Winter months bring serious threats for anyone spending time outdoors. Snow, wind, and freezing temperatures cause a host of complications, including an increased risk of hypothermia. This threat is generally understood by those with an adventurous spirit venturing in the frozen outdoors. However, even a small lack of understanding can cause an inconvenient situation to quickly turn into an emergency. 

Ultimately, it doesn’t matter if you are an intrepid adventurer or a preparedness-minded individual just going about your daily life. Understanding how hypothermia can occur, what can be done to prevent it, and how to treat someone in a hypothermic state can go a long way to helping us stay healthy and prepared through the winter months.

Thermoregulation

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To understand how hypothermia occurs and the impact it has on our body, we must first look at how the human body maintains an ideal temperature. The human body employs a process called thermoregulation to ensure our core body temperature is maintained at roughly 98.8 degrees F, a level that will keep our organ systems functioning at peak capacity. We experience some of these natural processes on a regular basis. When we become too warm our body will produce sweat to cool us down, and when we are cold we will shiver to produce more heat. These two examples are just a small part of the complex processes the human body employs to maintain our ideal body temperature. While efficient, extreme environmental conditions can overwhelm the body’s thermoregulation process. 

Hypothermia

Simply defined, Hypothermia is caused by a drop in core body temperature below 95 degrees F. This loss of core body temperature negatively impacts several essential systems in our bodies, including our cardiovascular, nervous, and respiratory systems. If left untreated, hypothermia can lead to a total failure of one or all these systems resulting in death. In most cases, if treated properly, hypothermia does not cause long-term damage; however, severe cases can cause long-term damage to body systems due to the reduction of blood flow. Long-term damage is most common in the extremities including arms, legs, hands, and feet.

How Hypothermia Occurs

Hypothermia can occur when the human body loses heat faster than it can produce heat. People can succumb to hypothermia in rural, urban, and wilderness environments — even while in a vehicle or building in certain conditions. Hypothermia most commonly occurs in freezing temperatures, but there are several other factors that can lead to hypothermia in temperatures of up to 50 degrees F.

• Water: The body will rapidly lose heat when exposed to cold water, making falling into icy waters a common cause for hypothermia. Submersion in water that is 32.5 degrees can lead severe hypothermia and death in under 15 minutes, but water temperatures up to 70 degrees can cause hypothermia in as little as 2 hours. Wet snowfall, and rain can also lead to hypothermia when the temperatures are above freezing.

• Wind: Our body is constantly surrounded by a thin layer of warm air that is generated by our body heat. This is an important part of our natural thermoregulation, and our skin is even adapted to trap more warm air when exposed to the cold by producing goose bumps. The reason the wind feels colder than the air around us is because it is blowing our protective layer of warm air away from us, leading to rapid heat loss.

• Skin Exposure: Ninety percent of our body heat is lost through our skin, and much of the rest is lost through respiration. Exposed skin in cold temperatures will result in rapid cooling of our body. Exposed extremities can not only cause heat loss but also cool the blood in those areas that will circulate back to our major organs, reducing core body temperature. 

• Sweat: Even in the colder months, physical exertion and clothing will produce more body heat and cause us to sweat. In the moment, that sweat is doing an important job of preventing us from overheating. But it can quickly become a problem if our clothing absorbs that moisture, producing effects similar to being submerged in cold water.

• Alcohol and Caffeine: Part of the human body’s response to rapid heat loss is vasoconstriction, which is the narrowing of blood vessels to slow blood flow to slow heat loss and reduce cooler blood returning to key organs. Alcohol, caffeine, and similar compounds cause vasodilation, which opens blood vessels increasing loss of core body heat. 

Sensitive Groups

Young children and older adults are more susceptible to hypothermia than other groups. Individuals with medical conditions such as diabetes, heart disease, and circulation disorders are also more prone to developing hypothermia. These groups can enter hypothermic states faster than others and even develop hypothermia in temperatures of 50 degrees when combined with some of the other factors mentioned above.

Signs and Symptoms

Hypothermia occurs over multiple stages, each with unique signs and symptoms. 

• Mild Hypothermia: Intense uncontrollable shivering

• Moderate Hypothermia: Shivering diminishes. Loss of coordination, fine motor control, and confusion. Bluing of lips possible.

• Severe Hypothermia: No shivering, Unconsciousness, rigid muscles, heart arrhythmias, and cardiac arrest.  

Prevention

In most cases, hypothermia is a treatable condition, but prevention is the best method to keep ourselves safe in the colder months

Avoiding extreme cold is the best prevention method. While this is not always possible, there are often reasons why schools and businesses close during extreme winter weather. The best way to avoid a cold weather emergency is to stay indoors during active storms. This reduces the likelihood of being stranded in a vehicle or receiving an injury that can slow or stop our ability to get to shelter.

