HYPOTHERMIA

What is it?

It is when there is a drop in the core body temperature; this can be any amount – even just one degree. The name literally means a deficiency of heat. Your normal core temperature is about 37 degrees, and hypothermia is when we see a drop from this. Winter Alpine conditions are prime to see anyone suffer from this life threatening condition.

The symptoms of this condition are one of the problems which can lead to death; they give the sufferer false indications are to the seriousness of the problem. For example, then the core temperature drops by one degree your response is to start shivering, but by two degrees lose you actually stop shivering. IT IS VITAL YOU CHECK UP ON YOUR BUDDY! If you see your friend suffering, but he is apparently unaware, talk to them.

Causes
There can lots of little things which all contribute to becoming hypothermic, obviously the environment is a huge factor. Alpine winds (up to 70miles per hour) will strip all the heat away form your body, if there is high humidity there will be more heat loss by convention, rain and snow will assist heat loss by conduction. Basically winter in the Alps is a niche for hypothermia. Poor quality equipment will be a factor too, if a jacket is not fully windproof (ie, has holes in it) you can expect to get cold quickly.
Symptoms

You will start to shiver, and as the condition progresses you will actually stop, this is probably the easiest sign of early hypothermia to see.

You will encounter a few mental issues. The words you try to use will come out slurred. In most cases the sufferer is unaware that he is infact cold, so you will see him trying to remove layers of clothing. This has a very bad effect, it will speed up the progression of the condition. So it is so very vital that you keep your eye on your climbing buddy.

The subject will become less sensitive to pain stimulus.

You will see a slowing of the sufferers pulse and breathing rate, this is often highlighted on the hill by their performance reducing (ie, they will slow down in their walking/climbing).

The skin of the subject will feel cold to touch.

They will stop drinking as much water as they were before they were cold, this again is an issue which if carries on unchecked will lead to dehydration. This again will push the case in to the category of a real serious issue.

Treatment
The purpose of any first aid you can give is to preserve and prevent further core heat loss; you should never try to rewarm the subject. The early you catch the hypothermia the easier it is to treat the subject, therefore it is vital your work as a team and watch over each other on the hill. In the case of rescue from the hillside there is often an “after drop”. This is where the core temp takes a rapid drop, the reasons for this is unknown, and normally causes the subject to collapse once rescued. You can expect the subject to be unconscious if their core temp is about 30 degrees, and there chance of survival if un-rescued is very low.

The most effective treatment is core re-warming and this is done by inhalation re-warming.

This is as simple as it sounds; make the subject breath in warm air. The air is normally around 45 degrees. Its safe to do, as it is non invasive (involves no surgery or injections), and as most of the heat loss of sufferers (10% to 30%) is lost by respiration it also prevents further cooling of the core. There are many advantages to this type of re-warming; one is that it heats the critical core (the head, neck and thoracic core) directly. With warming the head, you warm the brain, and impartially you warm the hypothalamus. This is the area of the brain that controls body temp, respiration and has a role in cardiac regulation.

It is important you try and immobilise the sufferer, as the cold peripheral blood will enter into the core and has a cooling effect. And a cold heart will lead to ventricular fibrillation. Also, ideally, your patient will be in a horizontal position. If your suddenly sit them up they will go in to shock and suffer a lot more, as horizontally they can maintain their blood flow better, which is important as you do not want their blood pressure to take a drop.
Also, try not to give your cold friend any oral drugs. They will have no real effect in a hypothermic patient, the drugs will only begin to take effect as the body warms up, and this can counter the natural warming processes of the body.

PREVENTION IS BEST, therefore make sure you have adequate gear to cope with the harsh conditions of an Alpine Hard Season. And always keep an eye on your friend, if they start showing the early signs, withdraw from the climb.

A.Johnson