HOW TO... Deal with hypothermia


Antti Kivimaki,  head of nursing at  The London Clinic explains how to deal with hypothermia

What is hypothermia?
To put it simply, you are at risk of hypothermia if you are in a situation where you are losing heat faster than your body can replace it. A person’s normal body temperature is about 37°C and they are classed as having mild hypothermia when their temperature drops below 35°C.

What are the first signs to look for?
The person’s skin will be pale and cold, they will have a faster breathing rate, and will also start to shiver. Shivering is part of the body’s compensation mechanism, using the movement to generate heat. It is important not to wait for someone to stop shivering before seeking medical help. If they do so, they may have entered moderate hypothermia, and this is a sign that their condition is deteriorating and urgent medical help is needed.

What should you do?
First, seek medical help. Then, if the person is outside, move them indoors, but if that is not an option look for the most sheltered place available. You need to get them into an environment where they can begin to warm up or at the very least stop losing heat. If they are wet, it is very important to remove wet clothing: the body loses heat much more quickly in wet clothes. Dry the person off and get them into something dry. Wrap them in warm blankets, towels or coats. The important areas to concentrate on are the head and torso. If their hair is wet, do your best to dry it. 

  • You need to get them into an environment where they can begin to warm up or at the very least stop losing heat

Anything else?
If you can, give them something warm to drink—but never alcohol. High energy foods like chocolate and hiking bars will also help, as they provide the body with extra energy. But it is vital only to do this if the person can swallow normally. Their swallowing mechanism may be compromised, so do not force them or there is a risk of choking. I would suggest asking them to cough first, then offering a small amount of water to make sure they can swallow safely. If they start to warm up, the situation is still not over, so just keep them warm and dry until medical help arrives.

What are the signs that the hypothermia is more severe?
The person can lose their ability to concentrate. They can become agitated, confused, lose their co-ordination and their breathing can become slower and more shallow. If a person has stopped shivering but shows no signs of having warmed up, then the situation is critical. At this point it is a medical emergency and you must must seek urgent medical help. In the final stages of hypothermia a person’s pupils can start to dilate, they can lose consciousness, have shallow or no breathing, a weak pulse and eventually cardiac arrest. 

Are there people who are more susceptible to it than others?
People who are unwell, immobile or are unable to move around to generate heat are at greater risk than the general population. The elderly and the very young tend to be more susceptible. But hypothermia is by no means confined to them. For example, a fit, healthy person who has had too much to drink and fallen asleep outside in a cold environment can very easily fall victim. Also, if you get caught in a cold wind with wet clothes you can be at risk, even if the overall weather is not that cold. The combination of wet clothing and a cold, steady wind can strip away heat very quickly.

What should you not do if you suspect hypothermia?
Never put the person in a hot bath or close to a heat source such as a heating lamp. You want to get them into an environment that feels comfortably warm. If a person heats up too quickly there is a risk of a condition called vasodilation. This is where the blood vessels dilate and the blood rushes back to the extremities too quickly. This can cause a rapid drop in blood pressure, which can be dangerous. The aim is to get the body to warm up at a steady but gentle and safe pace. As I said at the start, hypothermia can be a life-threatening condition so anything you do must be done after first seeking medical help.