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Online Training
The leaves have changed colour and are beginning to fall to the ground. The days are shorter and colder. The wind is crisp and chilling. Winter is on its way. Along with the winter season, there is an increase in the frequency of hypothermia from November to March in the Northern Hemisphere. In the Southern Hemisphere, it spikes from May to August annually. The incidence of mortality in the US is around 1500 per year. However, in much colder countries, the mortality rates are much higher. Canada, for example, averages thousands per year. Hypothermia is significant risk that should be taken seriously.
Hypothermia occurs when the body's core temperature drops below 35.0 °C (95.0 °F) in humans. The term comes from the Greek words 'ypo', meaning "under"; and 'thérmē'; meaning "heat". Symptoms vary depending on the severity of hypothermia. In mild cases, there is shivering and mental confusion. In moderate cases, shivering stops and confusion increases. Severe hypothermia can lead to hallucinations, paradoxical undressing, and an increased risk of cardiac arrest.
Primary hypothermia is caused by exposure to a cold environment and, very commonly, by cold-water immersion, and is exacerbated by risk factors including alcohol intoxication, low blood sugar, anorexia, and advanced age. Secondary hypothermia is caused by an underlying pathology that prevents the body from generating enough core heat, such as blood loss, medications and head injuries. Hypothermia in the face of trauma is especially insidious. When combined with hypovolemia, acidosis and hypokalemia, resulting in a trauma-induced coagulopathy that can be difficult to treat.
When you hear that someone died from exposure in a cold environment, this can often occur with Paradoxical Undressing. This usually happens in moderate and severe hypothermia, as the casualty becomes disoriented, confused, and combative, leading them to shed their protective layers inexplicably. This obviously increases heat loss. Another strange but self-protective behavior seen in the final stages of hypothermia is "terminal burrowing" or "hide-and-die syndrome." Those affected will seek out small, enclosed spaces, such as underneath evergreen trees or in a small area, often associated with paradoxical undressing.
The first step in prevention is hypothermia awareness and understanding the environmental threat and risk factors. Preventing hypothermia is simple: wear warm, clean, and dry clothing, maintain moderate physical activity and proper food and hydration, avoid alcohol and recreational drugs in cold environments, and plan your activities around the weather.
The best-laid plans and prevention measures are only part of the equation to reducing the high number of hypothermia deaths in colder climates. Anyone who ventures out on winter adventures or works outside during cold months must thoroughly know hypothermia treatments and be equipped with the tools to respond to cold casualties - see the Heat Loss Prevention Kit (HeLP). CTOMS Academy hosts two courses on this subject: Hypothermia Management—Foundation and Hypothermia Management—Advanced.
In the Hypothermia Management - Foundation course, Dr. Gordon Giesbrecht, a renowned expert in hypothermia, teaches the basics of understanding, identifying, and treating hypothermia. Students will gain a fundamental understanding of temperature regulation, the human body's physiology, hypothermia classifications, prevention of heat loss, and hypothermia. The course also includes a video on cold water immersion. Hypothermia Management Advanced, he builds on the Foundation course and provides detailed instruction on the pathophysiology of hypothermia, including hypothermia in the presence of trauma. This course is designed for professional care providers but is also beneficial for non-professionals.
With an ounce of protection and forearmed with knowledge of hypothermia prevention and treatments, we are better prepared to protect ourselves and those around us in this particularly hazardous season.
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