1. Hypothermia Depression of body core temperature Insidious, debilitating, can be fatal Common in winter outdoor activities Can occur at any temperature PREVENTION is the best treatment

2. Heat Balance Heat Gain Basal Metabolism Voluntary Exercise Shivering Intake – Food & Water Heat Loss Conduction Convection Radiation Evaporation Respiration HYPOTHERMIA

3. Other Risk Factors Alcohol Smoking Caffeine

4. Signs and Symptoms Judgement is the First Thing to Go If you are shivering you are mildly hypothermic A hypothermic hiker gets the “UMBLES” –grumbles –fumbles –bumbles –stumbles –tumbles Untreated hypothermia leads to coma and death

5. Stages of Hypothermia 98 - 95 degrees - Chilliness, numbness, minor muscular impairment. Shivering begins. 95 - 93 degrees - Muscle incoordination and weakness. Slow, stumbling pace. Confusion, apathy. Skin pale and cold to touch. 93 - 90 degrees - Gross muscular incoordination. Slow thought and speech. 90 - 86 degrees - Cessation of shivering. Stiffness and inability to walk or stand. Incoherent, confused, irrational. 86 - 82 degrees - Severe muscular rigidity. Patient barely arousable. Dilatation of pupils. Inapparent heartbeat and pulse. Skin ice cold. 82- 78 degrees and below – Unconsciousness and death.

6. Depth of Severity SHIT INCREASING DEPTH CORE TEMPERATURE DEPRESSION

7. Treatment Prevention, Prevention, Prevention Conscious –Remove wet clothes, add dry insulating layers –HYDRATE and give simple sugars (jello, cocoa, etc) –Exercise to generate heat Reduced Consciousness –“hypo wrap” Dry clothes, lots of insulation, windproof covering Do not attempt body-to-body rewarming Patient must be carefully evacuated and rewarmed in hospital