry bag). These clothes you never get wet and never paddle in.
2) Get inside your sleeping bag and use an insulating pad between your sleeping bag and the ground.
Heat production:
There are THREE ways to produce heat to prevent hypothermia.
1) Eat.
The body produces heat by the digestion and utilization of food. This is the main fuel source for the body's furnace. While in cold conditions you have got to eat to stay warm. And to digest the food you have got to stay hydrated. You can not digest food without water.
A little about food. Carbohydrates, with 5 calories/gram are quickly released into blood stream for sudden brief heat surge. Carbs are the best to use for quick energy intake especially for mild cases of hypothermia. Proteins, with 5 calories/gram are slowly digested and release heat over a longer period of time. Fats, with 9 calories/gram are slowly released but are good because they release heat over a long period, but it takes more energy and water to digest fats.
2) Exercise.
Heat is also produced during exercise, in our case paddling. But, you need to remain fueled to continue paddling Shivering is a natural mechanism that creates involuntary exercise and produces heat. But, if you are shivering, you are losing to hypothermia. You need to retain or produce more heat.
3) Warm things.
The body can also gain heat from external sources. These can include but are not limited to warm food and drink, chemical heat pads, fire, and of course the sun.
While paddling you can drink warm liquids that you have already prepared from a thermos. You can eat warm food that you have already prepared from aluminum foil or in the case of freeze dried foods, from the container they come in. Before you paddle, prepare a freeze dried meal with boiling water in its container, leave a spoon in it, and it's ready to eat and warm when you need it.
And while paddling you can utilize chemical heat pads by placing them inside your paddling jacket or pants (however, don't place them directly against the skin).
If you have beached up you can build an emergency fire, prepare warm food and drink, and use heat pads.
Stages and Signs and Results of Hypothermia:
This is about detecting hypothermia. It is not a math formula. It is the evaluation human beings and each one is different. It is also about being aware of and honest with yourself.
Mild Hypothermia - core temperature 98.6 - 96 degrees F:
1) Cold sensation begins - getting goose bumps feel cold, hands, nose, or feet are numb.
2) Shivering - not under voluntary control.
3) Can't do complex motor functions - can walk and talk but putting on a rappel harness is difficult and paddling strokes are sloppy.
These above three signs are enough for corrective action - retain or produce more heat.
Moderate Hypothermia - core temperature 95 - 93 degrees F:
1) Dazed consciousness - may at first appear alert, but mild confusion will become apparent.
2) Uncoordinated movements - the stumbles, walking isn't easy.
3) Slurred speech - the mumbles, or isn't talking at all because of the effort to speak correctly.
4) Loss of fine motor coordination - particularly in the hands, can't zip up parka.
4) Mild depression - may appear withdrawn, gets the "I don't care attitude".
5) Irrational behavior - may appear alert and "with it" but starts behavior that is not goal oriented.
6) Violent shivering - shivering has increased in duration.
If you have missed the signs before, NOW with any of the above signs, it is time to take ACTION.
Severe Hypothermia - core temperature 92 - 86 degrees and below:
Now the situation is immediately life threatening.
1) Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases
2) Person falls to the ground, can't walk, curls up into a fetal position to conserve heat
3) Skin is pale
4) Pupils dilate
5) Pulse rate decreases
6) At 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate. May be unconscious.
7) At 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.
The signs above indicate conditions that will soon lead to death if not quickly treated. At this point your paddle friend or adventure team mate has just become a patient. Seek medical help.
Critical Hypothermia - 85 degrees and under:
1) Unconscious - may appear dead.
2) Little or no apparent breathing or pulse.
3) Skin is cold - may be bluish and gray.
4) Muscular rigidity - very rigid
Assume the patient is still revivable, don't give up. Medical help is imperative. Look, listen, and feel for breathing and pulse every 2 minutes.
Treatment of Hypothermia:
The basic principle of rewarming a hypothermia victim (the victim could very well be yourself) is to conserve the heat they have (heat retention) and warm the victim (heat production), getting them back to normal.
In general...
1) Get the victim dry and out of the wind.
2) Gently remove all wet clothes (get dry).
3) Insulate the body, including head and neck (heat retention).
4) Apply mild heat to body core and rewarm gradually (heat production).
5) Handle gently.
Afterdrop: Is a situation in which the core temperature actually decreases during rewarming. This is caused by peripheral vessels in the arms and legs dilating if they are rewarmed. This dilation sends this very cold, stagnate blood from the periphery to the core further decreasing core temperature which can lead to death. Afterdrop can best be avoided by not rewarming the periphery. Rewarm the core only! Do not expose a severe hypothermia victim to extremes of heat.
