Talk:Hypothermia

This page gives medical advice, which is explicitly discouraged (see Wikipedia:What wikipedia is not). It should be altered to a more encyclopedic style, telling the reader what is done, not how to do it. --Delldot 23:59, 4 November 2005 (UTC)

Agreed. Some of the medical "advice" is decidedly dodgy anyway (such as giving warm drinks). I'll edit it later, unless anybody has objections? --John24601 16:12, 7 January 2006 (UTC)

I agree that the page shouldn't say "do this", but if the content can be sourced, I do think that it is can be appropriate for it to state that "the so-and-so organization recommends the following procedures." --Arcadian 16:47, 7 January 2006 (UTC)

Maybe it would be better to talk about the principles of treatment (such as slow rewarming), without going into specifics of "do this"? --John24601 17:02, 7 January 2006 (UTC)

I agree, alot of it is dodgy and I have tried my best to remove and disclaimer anything that is too risky, the whole warm water thing does nothing but make them feel warmer, removing the subject from the elements is the best thing anyone can do until aid arrives.TheHye

Since Wikipedia's guidelines discourage giving medical advice, and some of the first aid pointers are questionable anyway, I have deleted some of the material and relocated the more pertinent points (such as alcohol consumption being a risk factor). As a result I also removed the "How To" tag which had been placed on the page. Wildernessflyfisher 23:46, 9 October 2007 (UTC)

Normal Range - Which is correct?

Can someone clarify/correct what the "Normal" human temperature range is. Under Symptoms there appears to be 2 ranges - one that starts at 36.6 Celcius and one that starts at 35.0 Celcius.

Casualty vs Subject

Some anonymous user changed the word "casualty" to "subject"... is it just me, or is casualty a far more appropriate term to refer to someone with this condition? --John24601 16:52, 17 January 2006 (UTC)

(Referencing this edit) I agree that casualty is a better term, but we should probably wikify it to Casualty (person), which addresses the ambiguity in the term (which is probably why the anon changed it.) --Arcadian 17:02, 17 January 2006 (UTC)

How about patient then? Although that is currently not in favour with the powers that be in the brittish health service, we are encouraged to call our patients "clients" or "customers" *rolleyes* --John24601 18:03, 17 January 2006 (UTC)

I've got no problems with that. We've got an article for Patient that already includes the phrase "Health consumer or health care consumer is another name for patient." I've added links on Casualty (person) and Patient so each now references the other. I think either of those terms would be much better than Subject. --Arcadian 18:32, 17 January 2006 (UTC)

I changed the text from casualty to subject, because in the Search and Rescue community (at least in Washington State) that is the standard name we give anyone we are assisting. Calling a person a subject (a neutral name) is much less degrading than calling them casualties or patients.TheHye 22:50, 3 May 2006 (UTC)

I've had hypothermia 3 times, and have a pamphlet about it. It's essential to prevent "core-temperature afterdrop." Do this by adding heat to a spot over a vein, or warm air into the lungs. Mouth-to-mouth rescusitation has been used for this. The wrist is a good spot to add heat. 76.197.215.113 05:12, 14 April 2007 (UTC) Jean SmilingCoyote, 4/14/07

A swift death

How can you possibly die from acute hypothermia in seconds? I suppose being submerged in liquid nitrogen would bring a swift death, but I doubt the actual cause would then be hypothermia. In either case, there are surely no natural environments that would not at least take several minutes to kill a person, and thus I believe the wording "seconds or" should be removed. Maggu 12:04, 17 February 2006 (UTC)

Agreed. I think the point that the editor who wrote this is trying to make, however, is that cardiac arrest occurs within seconds/minutes. If left untreated, this is effectively death, but all the research suggests that a period of several hours may occur between such a cardiac arrest hapenning and it being successfuly treated. I think it all really depends on your definition of death, and whether we're talking about a natural process of events or one in which resuscitative efforts are made... --John24601 20:07, 17 February 2006 (UTC)

I am not a health professional but I have some experience of low temperature, and I doubt a young and healthy person could suffer cardiac arrest within seconds from being in a (naturally) cold environment. Even at -40 it takes a while for the body to cool down. Anyway, I see no objections so I'm editing the article. --Maggu 13:54, 27 February 2006 (UTC)

Well, I suspect this is talking about a cold shock response rather than hypothermia, so this would be a sudden exposure to cold - so suddenly falling through ice, or falling into deep, cold water on a hot day, triggering a cardiac arrest. Average Earthman 20:11, 18 March 2006 (UTC)

Hypothermia can occur at 50 degrees Fahrenheit, so don't fool yourself into thinking that it needs to be extremely cold to even have to consider it as a threat. Depending on temps you could die of hypothermia in less than 3 hours.TheHye 23:03, 3 May 2006 (UTC)