If you can’t avoid the cold, making sure you have the appropriate clothing and outerwear is very important. Creating layers that will help insulate our body is vital for any long-term cold exposure. Even if you aren’t planning on being outdoors for long, winter conditions can quickly shift, impacting roadways and vehicles that can lead to extended exposure to the elements.

• Base Layer: Base layers typically go beneath your other clothing, wool or synthetic base layers can reduce heat loss from sweat. Wool is a natural material that animals use to help regulate their body temperature. Unlike cotton, wool retains the ability to keep you warm when wet. Wool socks are especially important, as they will keep your feet warm and reduce the absorption of sweat and help prevent damage to your foot tissue. While not as efficient as wool, synthetic materials can help wick sweat and dry quickly.

• Mid Layer: This layer consists of your regular clothes, pants, shirt, etc. Again, avoiding standard cotton is a good idea, especially if you may get wet or plan on being very active and generating sweat. Materials that can absorb water from rain of melting snow will diminish our ability to stay warm, especially if facing declining temperatures throughout the day. Water resistant or waterproof pants can help prevent the loss of body heat. Keeping your core warm is vital. Your heart will be pumping blood from your core through your body, and cooler blood will be returning from your extremities. In extreme temperatures, including a fleece or insulated vest will go a long way to keeping your core warm.

• Outer Layer: This consists of your coat, hat, gloves, and shoes or boots. It is important that you get the appropriate outer layers, as most “fashion” hats, gloves, and coats will do very little to protect you from the elements. An insulated water-resistant coat or parka is a great option for dealing with cold wet environments. Wool beanies and gloves can serve as a good outer layer for your head and hands or be placed under a thicker hat and glove. Insulated waterproof footwear can help keep your feet warm and dry.

Winter Ready Vehicle

People often mistakenly view their vehicles as a potential shelter from the extreme cold. While a vehicle can provide shelter from wind and snow, it will not retain heat for very long if not running. While sheltering in a vehicle may not be an ideal long-term solution, keeping some basic supplies can help reduce the risk of hypothermia.

• Blankets: Keeping blankets in your vehicle, especially wool blankets, can provide a much-needed form of insulation in a cold weather emergency.

• Spare Clothing: Travel with a spare set of appropriate winter clothing. That spare set of warm and dry clothing can potentially save your life.

• Survival Kit: Having a survival kit, especially one that provides a means of making fire and the tools you may need to build a makeshift shelter is very valuable in an extreme cold survival situation.

• Fuel: It is important to ensure your vehicle has as close to a full tank of gas as possible during the cold months as the ability to keep your heat running as long as possible is vital in an emergency.

• Maintenance: Just as the winter is hard on our bodies, it is also hard on our vehicles. Making sure maintenance is up to date will help prevent unexpected vehicle breakdowns in extreme cold conditions.

Treating Hypothermia

While prevention is the best option, there are things you can do to treat individuals with moderate and severe cases of hypothermia until help arrives, or you can transport the individual to the care of a medical professional.

• If possible, bring the person indoors; if not, do your best to insulate them from the cold ground.
• Remove any wet clothing and replace it with warm, dry clothing if possible.
• Warm the person, focusing on their core using extra clothing and blankets.
• Do not warm extremities first (arms and legs), as this can cause arrhythmia (irregular heartbeat).
• Do not put in a warm bath, as this can cause arrhythmia.
• If conscious, offer warm fluids without caffeine or alcohol as they can speed heat loss.
• If the person is unconscious, begin CPR and contact emergency medical personnel immediately.

Final Thoughts

Hypothermia is a very serious threat during colder months, but it is something that can easily be prevented with some common sense and planning. The rapid pace of modern life often leads to people putting themselves in dangerous situations when traveling to work or running errands during extreme winter weather despite the warning systems we have in place to reduce the risk. 

There are other steps we can take to stay safe beyond just paying attention to extreme weather warnings and staying indoors during severe winter weather. Ensuring your home is supplied with essentials can reduce the need for travel during winter storms. Keeping your vehicle maintained and fueled up will reduce the likelihood of breakdown when traveling in the winter. Building and keeping a winter survival kit in your vehicle can ensure you have what you need if stranded to stay warm.  

The best option for preventing hypothermia is avoiding conditions that cause hypothermia. But if you can’t avoid being outdoors it extreme winter weather, then you must be prepared with the appropriate cold weather gear and armed with the knowledge and skills to keep yourself and those around you safe.

Read More From Issue 71

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Editor’s Note: This article has been modified from its original version for the web.

Written by Nicholas Italiano