How to Identify and Treat Hypothermia

Cold environments present a real hazard to workers. Just being in the cold can limit a person’s range of motion, creating a possible workplace hazard. Illnesses caused by the cold include trench foot, frostbite and hypothermia. The most serious of the cold stress illnesses is hypothermia, a condition in which core body temperature drops below the required temperature for normal metabolism and body functions. Symptoms of hypothermia vary depending on the level of hypothermia: mild, moderate, severe and critical. To ensure a safe winter workforce, you must be able to identify the symptoms of hypothermia and treat them.

Mild Hypothermia

When a person’s body begins to cool, the body’s natural reaction is to shiver to create internal heat. As the body cools, surface blood vessels begin to shut down to prevent the further loss of heat through the skin. Numbness to the extremities occurs, resulting in a loss of dexterity. Although the victim will be alert, other symptoms of mild hypothermia include a body temperature of 97 to 93 F and pain from the cold.

Moderate Hypothermia

As the victim’s body temperature decreases, shivering will become more violent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim still may appear alert. Surface blood vessels contract further as the body focuses on keeping the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may be blue. His or her body temperature now is around 93 to 90 F.

Severe Hypothermia

The victim now is showing obvious signs of the cold. Less blood flow causes confusion. Other symptoms include:

  • A body temperature of 90 to 82 F.
  • Shivering has decreased or stopped.
  • Confusion and loss of reasoning.
  • Slurred speech.
  • Semi-conscious to unconscious.
  • Muscular rigidity.

Critical Hypothermia

This is a life-threatening condition. The victim will die if not treated. Symptoms include:

  • A body temperature of less than 82 F.
  • Unconscious and may appear dead.
  • Little breathing.
  • Slow pulse.
  • Dilated eyes.
  • Rigid body.

Treating Hypothermia

The basic principles of rewarming a hypothermic victim are to conserve the heat he or she has and replace the body fuel he or she is burning to generate heat.

Victims of mild to moderate hypothermia are still conscious and can be treated without medical attention. Follow these guidelines:

  • Handle the victim gently and minimize his or her exertion.
  • Remove wet clothing and get the victim into warm, dry clothes. Wrap the victim in warm blankets, ensuring his or her head is covered. Place something warm and dry under the victim. Move him or her to a warm environment. Do not make the victim exercise to warm up.
  • Do not suppress shivering, even if violent. Shivering is the most effective way to generate body heat.
  • Do not massage the extremities (hands, arms, legs, feet, etc.) or the trunk.
  • Do not place the victim in a warm bath or shower.

Victims of moderate to severe hypothermia have an altered level of consciousness and fluctuating changes to their heart and respiratory rate. They may be shivering and their core body temperature is usually below 91.4 F. If someone is suffering from critical hypothermia, dial 911 immediately. Then follow these steps:

  • Handle the victim gently. Rough handling can cause heartbeat irregularities and death.
  • Check for airway obstructions and breathing or circulation problems and take appropriate action if there are any abnormalities. Initiate CPR only if no pulse is present after a one-minute assessment.
  • If CPR is necessary, assist breathing at 10 to 12 breaths per minute. Do not start cardiac massage unless it can be continued effectively without a break. It is more dangerous to start, stop and restart CPR rather than to wait until proper care is available.
  • Remove all wet clothing and replace with dry, warm blankets or a sleeping bag. If this is not possible, cover the victim with warm dry clothing, ensuring his or her head is covered. Place something warm and dry under the victim.
  • Move the victim to a warm, dry environment.
  • Do not suppress shivering, even if it is violent. Shivering generates body heat.
  • Do not give anything by mouth because of the high risk of vomiting.
  • Do not massage the trunk or extremities of the victim.
  • Do not place the victim in a hot bath or shower.
  • If available, heated, humidified air or oxygen should be administered.
  • Continue first-aid treatment even if the victim appears lifeless. The body can sometimes survive for hours at very low body temperatures without signs of life.
  • Arrange rapid transport to the nearest medical facility.

Hypothermia Prevention

Hypothermia can happen on a mild winter’s day or damp day in fall or spring. The basic principle for preventing hypothermia is to stay warm and dry and be prepared for a sudden emergency. You must know how to assess hypothermia and give help when it is needed, even if the victim resists help. He or she may be confused and unaware of what is happening, so it is up to you to recognize the signs of hypothermia and administer treatment.

About Michael Rich

Michael Rich is in charge of product development for Tempe, Ariz.-based Safety Services Co., a supplier of occupational health and safety training and compliance materials.

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