A Look at Hypothermia

Hypothermia can be defined as when the body reaches a lower core temperature than it can normally function and metabolize. Normal core temperature ranges are 98.6 degrees F or 37 degrees C. Hypothermia begins to set in when the core temperature falls below 95 degrees F or 35 degrees C. A person will go into coma at a core temperature of 79 degrees F.

Hypothermia causes the hypothalamus to shut down. The mortality rate of a hypothermic patient can be as high as 87%; death within 2 hours of first signs and symptoms. Exposure to the cold can cause generalized hypothermia and local cold injury. A local cold injury (or frost bite) is:
- When ice crystals form between cells of the skin by extracting fluid from the cells.
- Ice crystals will destroy and damage tissue if not warmed up. (Do NOT put pressure on the affected area!)
- Nylon is a good heat absorber coupled with thick cotton socks over top of them.

The five stages of hypothermia are:
1. Shivering at above 90 degrees F, fast respirations and heart rates.
2. Apathy (limp) and decreased muscle function; fine motor functions first followed by gross motor function.
3. Decreased level of responsiveness - glossy eyes and freezing of extremities.
4. Decreased vital signs - slow pulse and respiration rate.
5. Death

Hypothermia causes the brain to shut down. It's known as a "peaceful death". To warm a hypothermic patient you'll need to increase their core temperature one degree per hour. NEVER immerse the person in a tub of hot water or shower. Put them in your vehicle and turn up the heat, use heat packs in the groin, armpits, chest, and knees. You'll need to handle the patient carefully so as not to trip their heart into VFIB or VTACH.

Immersion hypothermia, just as it sounds, is when a person has fallen into water. When trying to warm these patients do NOT rub or massage their skin in attempt to help regain their circulation.
With these patients death can occur if water is less than 50 degrees F. It can take the body 10 minutes to reach the temperature of the water. The paramedic on the scene will not pronounce the person dead until they he/she has been warmed up first. "They're not dead until they're warm and dead".