The Cold Facts About Hypothermia

May on a Minnesota lake. Three men are in two canoes bracketed together in such a way as to make a catamaran. Two are in back and one is in front. They have spent the day camping and fishing. So far, the trip has been relaxing and fun. And then they paddled around a bend into a headwind. Water started splashing between the canoes, settling in one of them to the point all onboard were concerned. The bailing bucket they usually carried had burned up the night before in a campfire and all that remained were a few sponges. The water was getting higher in the canoe. A decision was made for one of them to move to the higher side but the man who was to make the move froze. The canoe swamped and within a minute, all three were in the 50 degree water.

"I look back at that moment, and the moments leading up to it," all the time says one of the survivors of this accident (who asked his name not be used). "But I never felt like I wasn't in control or that we weren't going to make it."

The water was 90-100 feet deep in the lake. The winds were hitting 15 mph and the seas were building. After a few minutes in the water, the brackets holding the canoes together came off. They knew there was a boat within a half mile of their location but attempts to signal with a canoe paddle weren't successful. They tried standing one canoe on its end to attract attention but the wind kept blowing it back into the water. It was becoming increasingly clear, these three boaters were in trouble and the longer they were in the cold water, the more trouble they were going to face.

"We were in there for almost an hour," the survivor says, "and I knew maintaining some degree of composure was going to get us through this. When panic sets in, that's when all the mistakes are made. So I kept saying 'hey now, this is a bad thing but we can overcome this.' I sensed one of the group was starting to panic so I made it a point to keep talking to him." He told the others he was going to swim to shore and get help, but the idea was quickly dismissed by the group. To do so would have been a fatal mistake because once out of the water, hypothermia was going to take hold faster than it already was doing. The three stuck together and they are alive today because of this decision. Wearing a lifejacket is another reason.

"My vest kept me alive, even though it kept coming unzipped as I tried to grab things that were floating past. After a while, I decided it was best to just hang on to the canoe. It also seemed that a lot of bright colors floating around would get someone's attention if we couldn't. When I look back I can tell you the mind is amazing. You are able to wheel through a lot of thoughts-actions-possibilities. I knew the day was still young and I knew more people would be out in canoes."

That's exactly how they were saved. Another canoe party came upon the three in the water and pulled them to shore. A nearby ranger station boat was called to the scene and took the wet and freezing boaters to a warm shelter. Each was suffering from various degrees of hypothermia. A series of good decisions after a single bad decision to paddle into some heavy weather is why they are alive today. That, and some luck.

"A few weeks later we received a voice mail from the rescue crew regarding the cost for the time to use the boat and the cost of food and so on. The total bill was $260. We talked about it and realized it cost about $90 a piece to stay alive that day. That's not too bad. I've saved that message and after a bad day at the office, I always replay it. One keeps a good perspective that way.

Signs of Hypothermia

Hypothermia occurs when the body temperature (also called core temperature) drops from the normal 98.7F as a result of prolonged exposure to cold water, wind or a combination of both. Once the body temperature drops, shivering naturally occurs as the body attempts to generate its own heat. As the temperature decreases, the victim becomes more disoriented. At 82 degrees F, unconsciousness occurs.

Mild

Body temperature is 98-96 degrees F. Shivering is involuntary. Can walk and talk but motor functions are difficult.

Moderate

Body temperature is 95-93 degrees F. The "umbles" begin with moderate hypothermia: stumble, mumble, fumble and grumble. On the latter, the victim can become violent. There is an attitude of "I don't care" and in some instances, victims have taken their hats off or tried to remove shoes and socks.

Severe

Body temperature is 92-86 degrees F. Shivering comes in waves. Then there is a pause before shivering begins again. The body is beginning to shut down as blood moves away from extremities and into the vital organs. The victim is drowsy and eventually falls asleep.

Things to Do (and Not Do)

Make sure you have a personal flotation device. If you don't, find it in the overturned boat. If someone has fallen in and isn't wearing one, throw one to them.

Don't try and swim to shore. The more activity you engage in, the more energy you are taking from your body. If hypothermia has begun, your body is going to become colder with increased activity. Stay where you are in the water. If alone, use the HELP posture (heat escape lessening position) in which you hold your knees to the chest with clasped arms. If you are with others, try and huddle together.

Treatment

Once out of the water have the victim lie on their back or side. If possible, get them out of the wind and in a dry environment. Lay them on a blanket or some kind of insulated material. If dry clothing is available, now is the time to get them into it.

Apply heating pads or hot water bottles under the blanket to head, neck, chest or groin. But be careful not to burn the victim's skin. Hypothermia will make a person's skin more sensitive to temperature than normal.

Do not apply heat to arms or legs. This forces cold blood in the arms and legs back toward the heart, lungs and brain and lowers the body temperature. This is called "after drop" and it can be fatal.

Apply your own warmth to the victim through direct body-to-body contact. Wrap a blanket around you and the victim. Remember the best kind of warm up is done slowly.

If conscious, give them warm-not hot-liquids with sugar. Avoid caffeine and alcohol.