Cold water shock can cause very quick death, if a person dives or jumps into the water and submerses his/her head in the process. The cold shock can cause an involuntary gasping inhalation, and if the person's head is underwater, that is an inspiration of water. This can lead extremely quickly to drowning. The way to prevent this is to get into the water feet-first, and not let the person's head go underwater. Rescue is still possible, and the person can still be viable for an hour (recorded by cold-water near drowning incidents), but the person will be unable to help him/herself, and rescue must be quick. Complications of inhaling salt- or freshwater need to be attended to, and so even if the person is brought back by the rescue, he/she must see a physician in a hospital to overcome the long-term effects of drowning.--John C. Ratliff 00:12, 12 December 2006 (UTC)

All true, but this is not hypothermia. -- Mwanner | Talk 12:06, 22 April 2008 (UTC)

Metrication

The page uses US units of measurement, which are of limited use to a global audience. Therefore I have tagged the page with the Metricate template.

When converting the units:

• If possible, use information from the original references.
• Do not convert them yourself without checking them first. The units themselves may have been converted from SI units for the article, and converting them back again may lead to loss of accuracy.
• For Wikipedia users who still use US units, it may be helpful to retain these units of measurement in the article in parentheses after the metric measurement. Example: 0°C (32°F).

--B.d.mills 06:41, 5 September 2006 (UTC)

I added the temperatures in Kelvin. --SaraFL 21:12, 22 September 2006 (UTC) 22:11, 22 September 2006 (BST)

The temperatures was a mess, sometimes fahrenheit first, sometimes celcius. Now everything is the same in the whole article. The format I used is °C (°F, K). Only one thing, is K really necessary?

--The temperatures are inconsistent and messy again. —Preceding unsigned comment added by 86.5.162.99 (talk) 23:04, 6 July 2008 (UTC)

scout handbook

I added what was listed in my scout handbook as a possible option under treatment.

72.230.77.103 23:42, 20 October 2006 (UTC)

Stages of Hypothermia in Humans

I have removed medical advice from this section, because Wikipedia is not a place for medical advice. Here is the removed text, if anyone is interested:

• Do not rub or massage the patient
• Do not give alcohol
• Do not give food or drink (this includes warm drinks, this is only in extreme cases. The reason being that blood is diverted from the major organs where it is needed, and is sent to the stomach and intestines to digest the food/liquid, therefore lowering the core temperature further.)
• Do not allow the body to become vertical
• Move the patient with care. If the patient is moved too much, fatal cardiac arrythmias such as V-fib could be triggered.

Any of these actions will divert blood from the critical internal organs and may make the situation worse.

What you should do...

• Call the emergency services.
• Get the patient to shelter.
• If possible, put the patient in a bath with medium-temperature water, with the clothes on. Do not do this to an elderly patient as death may occur since blood flows to the surface of the skin restricting flow to the heart and brain.
• Place hot water bottles (wrapped in a cotton sock) in the patient's armpits and between their legs
• Monitor the patient and be prepared to give Cardio-pulmonary resuscitation.
• Remove wet clothing if and only if a dry change is available.
• If in a wilderness environment (such as camping) and other treatments are not possible, remove wet clothing from the victim and from one other person. Both individuals should get into the same sleeping bag if possible, or wrap in the same blanket, if the sleeping bag is too small.

If the hypothermia has become severe, notably if the patient is incoherent or unconscious, re-warming must be done by trained professionals. Bystanders should only remove the patient from the cold environment and call emergency services to get advanced medical care as quickly as possible.

Note
Moving a severely hypothermic person can—and most likely will—cause ventricular fibrillation (cardiac arrest). So, if possible, wait for trained emergency workers arrive. If help is over thirty minutes away, move the patient to an area that shelters them from the wind and cover or wrap them in a blanket.

If there's any information that can be turned into encyclopedic content, feel free to do so. bCube(talk,contribs); 00:15, 6 December 2006 (UTC)

Hypothermia vs. pneumonia?

The article states:

Many people confuse Hypothermia and Pneumonia by name, yet they are two utterly different conditions.

To me, these conditions don't sound anything alike and I've never heard anyone confuse them. "Hypothermia" also sounds like "hypothymia" and "hypothyroid," but the article doesn't mention those. Would anyone object to removal of this sentence? Alki 00:25, 7 December 2006 (UTC)

Thank you, Larissah. Alki 17:53, 17 December 2006 (UTC)

Prevention

Under "Prevention," it is stated:

"This is possibly because the original research into hypothermia mortality in water was carried out in wartime Germany on unwilling subjects. There is an ongoing debate as to the ethical basis of using the data thus acquired."

