12-18-2004, 06:59 PM
A drop in your body's normal core temperature to 95 F or below is the key sign of hypothermia. The condition usually comes on gradually. Often, people aren't aware that they need medical attention. Common signs to look for are shivering, which is your body's attempt to generate heat through muscle activity, and the "umbles" — stumbles, mumbles, fumbles and grumbles. These behaviors may be a result of changes in motor coordination and levels of consciousness caused by hypothermia.
Other signs and symptoms may include: [ul] [li]Slurred speech [li]Abnormally slow rate of breathing [li]Cold, pale skin [li]Fatigue, lethargy or apathy[/li][/ul]
The severity of hypothermia can vary, depending on how low your core body temperature goes. Severe hypothermia will eventually lead to cardiac and respiratory failure, then death.
For people most at risk of hypothermia — such as those who are older, have mental or physical impairments or who are homeless — community outreach programs and medical and social support services can be of great help. Identifying and checking in on vulnerable individuals and groups, preventing prolonged exposure to the cold and ensuring adequate heating are ways to help reduce the number of hypothermia deaths. Monitoring bracelets may provide assistance for those who have problems with wandering from home. In addition, public health prevention strategies can help educate people about the dangers of prolonged exposure to cold.
Staying healthy in cold weather
Before you or your children step out into cold air, remember the advice that follows with the simple acronym COLD: [ul] [li]C for Cover. Wear a hat or other protective covering to prevent body heat from escaping from your head, face and neck. Cover your hands with mittens instead of gloves. Mittens are more effective than gloves are because mittens keep your fingers in closer contact with one another. [li]O for Overexertion. Avoid activities that would cause you to sweat a lot. The combination of wet clothing and cold weather can give you chills. [li]L for Layers. Wear loose-fitting, layered, lightweight clothing. Outer clothing made of tightly woven, water repellent material is best for wind protection. Wool, silk or polypropylene inner layers hold more body heat than cotton does. [li]D for Dry. Stay as dry as possible. In the winter, pay special attention to places where snow can enter, such as in loose mittens or snow boots.[/li][/ul]
During cold-weather months, keep emergency supplies in your car in case you get stranded. Supplies may include several blankets, matches, candles and some foodstuffs, such as granola bars or crackers. A cell phone also can come in handy. If your car is stuck in a snowbank, be careful about leaving the engine running, as infiltration of carbon monoxide inside the car may pose a silent danger.
Extreme cold, wet clothes — especially in the presence of wind — and being in cold water can all play a part in increasing your chances of hypothermia. People who are elderly, very young or have certain health issues are especially vulnerable.
Risks to older adults
People age 65 and older are especially vulnerable because they may have other illnesses or take medications that can interfere with the body's ability to regulate temperature.
Risks to the very young
Children can lose heat faster than adults do. Children have a larger head-to-body ratio than adults do, making them more prone to heat loss through the head. Children may also ignore the cold because they're having too much fun to think about it. And they may not have the judgment to dress properly in cold weather or to get out of the cold when they feel cold. Infants may have a special problem with the cold because they have less efficient mechanisms for generating heat.
Other factors that may place you at risk
[ul] [li]Psychiatric disorders. Individuals who have Alzheimer's disease or another illness that causes mental impairment may not be aware of the risks of being out in the cold. Wandering away from home is not uncommon among people with Alzheimer's, and many are unable to find their way back on their own, leaving them stranded and vulnerable to the weather. [li]Alcohol consumption. Alcohol may make your body feel warm inside, but it lowers your body's ability to retain heat. Don't drink alcohol and operate a boat or other watercraft. Alcohol can impair your ability to navigate the waters, increasing your risk of an accident and of falling into cold water. [li]Medical conditions. Some health disorders affect the body's ability to respond to cold or to produce heat. Examples include untreated underactive thyroid (hypothyroidism), stroke, severe arthritis, Parkinson's disease, trauma, spinal cord injuries, burns, blood vessel or nerve disorders that affect sensation in your extremities (for example, peripheral neuropathy in people with diabetes), dehydration and any condition that limits activity or restrains the normal flow of blood. Older adults are more likely to have one or more of these risk factors. [li]Water temperature. Another factor contributing to your risk of hypothermia is the length of time you're in cold water. Rescue time is crucial when a person accidentally falls into cold water. Chances of survival are affected by how cold the water is. The colder the water, the less the chance of survival. [/li][/ul] Water temperature Time until exhaustion or unconsciousness Expected time of survival in the water Under 32 F Less than 15 minutes Less than 15 to 45 minutes 32.5 to 40 F 15 to 30 minutes 30 to 90 minutes 40 to 50 F 30 to 60 minutes 1 to 3 hours 50 to 60 F 1 to 2 hours 1 to 6 hours 60 to 70 F 2 to 7 hours 2 to 40 hours 70 to 80 F 3 to 12 hours 3 hours to indefinite More than 80 F Indefinite Indefinite
Cold-water cautions
Water doesn't have to be extremely cold to cause hypothermia. Any water that's colder than body temperature causes heat loss. Water that's colder than 70 F can quickly begin to cause hypothermia. The following tips may increase your survival time in cold water, if you accidentally fall in: [ul] [li]Wear a life jacket. If you plan to ride in a watercraft, wear a life jacket. A life jacket can help you stay alive longer in cold water by allowing you to float without using energy and providing some insulation. [li]Don't panic. If you're unable to swim to safety, stay calm. Unnecessary movements require you to exert extra energy and lose body heat. [li]Position your body to minimize heat loss. Use a body position known as HELP (Heat Escape Lessening Position) to reduce heat loss while you wait for help. Hold your knees to your chest to protect the trunk of your body. If you're wearing a life jacket that turns your face down in this position, bring your legs tightly together, your arms to your sides and your head back. [li]Huddle with others. If you've fallen into cold water with other people, keep warm by facing each other in a tight circle. [li]Don't remove your clothing. Buckle, button and zip up your clothes. Cover your head if you have a hood. The layer of water between your clothing and your body will be warmed and help insulate you. [li]Don't attempt to swim unless you're close to safety. Unless a boat, another person or a life jacket is close by, stay put. Swimming expends extra energy, lowers body temperature and can shorten survival time by more than 50 percent.[/li][/ul]
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