Hypothermia Briefing

[Steam Flyer]

This is to be a short presentation to the general Yacht Club meeting next week. I have to trim it to two minutes, preferably a minute and a half and answer a few questions.

**** *** *******

XXYC Medical Minute: Hypothermia

What -IS- “hypothermia”? We normally operate at 98.6F which is quite warm. When the body gets too cold inside, all kinds of things go wrong including the chemical reactions in the nervous system; the heart malfunctions among other things.

WATER conducts heat approximately 25X faster than air. On cooler days... not necessarily cold... this means the risk of hypothermia increases. Dehydration also increases risk.

How cold? Rule of 50-50-50: the average person has a 50% chance of surviving 50 minutes immersion in 50*F water. 50 degree water feels really cold! This also means that it is easily possible to have a fatal dunking in water that is warmer than 50F.

Risk of hypothermia: What can happen to you? Death. That’s pretty serious. Loss of feeling in extremities mask the pain of tissue damage, nerves & blood vessels; Tissue damage can result in gangrene.

Because of mental symptoms of hypothermia, danger includes damage and injury from poor decision-making and clumsy crew work.

Do I (or you) have hypothermia? Watch for the “umbles”: stumbles, mumbles, fumbles

• Uncontrollable shivering
• Dizzyness or drowsiness
• Social withdrawal, becoming quiet and non-communicative
• Difficulty concentrating, difficulty speaking
• Fumbling fingers. For example, having more than just trouble texting—now the patient might drop her phone.
• Sense of discomfort or pain, sensation of numbness in extremities.

This (above) is mild hypothermia. the victim will recover on their own if removed from exposure to a warm dry place.

More Serious: all the above symptoms worsen.

• Stops shivering but still cold.
• Total loss of sensation, severe loss of coordination (pinky-thumb touch)
• may have burning sensation in extremities, may feel warm in body
• Nausea
• Blurry vision
• Inability to move muscles.

This person obviously needs help!

Loss of consciousness = CALL 911 NOW!!

Even if removed from exposure, victims of serious hypothermia need external warmth to recover. Be careful giving warm fluids because of nausea. Do not use heat on extremities.

Never give alcohol or caffiene to hypothermia victim. Limit their movement to reduce movement of cold blood from limbs into body core.

Because of mental symptoms of hypothermia, victims almost never recognize their problem.

 

[FlyingCircus2]

this is pretty good. 2 minutes is way too short for such an important subject though. I wouldn't feel bad if I went over.

If I had to take something out, I'd take out the first paragraph.

If I had to add something, I'd add a few more do's and dont's for treating hypothermia.

 

[pqbon]

Might mention cold shock and the fact that cold shock the short term problem and hypothermia is a "long" term problem (you don't get hypotermia in seconds or minutes but 10s of minutes). (I know the focus is on hypothermia but cold shock is so related and even less well known.)

Hypothermia is also a risk on the rail when not dressed properly. (I've personally never seen it MOB but have seen a few cases for mild to moderate on rail meat.)

 

[Zonker]

Having seen it a few time a key indicator is when somebody seems "stupid"

 

[Great Red Shark]

although it's important to have a baseline on that

 

[Gissie]

Having seen it a few time a key indicator is when somebody seems "stupid"

You mean tacticians?

 

[Sail4beer]

I remember being hypothermic as a kid in the fall series Laser races since we didn’t have any real foul weather gear. I’d run into the shower as soon as I could get back to the dock and it had to be cold or it felt like your skin was being burned. Being hypothermic is no joke and they should give you more time to discuss this topic.

 

[Steam Flyer]

I remember being hypothermic as a kid in the fall series Laser races since we didn’t have any real foul weather gear. I’d run into the shower as soon as I could get back to the dock and it had to be cold or it felt like your skin was being burned. Being hypothermic is no joke and they should give you more time to discuss this topic.

The "medical minute" is a regular feature at our meetings. At least passing mention of basic science is encouraged; going more than 2 minutes is not.

3 minutes and a giant claw descends from the ceiling and the time-wasting speaker is catapulted into the gaping jaws of a nearby tyrannosaurus.

