The relatively minimum kit I would carry for Cold-weather / Paddling:

In a Aloksak (Splash Caddy)
modified space blanket
tea candle (more stable)
Powergels ( 2 )
Rechargable Heat Packs (3)
1 for ea armpit and 1 for groin

Links:
Aloksaks
http://www.actiongear.com/cgi-bin/tame.e...2Fresults%2Etam

Modified Space Blanket
http://www.watertribe.com/Magazine/Challenge/ModifySpaceBlanket.asp

http://www.therangerdigest.com/Tips___Tr...e_hypo_kit.html

Rechargeable Heat Packs
http://www.nols.edu/store/wmi/firstaid_ezheat.shtml

Powergel
http://www.ems.com/products/product_deta...1932130acc28ece

Misc Info
http://www.geocities.com/bassclub_of_fortbenning/a_scary_lesson.html

http://www.dotzen.org/paddler/cpr/hypo.html

http://www.watertribe.com/Magazine/Challenge/MakeHypothermiaKit.asp

From past experiences during ocean kayaking I know that your hands can get so cold that you can't bend or open your fingers. How easy is that Aloksak bag to open? Would you be able to do it in case of emergency? I remember trying to open a ziper on a FAK with my hands numb after working for few hours in a freezing rain and it took me a while.

Matt

A loop of thread past through the hole on the zipper is very useful in these cases.

Burak
Istanbul

One word of caution - the "Reusable Heat Pack" from NOLS "Heats up to 130 degrees in 5 seconds."

I'll have to check, but I think this may be too hot for a casualty with hypothermia, especially severe hypothermia. The normal recommendation is to use a heat pad that's fairly close to normal body temperature (e.g. a plastic water bottle filled with a non-hypothermic rescuer's urine). For mild hypothermia, perhaps even moderate, the casualty may be aware enough to realise if the pads start to burn, but if they're semi-conscious or unconscious, you may not know anything's wrong until too late.

With these pads, I would ensure they're at least well-padded, or perhaps even use the "15 minutes on, 15 minutes off" principle (although I've never heard that being recommended for heat, only for ice). In any event, monitor the casualty continuously to make sure they're not overheating - paradoxical as that may sound. <img src="images/graemlins/confused.gif" alt="" />

It may be handy to heat up an enclosed space like a sleeping bag, blanket wrap, pancho, etc... The key would be to keep it off the patient.
Allen

Oh, I wouldn't even go that far - that might take too long for a patient who's hypothermic enough to require assistance. I would pad it - wrap it in a t-shirt or sweater, for example - and still monitor the patient closely, removing it from time to time to check it wasn't too hot. I just wanted people to be aware that "slap it on and leave it on" for something that hot is not a recommended practice <img src="images/graemlins/smile.gif" alt="" />

Yes wrapping it in a towel and applying would be the best way. We do it a lot with ice and heat packs just to prevent burns and as well as for patients comfort. 110 degrees would be a perfect direct apply temperature to the body. You also have to remember that you can't apply heat packs (dry heat) to frostbites. Those can only be re-warmed by water at 110 and extremity has to be suspended without touching walls of the container.

The best way to test if patient is severely hypothermic is by touching his abdomen. When body goes into shock due to heat lost it will pull whatever blood it has and keep circulating it thru vital organs to keep them going while the extremities are ignored since too much heat lost happens there. If abdomen is cold that means that you have severe case of hypothermia on your hands. Be prepared to start cpr on sever hypothermic victims. A lot of them go into cardiac arrests due to low respiratory rate and pulse.

Also when treating hypothermia you have to make sure that the air that patient is breathing is warm. It's hard to accomplish in outside environment (without actually doing rescue breathing) but it has to be done to prevent contradictory effect to active re-warming you will be doing on other parts of the body. Also ask the person who you treating not to help you. It causes stale cold blood from extremities to comeback to the body at faster rate which further lowers down core temperature.

Matt

Paul, I know you might have been talking about purely kayaking (?) but I've got to say that in the UK , where our mountains (unfortunately) lend themselves to hypothermia we don't go a lot on heat packs of any kind. UK treatment insitu is usually get casualty in shelter and heat it, or better still,get casualty in sleeping bag and join them - Shared Mutual Body Warmth. The latter is particularly welcome if one of the parties is a nubile young lady from a Signal regiment <img src="images/graemlins/tongue.gif" alt="" /> (sorry ladies!).

Though there is legitimate comment regarding how hot a heat pack gets, the hypothermia kit really is for when you are alone and have little or no gear. Hunting, steelhead fishing, trapping, wilderness snow activities and cross country skiing would be expamles. Kind of like a PSK for cold weather. There always is/was recommendations for adding fire-starting and brewkit.