When your body temperature drops below 35°C, this is called hypothermia – a potentially fatal condition that can cause your heart and respiratory system to fail if not treated urgently. Michelle Kieck, ER24 Branch Manager, Pietermaritzburg, explains.
Although Kwa-Zulu Natal doesn’t get as cold as other provinces during winter, the Pietermaritzburg branch gets frequent callouts for hypothermia as the weather changes. “This doesn’t necessarily mean the patient is blue and cold and looks like they’re from the Titanic,” explains Kieck. “Hypothermia simply means their core body temperature has dropped below 35°C.”
Hypothermia is caused by prolonged exposure to very cold temperatures. This causes your body to lose heat faster than it's produced. When your body temperature drops, your heart, nervous system, and other organs can't work as well as they usually do. Left untreated, it can cause your heart and respiratory system to fail and may eventually be fatal.
Signs of hypothermia
Mild hypothermia
- Shivering
- General tiredness
- Lethargy
- Confusion
- Paleness – because blood has shunted to vital organs, such as the brain, heart, and lungs
- Pins and needles – due to hands and feet losing adequate blood supply.
Moderate to severe
- Decreased heart rate
- Decreased consciousness
- Slow breathing
- Low blood pressure
- Extremities have shut down.
How do you prevent hypothermia?
“The most obvious way to prevent hypothermia is to find a safe, warm place to be when the temperatures drop,” says Kieck. “The problem is that some of our patients are homeless and don’t have this option. Children and the elderly are particularly susceptible to hypothermia.”
She recounts a serious case during loadshedding, when the electricity had been off in a particular informal settlement for two weeks. “We had to take a six-month old baby to hospital for urgent treatment because the house had no insulation and no heat. He was already extremely lethargic when we got there and had to spend several days in hospital.”
Be sensible when outdoors in winter
“If you play sport, compete in races, or go hiking and camping in winter, it’s important to be sensible and prepared. Know the area, don’t hike alone, and ensure you have proper equipment for the weather. A first aid kit, space blanket, and wet-weather gear are essential.”
During a recent three-day, 270km mountain bike race that took place in KZN, some participants presented with hypothermia, says Kieck. “We had to get them out of the race on the first or second day. They’d been in wet clothes for hours and were pushing too hard. Elite sportspeople often fight through the pain, sometimes with detrimental results.”
What to do if someone has hypothermia
“Don’t expect to simply throw a blanket over the patient,” Kieck warns. “Rather get them out of the elements and remove their damp clothing while you wait for an ER24 crew to arrive. Warm them up slowly in a space blanket, with a fluffy blanket underneath to insulate the heat. You can warm them further by rubbing their arms and legs. Do it gently as sudden blood flow can cause pain.
“If the person is fully awake and able to swallow normally, warm drinks can assist in the warming-up process. However, if the person has decreased consciousness, don’t try to feed them or get them to drink as they will aspirate, meaning the food or fluid will get into their lungs. When ER24 arrives, we’ll perform fluid resuscitation via a warm drip and transport them to hospital if necessary.”
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