Fight the Elements First: Hypothermia Care [Infographic]

24 October 2023

Ben Cooper ENP & Dr. Sean Hudson

Ben Cooper ENP (Left) & Dr. Sean Hudson (Right)

Emergency Nurse Practitioner Ben Cooper and Dr Sean Hudson MBE, bring decades of cold environments experience working close to home as part of England’s Mountain Rescue Teams and across the world from the Himalayas to the South Pole.

Ben Cooper ENP (Left) and Dr. Sean Hudson (Right)

→  Download Infographic on Behavioural Changes to Help Identify Hypothermia; The ‘Umbles’.

Securing a Protective Environment: The Priority

When someone is suffering from hypothermia, the number one priority is getting them out of the weather. The cold, wet, and wind are enemy combatants you must vanquish before medical care can truly begin.

Attempting treatment while still exposed to the elements is bringing a knife to a gunfight. No amount of emergency blankets, hot packs, or calorie gels will be effective if the body is actively losing more heat than you can provide. You’re just bailing water on a sinking ship. We call this ‘bothies before bandages’.

Assessing and Quick Fixes

That’s why emergency rescuers are laser-focused on securing a protective environment first. This could mean setting up an emergency tent or shelter to establish a wind and waterproof cocoon. Foil blankets have very limited use here – they retain heat but don’t prevent air or moisture penetration. Proper overhead coverage and insulation from the ground are essential to provide a stable heat-preserving microclimate. 

Refuelling the Inner Furnace: Calorie Intake 

The next priority is a quick assessment, shivering not shivering, a quick fix or time to think about the prolonged field care of a hypothermic victim, using the Swiss scoring method. A quick fix exchanging any wet garments for warm, dry insulating layers to stem convection losses. Dry base layers and hats that seal heat escaping from the head and neck are key. Again, this is about stopping further heat drain, not active warming.

Advanced Rewarming Techniques

With exposure treated, rescuers can move on to the critical step of refuelling the inner furnace. Calories in the form of sugary drinks provide the raw materials for the body to ramp up shivering thermogenesis and generate its own warmth. Hot liquids also confer some core temp benefits.

Only once the environment, clothes, and calorie intake are addressed do more advanced rewarming techniques come into play. This includes chemical and electric heating packs, mild exercise, and full-body insulation wraps, the body burrito and the hypothermia prevention management kit ‘ HPMK’.

The Mistake to Avoid: Addressing the Environment First

Some rescuers make the mistake of skipping ahead to active warming measures without having secured the environment first. But this is like applying a bandage before disinfecting – infection will set in. Stopping the bleeding takes priority. So before unleashing your arsenal of heating aids, be sure you’ve won the weather battle. Get victims under cover, in dry clothes, and drinking energy. With exposure treated, recovery can begin. The elements are a foe that must be defeated before all else in hypothermia care.

Don’t let the enemy at your back while trying to win the war.

Hypothermia will kill on the hill any time of the year.

Thrive in the cold with our Polar Medicine Courses! 

→  Download Infographic on Behavioural Changes to Help Identify Hypothermia; The ‘Umbles’.

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