Hypothermia

Hypothermia occurs in cold environments when the normal body temperature of 37°C (98.6°F) drops below 35° (95°F).

It can also happen due to prolonged exposure, rain, wind, sweat or being under cold water.

The usual response to getting too cold is to increase activity, however, if exposure continues then the body’s own automatic defence mechanisms will attempt to preserve further heat loss by:

involuntary shivering to ensure major organs stay at normal temperature;
restricting blood flow to the skin, and
releasing hormones to generate heat.
These responses are usually inadequate to protect the body and they also drain energy reserves. It is when body energy is exhausted that hypothermia becomes potentially life-threatening.

Without treatment people with hypothermia can rapidly become very ill, lose consciousness and die. There is also an increased risk of stroke or heart attack due to blood clots forming.

It is important to treat the signs of hypothermia as a medical emergency, and to judge the symptoms rather than what a person says about their own condition. Hypothermia kills people every year - older people especially may not notice that their body temp has fallen, their rooms are too cold, or they can’t move about very well.

Hypothermia is caused by getting too cold.

Certain groups are at particular risk from getting hypothermic such as:

older people,
homeless people,
babies under 12 months in cold bedrooms,
people recovering from accidents,
people with other conditions, for example, mental health problems, heart problems, hypothyroid, on sedatives, alcoholism,
people on medication, and
people who expose themselves to extreme weather conditions eg climbers, walkers, skiers.

Symptoms vary depending upon the severity and length of exposure to cold.

Mild:

shivering,
feeling cold,
low energy,
reduction in normal endurance, and
cold red skin.
Moderate:

violent shivering,
inability to think or pay attention to events,
confusion, so people may not know they are affected,
loss of judgement and reasoning,
poor movement, stumbling,
feeling fearful,
memory loss,
fumbling hands,
drowsiness,
slurred speech,
apathy, listlessness, indifference, and
slow, shallow breathing and weak pulse.
Severe:

loss of control of hands, feet, and limbs,
shivering stops,
unconsciousness,
shallow or no breathing, and
weak, irregular or no pulse

Diagnosis is made from symptoms. Body temperature is below 35° (95°F).

Contact emergency services and get urgent medical assistance.

However if medical care is not possible:·

find shelter,
insulate to prevent further heat loss,
change out of wet clothing,
warm the centre of the body first by whatever method you can to protect major body organs eg using an emergency blanket (‘space blanket’), your own body heat, skin-to-skin contact, or dry layers of blankets, clothing, towels, or layers of sheets,
give warm drinks (but no alcohol), and
when the temperature increases keep dry and warm.

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Some of the measures to prevent hypothermia are:

avoiding cold environments,
layered clothing to trap warm air,
eating and drinking to provide energy,
staying as active as possible to ensure circulation,
avoid things that may restrict circulation,
wearing a hat (prevents up to 20% heat loss through the head) and other insulating clothing,
staying dry (wet clothes lose about 90% of their insulating power), and
staying out of the wind. NHSDEC07