Oddly enough, for good topics (which I don't think this will be) the audience (members) ask questions and relate anecdotes for a long time afterward.

The goal is to have club meetings be interesting interesting and informative, not a long series of interminable reports from the committee on cats followed by an even longer one from the committee on dogs. But as always, YMMV and people always want to invest lots of time in the subject THEY are interested in. I got asked to do this because one of the junior sailors was explaining hypothermia and heat stress to a less-well-informed adult, when asked how she knew all this she said "Well Coach Steam taught us all about it..."

 

[duncan (the other one)]

Nice - but I'd add a little about immediate first aid for a hypothermia victim in the absence (or delay) of emergency services, with a focus on what can be done on a boat.

Serious hypothermia is only generally encountered on a yacht due to some sort of incident - MOB, etc.

"Yacht club" suggests yacht, so:
* Remove any wet clothing
* Add warmth - eg: Body-body contact under a sea rug or thermal (emergency) blanket
* etc..

If the audience is dinghy sailors, then the first aid part should be focussed on what can be done on the rescue boat (probably limited to some shelter from weather, an emergency blanket and a warm embrace) and immediately upon return to shore(either by rescue or self); again, dry clothing, gentle warmth, etc.

 

[cyclone]

Realizing that recognizing insidious onset hypothermia is different from the obvious hazard of breaking through ice, I think these Canadian videos are worthwhile as additional references.

Sailing Safe - iceboat.org

www.iceboat.org

 

[Lark]

i like it. Observation: Most fatalities here (inland) are kayakers on warm winter days. Small water kills just as quickly when the muscles stop working.

 

[Brass]

Doug,

Couple of things.

Mental consequences include increased aggression. Sounds like a joke, but loudly saying when asked, that "I don't have hypothermia" is likely to be a symptom of hypothermia.

Heat loss is inversely proportional to the 7th power of body mass. A skinny little kid, or slight woman can be well into stage 2, before a big fat guy supervising them is even feeling chilly.

Treatment requires positive increase in warmth. Get em in a car with the heater running, or down below with the engine running with the cover off.

 

[giegs]

I would change "mental" to "cognitive" unless there's a vocabulary barrier.

The 'umbles are a foundational concept, but students tend to have too dramatic of an idea of how they'll present and might miss earlier clues. You're generally looking for any impairment that develops. Is someone being a dipshit/acting not quite right AND its cold? Probably an issue.

When conditions are right, assessment really needs to be a proactive exercise.

 

[Steam Flyer]

@Brass and @giegs mucho thanks, good contributions. I've got to trim the verbally presented material but I will have a handout, with some references too.

 

[giegs]

Here's the hypo section from a current WFR student manual. Might give you some ideas on how to tighten up for a presentation.

 

[spankoka]

The episode of "Deadliest Catch" where they are violently pulling the wet gear off the recovered MOB is instructive here. Those guys learned best practices somewhere. in spite of obviously being a mixed bunch with maybe not a lot of advantages in life. Surely, pleasure boaters should do as well in the same situation.

I suppose it is Alaska DNR that gave them lessons on that. Not to be political, but it never fails to amaze me how the US has such diligent but unappreciated civil servants.

 

[dogwatch]

Two minutes is about 300 words, spoken quite fast and no allowance for questions. I haven’t put your text into a word counter but that looks a lot more than 300 words to me. Not sure the subject can be done in 2 minutes. The sailing first aid class run at my club spends around an hour on hypothermia.

 

[Leeroy Jenkins]

Probably not enough time to go into circum rescue collapse, but you could throw in that it's important to try to recover someone horizontal and keep them that way.

 

[Autonomous]

Interesting. Just learned I got hypothermia on a 1,500+ mile in < 24 hour Bun Burner Gold motorcycle ride. I got cold riding west over the continental divide at night with 500 miles to go. Still felt chilly the next day.

 

[Tax Man]

Lots of material here
More focused in immersion than dry cold, but people can fall off boats.

1/10/1

www.coldwaterbootcamp.com