Kevin Rooney said:
Well, with all due respect to Dave and others - if I were ever in a situation and there was no other way to warm someone with life-threatening hypothermia, then I could care less what some journal said - a heat source (another human body), no matter how feeble, has got to be better than nothing. And, knowing that you're actively trying to do something rather than sitting around watching the person freeze to death has got to produce better memories in your old age than the alternative.
Well if I listen to the current medical thinking on the subject it really doesn’t seem to be of any use. Maybe I didn't explain this correctly the first time. It is very simple and fully accepted by the medical community that someone in stage III hypothermia cannot be rewarmed from anything that can be reasonably done in the field. At least that is what I was taught. The usual treatment for this is abdominal lavage, warmed IVs, extracorporeal rewarming with cardiopulmonary bypass, close scrutiny of the electrolytes etc.
Body to body contact doesn't work because the persons extremities are shunted and vasoconstricted. This means that virtually no blood is moving from the extremities back to the core. If you place a body to warm this person up none of the "warmed" blood get back to the core. Their furnace has shut down and cannot be refired because they can't get water and food in. If you place hot water bottles or the such on the arms and legs you stand a good chance of giving this person pretty serious burns with relatively low temperatures. Again the reason is that the heat you are applying, while it feels fine to you, burns a hypothermia patient because none of the heat is being pulled away from him because no blood is moving.
I know the old thinking was that you crawl into a sleeping bag with a person and in stage I or II that may have some merit though you are still much better of feeding and hydrating them if their airway isn't compromised. We know a lot more about this now and I haven't had one doc who specializes in wilderness or emergency medicine tell me that there is any merit to the crawling into the sleeping bag with the person scenario.
You ask if it is better than doing nothing and it actually isn’t. Instead of doing that you should be trying to do the medically sound thing which is to get this person into a hypothermia wrap and getting them off the mountain as gently as possible. Trying to stay in a sleeping bag with them is just delaying the treatment that they need to get to so they can stay alive. And the longer they stay in that state, the more unlikely they will recover. There is a technique used to rewarm hypothermia patients called active external rewarming for mild and moderate hypothermia. It uses blankets at 105degrees F in order to actually accomplish this. You don't have enough heat, or high enough heat to accomplish this in the field.
Medical science is funny because you can almost find at least one doctor who shares a certain point of view. On this subject though I have been taught and read the same thing over and over. It doesn’t work and isn’t recommended.
Here is a chart to the signs and symptoms of hypothermia and related core temp.
F
99-96 Shivering. Poor complex tasking.
95-90 Violent shivering. Poor speech and thinking. Amnesia. Tachycardia.
90-86 Increasing muscle rigidity. Blue/ puffy skin. Jerky movement. AMS with false normal appearance.
85-82 Decreased reflexes and A fib.
<82 Coma, cardipulmonary failure, pulmonary edema, V fib and death.
Here is at least one excellent reference on the subject:
Hypothermia and localized cold injuries
By Andrew S. Ulrich, MD*, Niels K. Rathlev, MD
Department of Emergency Medicine, Boston University School of Medicine
Published in the Emergency medicine clinics of North America 22 (2004) 281–298
Hope this helps make it a little clearer.
Bear in mind I am not telling anyone what to do. I am just telling you the course of treatment I would pursue.
Regards,
Keith
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