Is this really relevant? If so, could we get a reference? If not, I'd say take it out. 64.90.198.6 21:29, 8 December 2006 (UTC)

What data there is appears to be worthless. See my references below. --AJim (talk) 02:01, 10 January 2009 (UTC)

Single blog page source?

At the end of the article this is listed as external links:

http://furtech.typepad.com/blizzard_insulation/

It's a one page "blog" that is more an ad for the company. Does this belong? Pgrote 07:01, 7 January 2007 (UTC)

Removed link. This is about their insulation product, as you can see by:

The Blizzard Reflexcell products are one of the few effective survival products as...

It provides some information, but not enough specific to hypothermia. It also seems we have a lot of external links, which may be considered too much (WP:EL). Insanephantom (please comment on my Editor Review!) 08:29, 7 January 2007 (UTC)

Someone put that link back in. I removed it again. Jerdwyer 04:56, 30 January 2007 (UTC)

Appears Incorrect

Someone needs to fix the page - it has been vandalized. —The preceding unsigned comment was added by 69.245.111.170 (talk) 03:21, 15 February 2007 (UTC).

What is it like?

Yesterday a close friend of mine died of hypothermia. I know that we can never really know what it would be like, but I wonder if someone could say subjectively what it would be like to die of hypothermia. Would it be unpleasant or peaceful? Like slipping to sleep? -- 125.238.203.52 12:15, 9 June 2007 (UTC)

Well, I haven't been at the point of death, but eventually the feeling in your body would go away and you'd feel very numb. can't say beyond that.24.77.19.12 (talk) 23:19, 10 February 2008 (UTC)

I know

I had hypothermia in Janurary of 2006. I was in stage 3, and I took off my clothes for some reason (Paradoxical Undressing), and then curled up in a ball. I couldn't move and stopped shivering, and then uncontrollably started falling asleep. It did feel like I was slipping away, and was peaceful, for some reason, which i cannot explain, I all of a sudden was awake and I could move my body again. I lived (of course) but got frostbite on my toes and now my body is cold all the time, and even in the summer, it feels like my toes are 'freezing'. —Preceding unsigned comment added by 208.123.37.195 (talk) 06:26, 6 December 2007 (UTC)

Seaside misinformation?

I've removed the following: "Many seaside safety information sources fail to quote survival times in water, and the consequent importance of diving suits. This is possibly because the original research into hypothermia mortality in water was carried out in wartime Germany on unwilling subjects. There is ongoing debate as to the ethical basis of using the data thus acquired." This story seems strange: I have a hard time even understanding what is meant by the term "seaside safety information source". The passage implies that there are people who would benefit from having information about exact survival times in cold water (as opposed to having practical guidelines along the lines of "if it's below x degrees in the water, wear a wetsuit or drysuit"), but that the information is being kept from them due to an ethical debate. Can anyone clarify? Kla’quot (talk | contribs) 07:22, 10 October 2007 (UTC) ok you can died for hypothermia just ask Jack London. —Preceding unsigned comment added by 170.158.32.100 (talk) 13:42, 11 March 2008 (UTC)

The Nazi data in question appears to be of no value. See my references below. --AJim (talk) 02:05, 10 January 2009 (UTC)

Paradoxical undressing

First of, I'm not a doctor. But I believe this phenomenom is related to the way humans feel heat and cold.

From my personal experience I know that "slightly too hot" water can feel like very cold water, and vice versa. Additionally, most reports of this phenomenom I have read indicate that the victim felt very hot and thus discarded its clothing.

So, maybe there's not too big of a difference in feeling heat and cold, and once the consciousness is impaired, differentiation might become impossible. Also, reasoning might be lost, as one should be aware that one is cold .. not hot.

On a related note: I guess everybody is farmilar with the "hot hands" one gets after touching very cold things for prolonged periods, like snowballs. This might contribute, too. —Preceding unsigned comment added by 87.168.225.78 (talk) 16:02, 29 May 2008 (UTC)

Loss of Vasomotor Tone and Surge of Blood to Extremities?

Could the author please provide a citation for the part about blood pouring to the extremities? If not, could one of the editors please add a "citation needed" sticker?

I ask because conventional wisdom says the body shuts off the extremities somehow, and I think that's pretty much as far as a standard Scout or Red Cross first aid course takes it. You'd think they'd mention the other thing if it's known to happen. You'd think they'd want first aiders to know about that.

I tried a quick Web search for hypothermia +"vasomotor tone" and didn't find anything about this phenomenon.

And that's why I think a citation would be a good idea. Kkken (talk) 11:20, 3 August 2008 (UTC)

Nazi discovery of hypothermia?

