Hypothermia & Dehydration

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Hypothermia & Dehydration
Hypothermia: Legal Aspects

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By Bob Amick

We have found that mild cases of hypothermia respond well to getting in a warm shower or tub, and also drinking warmed "gatorade" (or other equivalent "sports" drink. This seems to help the muscles restore the homeostasis by improving fluid volume and electrolyte balance in the circulatory system; and by providing an easily absorbed supply of glucose which is directly metabolized by the muscle tissue.

It is seldom advantageous just to get in a "warm bed" because the body needs to generate the heat needed to maintain warmth, and the insulation afforded by a bed does not really contribute much when heat is not being adequately generated by the body. Although if an electric blanket or heat pad were used as an external heat source, that might be of assistance.

We used the warm gatorade* technique at the last National Scout Jamboree where I worked in a Subcamp Medical Center. Many Scouts had gotten wet and chilled during the rainstorm, and seemed to "pop right back" after taking in warm gatorade. (Of course a good night's sleep in a warm sleeping bag and a healthy dinner didn't do any harm for the "two-legged incinerators" either!)

(*It is important to dilute the gatorade to "half strength" with water when using it to treat dehydration.

For more sustained prevention, another factor in nutrition is to consume foods such as cheese which have a slow release of concentrated energy in the form of milk fat (or in some cases vegetable fat). This works especially well before going to bed. If you give Scouts a "cheese and crackers" snack before going to bed, the slow digestion of the cheese seems to release energy uniformly throughout the night. A healthy dinner of carbohydrate foods such as pasta are also beneficial before going to bed.

Once again, dehydration seems to be one of the chief contributors to susceptibility to hypothermia because there is not enough fluid volume in the blood which is readily available to the muscles to properly metabolize nutrients and dispose of wastes through the liver and kidneys. As most Scouters know, a great deal of water is lost through respiration, especially in cold weather when relative humidity is low. Perspiration also takes a toll, and if water consumption is not frequent, which it tends not be when cold weather is present, dehydration can easily occur. Most people do not even feel thirsty when they are already dehydrated.

Headache and mild chest pain** or other muscle aches and pains are also directly symptomatic of dehydration, and could be mistaken for "flu" symptoms which may explain the symptoms mentioned in the previous post. (**Caution: chest pain can also be associated with heart attack, so if a crushing pain is present and/or other symptoms such as shortness of breath, pain radiating into the arms or neck are present, immediate evaluation by a physician and/or paramedics is essential!)

One very reliable measure to determine the presence of dehydration is to observe the color of urine. If urine is dark amber, it means that waste products are being concentrated by the kidneys due to insufficient intake of water. Infrequent urination is also indicative of the same problem. Most people think dehyrdation is mainly a problem in hot weather, but in fact, it occurs probably almost as often in cold weather because no one considers the imperceptible loss of water through respiration and perspiration.

At the Jamboree, we were encouraging Scouts to drink about 10 ounces of water per hour (not pop or sugared drinks because sugar requires a great deal of water to digest and contributes to further dehydration). It is recommended that same amount of water be consumed for winter activities as well. It is far better to drink water frequently and in smaller quantities to keep up with the constant loss of water as noted above.

Bob Amick, EMT-B, is Exploring Training Chair at Longs Peak Council, Boulder, CO

Heath & Safety