Winter weather hazard #1: hypothermia

mittens

A few weeks ago, the national news headlines were: “At least 10 people were reported dead by plunging temperatures that gripped the country; many of the fatalities were attributed to hypothermia and related accidents”.  It seems that our St Louis area is subject to winter weather changes on a continuous basis. For those of us who have lived in the area a while, it is important to not be too complacent about the possible dangers of all winter hazards, not just snow and ice. This article will focus on hypothermia.

When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it. When your body temperature drops, your heart, nervous system and other organs can’t work correctly. Left untreated, hypothermia can eventually lead to complete failure of your heart and respiratory system and to death. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water. If your body temperature is below 95°, the situation is an emergency—get medical attention immediately.

People at risk for hypothermia include elderly people with inadequate food, clothing, or heating; babies sleeping in cold bedrooms; people who remain outdoors for long periods—the homeless, hikers, hunters, etc.; and people who drink alcohol or use illicit drugs. People with a mental illness, dementia, alzheimer’s, or another condition that interferes with judgment may not dress appropriately for the weather or understand the risk of cold weather. People with dementia may wander from home or get lost easily, making them more likely to be stranded outside in cold or wet weather. Certain medical conditions can affect your body’s ability to regulate body temperature. Examples include underactive thyroid (hypothyroidism), poor nutrition, stroke, severe arthritis, Parkinson’s disease, trauma, spinal cord injuries, burns, disorders that affect sensation in your extremities (for example, nerve damage in the feet of people with diabetes), dehydration, and any condition that limits activity or restrains the normal flow of blood. Hypothermia isn’t always the result of exposure to extremely cold outdoor temperatures. A person may develop mild hypothermia after prolonged exposure to indoor temperatures such as, in a poorly heated home or in an air-conditioned home. Certain medical conditions can affect your body’s ability to regulate body temperature. Examples include underactive thyroid (hypothyroidism), poor nutrition, stroke, severe arthritis, Parkinson’s disease, trauma, spinal cord injuries, burns, disorders that affect sensation in your extremities (for example, nerve damage in the feet of people with diabetes), dehydration, and any condition that limits activity or restrains the normal flow of blood.

Warnings signs of hypothermia in adults include shivering, exhaustion, confusion, fumbling hands, memory loss, slurred speech, and drowsiness. Shivering is your body’s automatic defense against cold temperature — an attempt to warm itself. Constant shivering is a key sign of hypothermia. Other signs could be: poor decision making, such as trying to remove warm clothes, very low energy, apathy or lack of concern about one’s condition, progressive loss of consciousness, weak pulse, slow/shallow breathing. Some of these signs are also symptoms of hypoglycemia (low blood glucose); so for people with diabetes, testing your blood sugar becomes more important to prevent danger.  In infants, the signs of hypothermia are bright red, cold skin, and very low energy.

The mechanisms of heat loss from your body include the following: a) radiated heat – most heat loss is due to heat radiated from unprotected surfaces of your body, such as not wearing a hat, scarves, gloves; b) direct contact – if you’re in direct contact with something very cold, such as cold water or the cold ground/concrete from a slip or fall, heat is conducted away from your body. Because water is very good at transferring heat from your body, body heat is lost much faster in cold water than in cold air. Similarly, heat loss from your body is much faster if your clothes are wet, as when you’re caught out in the rain; c) wind – wind removes body heat by carrying away the thin layer of warm air at the surface of your skin. A wind chill factor is important in causing heat loss.

Seek immediate medical attention for anyone who appears to have hypothermia. Until medical help is available, follow these general hypothermia treatment guidelines. When you’re helping a person with hypothermia, handle him or her gently; limit movements to only those that are necessary; don’t massage or rub the person; excessive, vigorous or jarring movements may trigger cardiac arrest. If possible, move the person out of the cold to a warm, dry location or shield them from the cold and wind as much as possible. Remove wet clothing; cut away clothing if necessary to avoid excessive movement. Cover the person with layers of dry blankets or coats, including covering the person’s head, leaving only the face exposed; to insulate the person’s body from the cold ground/surface, lay the person on their back on a blanket or other warm surface. Don’t apply direct heat, such as hot water, a heating pad or a heating lamp to warm the person; the extreme heat can damage the skin or even worse, cause irregular heartbeats so severe that they can cause the heart to stop.

Tips to prevent hypothermia include using the advice that follows with the simple acronym COLDcover, overexertion, layers, dry. Cover: wear a hat or other protective covering to prevent body heat from escaping from your head, face and neck. Use mittens instead of gloves because mittens keep your fingers in closer contact with one another. Overexertion: avoid activities that would cause you to sweat a lot. The combination of wet clothing and cold weather can cause you to lose body heat more quickly. Layers: wear loose-fitting, layered, lightweight clothing. Outer clothing made of tightly woven, water-repellent material is best for wind protection. Wool, silk or polypropylene inner layers hold body heat better than cotton does. Dry: stay as dry as possible; get out of wet clothing as soon as possible. Be especially careful to keep your hands and feet dry, as it’s easy for snow to get into mittens and boots. Additionally, to keep children safe outdoors, the American Academy of Pediatrics suggests: dress infants and young children in one more layer than an adult would wear in the same conditions. Limit the amount of time children spend outside in the cold, by having them come inside frequently to warm themselves.

For people most at risk of hypothermia, community outreach programs and social support services may be helpful. If needed, contact your local public health office for available services, such as the following: assistance for paying heating bills; “check-in” services to see if you and your home are warm enough during cold weather, homeless shelters, and community warming centers.

Other winter weather hazard information coming soon: carbon monoxide dangers and frostbite…..are you prepared?

Sources:  Centers for Disease Control and Prevention; www.cdc.gov; (800-232-4636); TTY: (888) 232-6348;  and the Mayo Clinic; www.mayoclinic.com

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