Is it not true that many of discoveries regarding hypothermia came from Nazi Germany's human experimentation? Should that be mentioned? —Preceding unsigned comment added by 72.39.23.16 (talk) 11:49, 10 August 2008 (UTC)

I think that was actually the Japanese, the Japanese conducted experiments on POWs and civilians during the Sino-Japanese war in the 1940s. They would throw cold water on people tied outside in the freezing cold, and they actually figured out the optimal temp of warm water those that caught hypothermia had to be immersed in. - (99.226.65.111 (talk) 03:55, 23 October 2008 (UTC))

I have in my hands a copy of a Special Article in the New England Journal of Medicine, May 17, 1990, Vol. 322 No. 20 pp 1435-1440, by Robert L. Berger, M.D., Nazi Science - The Dachau Hypothermia Experiments. He cites Alexander, L The treatment of shock from prolonged exposure to cold, especially in water. Combined Intelligence Objectives Subcommittee. Target no. 24 Report no. 250. Washington D.C: Office of the Publication Board, Department of Commerce, 1946.

• there were experiments. (but the Nazis did not "discover" hypothermia)
• the original data from these experiments has been lost
• the 228-page report by Leo Alexander contains a reproduction of a 56-page report to Heinrich Himmler by the Dachau investigators
• Dr. Berger says that this report "is essentially the only primary reference cited in the literature on the Dachau study."
• Dr. Berger concludes "On analysis, the Dachau hypothermia study has all the the ingredients of a scientific fraud, and rejection of the data on purely scientific grounds in inevitable. They cannot advance science or save human lives." ... "Future citations are inappropriate on scientific grounds."

--AJim (talk) 01:57, 10 January 2009 (UTC)

Sexual Activity

I know now that alcohol makes hypothermia worse in spite of making people FEEL warm (hence it being recommended in the past)...but what about sex? Sexual activity make people feel warmer, but does it actually make them warmer. Does sexual activity, or rigorous exercise for that matter, generate heat from the fat people have in their bodies + the motions they make, or those it simply cause heat to rise to the surface and therefore drop core temp faster? (99.226.65.111 (talk) 03:58, 23 October 2008 (UTC))

What does this mean?

The fingers decrease dexterity due to pain or numbness, safety, work capacity, and increase the risk of developing nonfreezing cold injury.[1][3]

This sentence seems to be half-finished. —Preceding unsigned comment added by 87.194.119.148 (talk) 23:51, 14 November 2008 (UTC)

What air temperatures increase the risk for the different stages of hypothermia?

There is information in this article about water temperatures and body temperatures but there isn't anything on what air temperatures or temperature at ground level that would cause the different stages of hypothermia. This would be very interesting to know. --John10001 (talk) 14:30, 23 November 2008 (UTC)

Having experienced hypothermia several times I've looked for that information as well. The variables are so many: air temperature, dewpoint, wind speed, shelter (or not), clothing (adequate layering ?- cotton or non cotton ?), how recently a good meal had been eaten; that it is difficult to make a hard and fast rule. It has been written ( and I'll hunt for the reference some day ) that more people get hypothermia when the temperatures are in the 35-50 F temperature range than in the 0 - 15 F range....presumeably because in the colder temps you are on guard for that sort of thing. In the 35 years I've been hiking, I'm always on my guard if the temps are under 50 F. Robert Falcon (talk) 21:40, 4 March 2009 (UTC)

Could someone redo the citation?

In the section under Paradoxical Undressing, there is a citation in parentheses. This should be changed, if I'm not mistaken. —Preceding unsigned comment added by 216.189.133.142 (talk) 00:35, 11 December 2008 (UTC)

US Coast Guard and 50/50/50 rule

There's a paragraph claiming that the US coast guard advocates lifejackets for preventing hypothermia on the grounds that if you're in water at 50 degrees F for 50 minutes, you're 50% more likely to live if you wear a lifejacket. Unfortunately, the citation link is broken and it looks like that page really no longer exists; and the modest amount of searching I've done hasn't tracked down anywhere where the USCG still promotes anything that looks like that 50/50/50 rule. Can anyone do better? If not, we should either (1) delete the paragraph, (2) say that the USCG *used to* talk about a 50/50/50 rule, or (3) find some other entity that still does and cite them instead. Also, it's totally unclear to me that this is really about hypothermia *prevention*; surely at least part of the point is that if you're hypothermic and your muscles aren't working right then you won't be able to swim any more, so if you have no flotation device then you die. I've made that paragraph say "protection" rather than "prevention" for this reason, but I'm open to correction from people who know more about this than I do. Gareth McCaughan (talk) 12:34, 14 December 2008 (UTC) Hi people —Preceding unsigned comment added by 65.185.64.38 (talk) 20:59, 6 March 2009 (UTC)