Sudden drops in blood pressure from sudden or quick movements can also lead to afterdrop.Leave the victim horizontal because vertical position changes can also lead to afterdrop.
Mild to Moderate Hypothermia Treatment:
1) Reduce heat loss - getting the victim dry, out of the cold, and out of the wind (shelter).
2) Increase heat retention - additional layers of dry clothing OR sleeping bag
3) Increase heat production by physical activity and / or food and water intake:
3) Increase heat production by warm (not hot) liquids. Give warm sweet (carbs) drinks. DO NOT give alcohol (opens the capillaries and will increase peripheral heat loss), caffeine (causes water loss), or tobacco (closes capillaries and will increase risk of frostbite).
4) Increase heat production with external sources. These can include fire, chemical heat pads, or from body to body contact with a warm person. The best method for body to body contact warming is in a sleeping bag with both victim and warmth giver dry and both in light clothing.
Sidebar to adventure racers: If you have a team mate (or you yourself) that is hypothermic, giving the care and allowing the victim to properly warm up and rest for a couple hours is your ONLY course of action. You know yourself, that if you are in a race that is cold and wet, many teams will not finish.
But, if your team hypothermia protocol is in play... Your team will finish.
I was in the Adrenaline Rush '03 and witnessed the lead team, with more than 2 hours lead drop out from hypothermia... Bad hypothermia protocol.
Severe Hypothermia Treatment:
Same general principles apply but extra effort must be given to heat retention. And special care must be given to food and liquids.
1) Shelter: Warm - Dry - Out of the Wind
To reduce heat loss and increase heat retention get the victim in a Hypothermia Wrap:
The idea is to provide a shell of total insulation for the patient. No matter how cold, patients can still internally rewarm themselves much more efficiently than any external rewarming.
Make sure the patient is dry, and has a polypropylene layer to minimize sweating on the skin.
Get the victim in a sleeping bag and further insulate the sleeping bag. Pay particular attention to getting insulation between the victim and the ground. Include an aluminium "space" blanket to help prevent radiant heat loss.
2) Add Fuel & Fluids:
Warm Sugar Water - for people in severe hypothermia, the stomach has shut down and will not digest solid food but can absorb water and sugars. Give a dilute mixture of warm water with sugar every 15 minutes (sugar source should be simple carbs).
Urination - people will have to urinate from cold diuresis. Vasoconstriction creates greater volume pressure in the blood stream. The kidneys pull off excess fluid to reduce the pressure. A full bladder results in body heat being used to keep urine warm rather than vital organs. Once the person has urinated, precious body heat will be used to maintain the temperature of vital organs. So in the end urinating will help conserve heat. You will need to help the person urinate. Open up the Hypothermia Wrap enough to do this and then cover them back up.
3) Add Heat:
Heat can be applied to transfer heat to major arteries - at the neck, at the armpits, at the groin, and at the palms of the hands. Use chemical heat pads, warm water bottles, warm rocks, towels, or compresses
Rescue breathing can increase oxygen and provide internal heat.
4) Get medical attention.
Dehydration: Causes, Symptoms, Effects, Treatment
Causes: Not drinking water and drinking diuretics instead of water (coffee or other drinks with caffeine). Kayakers often find themselves dehydrated because they are paddling, paddling, paddling and their water bottle is...somewhere. To use their bottle they have to stop paddling to drink and often when they do stop to drink they don't drink enough.
A little coffee is fine before paddling, but you probably don't need to do what I do and take a thermos of coffee with you while paddling in the summer.
Symptoms: These are the signs of dehydration.
If you are paddling alone just pay attention to yourself. If you a kayaking with others, give a little attention to your mates. Make sure they and you are drinking water, sweating, peeing, and getting enough rest.
If you or your friends are light headed, dizzy, or confused you have gone too far without caring for yourselves.
1) thirst
2) less-frequent urination
3) dry skin
4) fatigue
5) light headedness
6) dizziness
7) confusion
8) dry mouth and mucous membranes
9) increased heart rate and breathing
Effects: Basically if you have let yourself become dehydrated you will not have the fluids in your body to produce sweat, the body's wonderful evaporation process. So, you won't cool off and can likely spiral down into the next level of heat injury, heat exhaustion.
Treatment:
Have water in your bladder/bottle, and drink it occasionally. Most athletes
during strenuous activity need about 16oz to 28oz per hour. This of coarse will vary with the individual and with the heat and humidity. But, more than a quart per hour every hour for an extended period could lead you to OVER-HYDRATION, which is just as dangerous. Replace electrolytes.
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