Hypothermia

An Overview

Hypothermia is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Normal body temperature is around 98.6 F (37 C). Hypothermia (hi-poe-THUR-me-uh) occurs as your body temperature falls below 95 F (35 C). When your body temperature drops, your heart, nervous system and other organs can’t work normally. Left untreated, hypothermia can lead to complete failure of your heart and respiratory system and eventually to death. Hypothermia is often caused by exposure to cold weather or immersion in cold water. Primary treatments for hypothermia are methods to warm the body back to a normal temperature.

Symptoms for Hypothermmia

Shivering is likely the first thing you’ll notice as the temperature starts to drop because it’s your body’s automatic defense against cold temperature — an attempt to warm itself.
Signs and symptoms of hypothermia include:
• Slurred speech or mumbling
• Slow, shallow breathing
• excessive shivering
• slowed breathing
• slowed speech
• clumsiness
• stumbling
• confusion
• Weak pulse
• Clumsiness or lack of coordination
• Drowsiness or very low energy
• Confusion or memory loss
• Loss of consciousness
• Bright red, cold skin (in infants)

Causes of Hypothermia

Cold weather is the primary cause of hypothermia. When your body experiences extremely cold temperatures, it loses heat more quickly than it can produce it. Staying in cold water too long can also cause these effects. The hypothalamus, the brain’s temperature-control center, works to raise body temperature by triggering processes that heat and cool the body. During cold temperature exposure, shivering is a protective response to produce heat through muscle activity. In another heat-preserving response — called vasoconstriction — blood vessels temporarily narrow.
Normally, the activity of the heart and liver produce most of your body heat. But as core body temperature cools, these organs produce less heat, in essence causing a protective “shut down” to preserve heat and protect the brain. Low body temperature can slow brain activity, breathing, and heart rate. The inability to produce adequate body heat is extremely dangerous. Your body temperature can drop quickly and significantly.
Exposure to colder-than-normal temperatures can also cause hypothermia. For example, if you step into an extremely cold, air-conditioned room immediately after being outside, you risk losing too much body heat in a short period.

Risk factors

Age

Age is a risk factor for hypothermia. Infants and older adults have the highest risk of developing hypothermia. This is due to a decreased ability to regulate their body temperature. People in these age groups must dress appropriately for cold weather. You should also regulate air conditioning to help prevent hypothermia at home.

Mental Illness and Dementia

Mental illnesses, such as schizophrenia and bipolar disorder, put you at a greater risk for hypothermia. Dementia, or memory loss that often occurs with communication and comprehension difficulties, can also increase the risk of hypothermia. People with impaired mental judgment may not dress appropriately for cold weather. They also may not realize they’re cold and may stay outside in cold temperatures for too long.

Alcohol and Drug Use

Alcohol or drug use can also impair your judgment about the cold. You’re also more likely to lose consciousness, which can occur outside in dangerously cold weather. Alcohol is especially dangerous because it gives the false impression of warming the insides. In reality, it causes the blood vessels to expand and the skin to lose more heat.

Diagnosis

The diagnosis of hypothermia is usually apparent based on a person’s physical signs and the conditions in which the person with hypothermia became ill or was found. Blood tests also can help confirm hypothermia and its severity.
A diagnosis may not be readily apparent, however, if the symptoms are mild, as when an older person who is indoors has symptoms of confusion, lack of coordination and speech problems.

Treatment

Handle the person with care.

Handle the affected person with care. Don’t massage them in an attempt to restore blood flow. Any forceful or excessive movements may cause cardiac arrest. Move or shield them from the cold.

Remove the person’s wet clothing.

Remove the person’s wet clothes. If necessary, cut them off to avoid moving the individual. Cover them with warm blankets, including their face, but not their mouth. If blankets aren’t available, use your body heat to warm them.
If they’re conscious, try to give them warm beverages or soup, which can help to increase body temperature.

Apply warm compresses.

Apply warm (not hot), dry compresses to the individual, such as a warmed water bottle or a warmed towel. Only apply the compresses to the chest, neck, or groin. Don’t apply compresses to the arms or legs, and do not use a heating pad or heat lamp. Applying a compress to these areas will push cold blood back toward the heart, lungs, and brain, which could be fatal. Temperatures that are too hot can burn the skin or cause cardiac arrest.

Medical treatment

Depending on the severity of hypothermia, emergency medical care for hypothermia may include one of the following interventions to raise the body temperature:
• Passive rewarming. For someone with mild hypothermia, it is enough to cover them with heated blankets and offer warm fluids to drink.
• Blood rewarming. Blood may be drawn, warmed and recirculated in the body. A common method of warming blood is the use of a hemodialysis machine, which is normally used to filter blood in people with poor kidney function. Heart bypass machines also may need to be used.
• Warm intravenous fluids. A warmed intravenous solution of salt water may be put into a vein to help warm the blood.

Prevention

Preventive measures are key to avoiding hypothermia.

Clothing

The simplest steps you can take involve the clothing you wear. Dress in layers on cold days, even if you don’t think it feels very cold outside. It’s easier to remove clothing than it is to battle hypothermia. Cover all body parts, and wear hats, gloves, and scarves during the winter. Also, take care when exercising outdoors on cold days. Sweat can cool you down and make your body more susceptible to hypothermia.

Staying Dry

Staying dry is also important. Avoid swimming for long periods and make sure that you wear water-repellant clothing in rain and snow. If you’re stuck in the water due to a boating accident, try to stay as dry as possible in or on the boat. Avoid swimming until you see help nearby. Keeping the body at a normal temperature is important to preventing hypothermia. If your temperature falls below 95°F, you should seek medical help, even if you feel no symptoms of hypothermia.

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