speech, loss of coordination or incoher- 

 ence, take the individual to a hospital. 

 It's best to let trained medical personnel 

 rewarm the victim due to potential 

 physiological complications. 



But hypothermia accidents often 

 occur in remote areas where access to 

 medical facilities is not readily avail- 

 able. In this case, friends, family or 

 coworkers may be called upon to 

 rewarm the victim. Proceed carefully 

 and gently. Too much jostling could 

 send the victim into cardiac arrest. 



First, move the victim to a warm 

 location and remove wet clothing. Place 

 blankets or a sleeping bag over the 

 individual. If hot packs, hot water 

 bottles or heating pads are available, 

 apply them to the groin, head, neck and 

 sides of the body. If none of these items 

 is available, one of the rescuers should 

 warm the victim with his or her own 

 body heat. With a bare torso, get under 

 the coverings with the victim and press 

 next to him or her. Once shivering has 

 stopped, the victim has lost the ability 

 to generate heat, so simply wrapping an 

 individual in a sleeping bag or blanket 

 will not help. A heat source is required. 



Do not warm, rub or stimulate a 

 severely hypothermic person's hands, 

 arms, feet and legs. Warming these 

 extremities can cause a serious, life- 

 threatening reaction called afterdrop. As 

 the body cools, it shuts off blood 

 circulation to the extremities to con- 

 serve warm blood around the vital 

 organs. If the arms and legs are in- 

 cluded in the rewarming process, they 

 will warm more quickly than the body's 

 core. The brain will think the emer- 

 gency is over and reopen circulation. 

 This will return cold blood to the vital 

 organs, causing a renewed decrease in 

 the body's core temperature and 

 possibly sending the victim into cardiac 

 arrest. 



Likewise, do not force severely 

 hypothermic victims to consume hot 

 drinks. Often individuals are only 

 semiconscious and could easily choke. 

 In addition, hot drinks draw warm 

 blood away from vital organs, where it 

 is needed. 



Also, do not perform cardiac 

 pulmonary resuscitation (CPR) on 



hypothermia victims. It is difficult to 

 distinguish between severe hypothermia 

 and cardiac arrest, but chest compres- 

 sions or any other rough handling of a 

 severely hypothermic person could 

 convert a slow, low heart rhythm into 

 ventricular fibrillation, a form of heart 

 attack. Check for any body movement or 

 breathing, both of which are lacking in a 

 heart attack victim, and feel for a pulse 

 in the neck for a full minute before 

 initiating CPR. 



Prevention 



The best cure for hypothermia is 

 prevention. Be prepared for cold weather 

 by dressing properly. If you're going to 

 be on the water, wear a personal 

 flotation device (PFD). Layering is the 

 key to staying dry, warm and comfort- 

 able. Wear a number of garments that 

 can be donned or removed depending on 

 the weather and the level of exercise. At 

 least one layer should be wool or 

 polypropylene. Unlike cotton or down, 

 these fabrics retain their insulating 

 ability even when wet. 



Always cover your head when 

 temperatures drop below 50 F. As much 

 as 30 percent of your body heat is lost 

 through your head. Eat high-energy 

 foods and drink water regularly. 



If you're hunting, hiking or canoe- 

 ing in the cold, avoid exhaustion by 

 knowing your limits. If you get lost, 

 avoid panic and other energy-depleting 

 activities. Always carry with you fire- 

 starting materials, a VHF radio to call 

 for help if lost or hurt, and a first-aid kit. 



On the Water 



What if you find yourself in cold 

 water? 



Remain calm and keep quiet. 

 Thrashing about will hasten your body's 

 heat loss and allow water to enter your 

 clothing. If you aren't wearing a PFD, 

 allow the air trapped between your 

 layers of clothing to help keep you afloat 

 by assuming a back-float position. 



Your chances of survival and 

 avoiding hypothermia are increased if 

 you are wearing a PFD. Even if you are 

 a strong swimmer, you can be quickly 

 overcome by cold water. The most 

 effective PFDs are the ones that fit well. 



hold your head out of the water and 

 allow you to adopt the "heat escape 

 lessening posture," or HELP position. 

 In this position, keep the knees together 

 and pulled up as far as possible. Cross 

 your ankles and hug your sides. This 

 protects the high heat loss areas of the 

 chest, armpits and groin. 



Climb on any floating object to get 

 more of your body out of the water. 

 Even in wind, rain and spray, you will 

 be better off in the air. If more than one 

 person is in the water, huddle together 

 to reduce heat loss with arms around 

 each other and as much body contact 

 as possible, especially at the chest. 

 This technique is most feasible when 

 individuals are wearing PFDs. 



For commercial fishermen who 

 work on water throughout winter and 

 in stormy weather, survival suits or 

 immersion suits are a good investment. 

 These suits allow extended survival in 

 cold water. 



If you know you're going over- 

 board into cold water, cover your mouth 

 and nose. This technique will combat 

 the torso reflex, which is the body's 

 automatic gasp for air when cold water 

 hits the chest. 



Susceptibility 



Susceptibility to hypothermia 

 depends not only on the conditions of 

 exposure but also on other factors. 



• Children are considerably more 

 susceptible than adults, who are larger. 



• Older adults are more likely to become 

 hypothermic than younger adults. 



• Thin people are most susceptible than 

 heavier ones. 



• Men are more prone to hypothermia 

 than women, who generally have a 

 thicker fat layer. 



• Alcohol and drugs may impair 

 shivering or dilate surface blood 

 vessels, therefore masking symptoms. 



• Certain medical conditions, such as 

 hypothyroidism, diabetes and 

 epilepsy, may make a person particu- 

 larly susceptible to hypothermia. 



This story was adapted from an 

 article written by Martha Walters of 

 the Michigan Sea Grant College Program 

 for Mariners Weather Log. □ 



COASTWATCH 19 



