# Hypothermia - sends a shiver down your spine



## kayaksportsmark (Apr 1, 2009)

Further to the post on Cold Shock. Lets look at Hypothermia, its symptoms, treatment and most importantly its prevention.

Hypothermia occurs when we lose heat faster than our body can produce it. Normal body core temperature is around 37`C, below this hypothermia develops. Factors that contribute to hypothermia include low temperatures, winds and damp conditions, as kayakers we also have water playing a large part. Heat loss from the body is 30 times more rapid when the skin is wet than when it is dry.

Kayakers get plenty of water on them even when they remain upright while paddling. So our risk of hyperthermia is greater than average. Refrain from alcohol as it sends heat to the skin which is then lost.

Hypothermia is defined as a core body temperature below 35`C. Symptoms include shivering, reduced energy, lapses of attention, nausea. As the internal temperature drops, people become more disoriented and irrational. At 30`C core temperature, shivering stops and muscle activity slows, unconsciousness may occur and become more prominent as the condition progresses, a desire to go to sleep becomes overwhelming. At 25`C the person may reach a state of coma.

Stages of Hypothermia and treatment:

Stage 1. Mild: 35`C 
Maximum shivering, fatigue, nausea, confusion, poor coordination, slurred speech, usually conscious but with apathy and slowed thinking.
Treatment: Remove wet clothing, get skin dry and begin active re-warming. Protect from the elements. Give warm, sweet drinks, build fire, provide insulation such as sleeping bag or thermal blanket. Monitor condition.

Stage 2. Moderate: 30`C
Most shivering stops, muscle cramps and rigidity, disorientation, sleepiness, consciousness clouded, breathing and pulse become slow and difficult to detect.
Treatment: Requires evacuation to a warm environment and medical evaluation. Handle patient with gentle care. Lay flat and insulate, give warm drinks if conscious and able to swallow, gentle re-warming is required so DO NOT rub or massage nor expose them to excessive heat e.g fire.

Stage 3. Severe: 25`C
Progressive loss of consciousness, heartbeat irregularities,, pupils fixed and dilated, coma like, cardiac and respiratory arrest. 
Treatment: Immediate evacuation, monitor condition, may require basic life support/ CPR.

Of course, the best treatment is PREVENTION. Dress for the environment and the fact you will no doubt get wet. Be aware of the initial signs of hypothermia and get out of the water and warm again before it gets worse.
What to wear: 
• Most heat loss is through the head so a beanie (wool or fleece) or a neoprene skull cap is advised, must fit under helmet so no pompom.
• Your hands will be in the water a lot so neoprene gloves are a great idea, special paddler gloves aren't as thick in the palm and fingers so allow a good grip on the paddle, kitchen gloves, there are also paddler mittens called pogies. 
• Your feet will get cold in the hull of your boat so neoprene booties, neoprene slippers or neoprene socks are good. 
• For the legs and upper body it depends on the temperature, you may choose thermals, wetsuit, spraytop/cag or a drysuit or a combination of them.

Stay safe this winter and enjoy your kayak fishing.


----------



## geecee (Mar 5, 2010)

Two excellent and very relevant posts, Mark. To reinforce the message a little, it may be useful to briefly outline a personal experience.

Some many years ago when I was much younger and fitter, I was helping to load a pontoon which flipped, tossing me into very cold salt water (about -2C). I was wearing layered cold weather clothing and heavy boots which didn't assist swimming (and no PFD - don't ask). By the time I reached the surface the cold water began to get through my clothing and did indeed take away my breath. At that stage I found I'd been thrown some distance from the pontoon, so I turned on my back and began to swim to it. By the time I reached it, I had no sensation in my body and was essentially running on reflex. I already was entering the 'apathy' stage and survival seemed almost academic, it was almost like watching as a third party. Luckily a companion on the pontoon had managed to grab a mooring rope when it flipped, and had stayed on board. He hauled me onto it, as I no longer had the strength to get myself on, after just a minute or so. Soon after, a rope was dropped to me from the ship alongside (I was incapable of climbing the rope ladder) and I was bundled fully dressed into a hot shower. Even after that, and plenty of dry clothing, I was still shivering uncontrollably hours later.

A set of extreme conditions, admittedly, but the main difference with the water temperatures we're likely to encounter when kayaking in winter around Oz is the speed at which the stages of hypothermia develop. The following link gives good advice and a temperature chart - though the chart gives times to "exhaustion or unconsciousness", I'd say from my experience that the time for useful functioning (ie at which you would be able to take care of yourself) is substantially less. http://www.ussartf.org/cold_water_survival.htm Because the heat transfer is so much greater while immersed, the most important consideration is to get out of the water ASAP to avoid the drowning risks associated with hypothermia. Then it's a matter of getting dry, warm etc. - maybe easier said than done, depending on the circumstances. Time then becomes everything.


----------



## cruiser (Dec 19, 2007)

Very good info and good follow up, thanks kayaksportsmark its helping me solve a few questions

cheers cruiser


----------



## Dodge (Oct 12, 2005)

geecee said:


> Because the heat transfer is so much greater while immersed, the most important consideration is to get out of the water ASAP to avoid the drowning risks associated with hypothermia. Then it's a matter of getting dry, warm etc. - maybe easier said than done, depending on the circumstances. Time then becomes everything.


Had a similar experience to that described by George but in the warmer water of Rainbow Channel in Moreton Bay Q in autumn.

We were part of a group of maybe 30 boats searching for a man overboard at night and were lucky enough to find after he had been in the water for a little over 2 hours and when we lifted him into the boat it proved to be a mate Geoff from the past.

Although the water would not be called cold [guess maybe 20c] when we dropped him on the floor of the cockpit he was shivering uncontrollably and we covered him with towels, bunk cushions and anything fabric to warm him up a bit as he was in dire straights.

Met the police and a doctor at the Little Ships Club and wanted to slip some rum into him but the doctor said that would not warm his core and asked for soup instead ..luckily the rescuers were not inhibited in that way so we resumed celebratory drinking.

Geoff was still shivering an hour later despite soup, hot shower, and warm clothing, and this outcome was from warmer water, and was quite an insight into hypothermia.


----------

