How to Treat Severe Hypothermia

If you recognize someone as severely hypothermic, his or her life is in serious danger. Begin treatment right away to prevent worsening of the condition.

Difficulty: Easy

Instructions

Things You'll Need:

• Dry clothing
• Sleeping Bags
• Sleeping Pads
• Vapor Barriers

Prevention and Assessment

1. Do everything in your power to prevent hypothermia before it occurs (see "How to Prevent Hypothermia").

2. Assess the degree of hypothermia (see "How to Recognize and Assess Hypothermia").

3. Treat for severe hypothermia, if that's what you diagnose.

Treatment: Prevent Further Heat Loss

4. Remove the affected person from the cold, wet and/or windy environment.

5. Dry the person off, replacing wet clothing with dry clothing.

6. Shelter the person however possible: in a cave, under an overhang, in an improvised shelter such as a tent or under a rain fly.

7. Make sure the person is wearing a dry hat: A large percentage of body-heat loss occurs through the head.

8. Cover the neck with something dry: A lot of heat is also lost through the neck.

9. Insulate the person from the ground and the surrounding cold by having him or her lie in a sleeping bag on a sleeping pad.

Gentle Rewarming

10. Place hot water bottles (filled with hot water) and/or chemical heat packs inside the sleeping bag and against the clothing of the hypothermic person.

11. Build a "hypothermia wrap" by placing dry clothing over all exposed parts of the person except his or her mouth and nose, and wrap a vapor barrier - a tent fly, plastic garbage bags, anything that will minimize the escape of heat - around the person.

Tips & Warnings

• Be innovative in finding ways to avoid moving the hypothermic person while making the hypothermia wrap. For example, if putting him or her in a tent, cut a hole in the floor of the tent rather than lifting the person into the tent.
• If at all possible, zip two sleeping bags together and have a (non-hypothermic) rescuer lie in the bags with the hypothermic person as an extra source of heat.
• Wrap the hot water bottles and chemical heat packs in socks, or some other form of dry insulation, to prevent damage to clothing.
• For greatest efficiency, place the hot water bottles and/or heat packs in the following places: in the hands, on the neck, on the chest, on the stomach, on the abdomen, in the groin.
• Place as many dry, insulating layers as possible on top of the sleeping bag as well as over any places where heat might be prone to escape, such as the opening of the sleeping bag.
• Build a fire, or fires, only after the wrap is complete, and make sure there is no danger of anything catching on fire or of anyone getting burned.
• Do not place water bottles or heat packs against naked skin.
• Do not evacuate a severely hypothermic person by hand, since the jolting and jarring of the journey severely risks ventricular fibrillation. Instead, send a rescuer out to arrange a helicopter evacuation and to consult with medical professionals about other rescue options.
• Rewarming of a severely hypothermic person must be gentle. Overly rapid rewarming could shock the heart into ventricular fibrillation.
• If the person is not at least "A and O times 3" on the Level of Consciousness scale (see "How to Assess Level of Consciousness") - as he or she almost inevitably won't be if severely hypothermic - do not administer food or liquids.
• A severely hypothermic person who cannot be evacuated by helicopter is in a sorely grave position. All you can do is as much of this external rewarming as possible, and send someone out to report to and consult with medical professionals.
• Even if the person seems dead to you, treat for hypothermia since his or her abnormally slow and weak pulse and breathing may fool you into thinking that they have stopped entirely. An old adage goes: "No one is dead until warm and dead."
• Do not perform CPR, even if you think the heart has stopped. To jolt the person in this way is to encourage ventricular fibrillation and, almost inevitably, death.
• Hypothermia can strike in any season, especially in the high country. Keep a close eye on the weather whenever you go in the wilderness, and adjust your plans as necessary to avoid the risk of hypothermia.
• Hypothermia can and does kill. Prevention is the best medicine (see "How to Prevent Hypothermia").
• Avoid tight-fitting clothing - including footwear - which might impair circulation.
• This information is not intended as a substitute for professional medical advice or treatment.

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