One problem with hypothermia is it affects your dexterity. This can be used to your advantage by giving you a good way to check if you are starting to show signs of hypothermia.

It is quite simple and easy to remember. Touch your thumb to the tip of your little finger and ring finger. If you can’t do this it is time to stop, find shelter, get fluids, simple and complex carbs in side yourself and get warm.

If you can’t do this simple test then you are going to start to struggle to do simple things like light fires and turn on cookers. Once you have lost the manual dexterity you are on a slow downward slid. You need to avoid this at all costs.

Disposable heat pads are great providing you have the dexterity to remove them from their packaging, use your teeth. They activate automatically once exposed to air. Shove them under your wrists, armpits, around your neck and in your groin. These are areas were they can heat the blood going back to your heart with the minimum of insulation from body fat. They provide heat for between 10 and 12 hours depending on which product you buy. I would highly recommend them.

I can highly recommend Blizzard Survival Bags, if you don’t intend to carry a sleeping bag. I know many people on this forum do not like them but that is because they have very little experience of them. The fact that most mountain rescue teams, search and rescue teams, military search assets in the UK and Europe uses them suggests they are good bits of kit. I have personally spent many nights out in all weathers in a Blizzard Bag and have never been overly uncomfortable; in fact I am surprised how warm they are.

If you only plan to make day trips it is impractical to carry a tent, the best compromise is a Bothy bag. These work best if used as a group shelter but combined with a blizzard bag or something similar they are very effective at protecting you from the elements. These have not found favour in the states until relatively recently. US climbers who climb world wide with European climbers discovered how versatile and effective they are. Understandably these climbers took them back to the States and they are slowly becoming more accepted by the rest of the outdoor community.

Bothy bags have been attributed to countless lives saved across Europe. An excellent bit of kit which I never leave at home.

I apologize in advance for a long and slightly off-topic post.


The first part of this statement possibly has some validity but the way to deal with early recognition of hypothermia is to assume that any presentation of hypothermia-like symptoms is hypothermia. Treating someone for mild hypothermia will not hurt them at all and could prevent the progression to moderate or profound hypothermia. Symptoms of hypothermia are not unknown and have been well presented in prior posts.

To address the second part of this statement, consider some examples.

The first examples are cold water immersion or a crevasse fall. If only one person in a group gets wet or falls in a crevasse why would anyone else be cold?

Another example is a cold/cool weather environment conducive to hypothermia. If a group member exercises poor self management by failing to eat, drink, stay dry and dress properly and becomes symptomatic of hypothermia why would others in the group who took care of themselves be cold?

Saying that, if one then all, is a dangerous mindset, particularly for a group leader, since judging anyone else's condition by your own does not work. What if you are not at all cold and symptomatic of hypothermia and then say that no one else could be either and ignore someone who is symptomatic?

I think it is good to say, however; that if one person in a group is symptomatic of hypothermia then conditions exist that can lead to hypothermia in others and people should be careful to exercise good self management.

My experience with cold injuries/illness comes primarily from more than a dozen years as a full-time mountaineering/climbing guide in Alaska and the the Pacific Northwest during which time I treated people in the field with mild to severe hypothermia. As a side note, I too was taught by my physician advisors not to perform chest compressions on a "cold" patient.

I guess a Blizzard Survival Bag has its place for cold weather injuries above 10C otherwise I just don't believe the marketing hype. The Tog rating (uncompressed material) is around 6-8 Tog, this is a summer bag rating. For hypothermia victims, where thermo regulation has become erratic, in a just above freezing environment (0-5C) then even a substantial 1.2-1.5kg High spec Down bag (10-12 Tog) might not cut it, to provide enough thermal insulation to negate the bodies continuing heat loss. Also it should be pointed out that wet clothing may have been removed requiring an even more effective cold weather bag.

http://www.blizzardsurvival.com/

The companies marketing is suspect, with many dubious claims IMHO.





For days trips I also like to take along a Thermorest Lite Seat as well to stop the backside from freezing whilst sitting in snow or on wet cold ground. Bothy bags are very useful allowing groups to sit together and prepare warm drinks and food in their own warm and cosy micro environment once the Gas stove has been lit in the centre whilst the rain, snow and wind blows about outside.

I agree, your right and you have worded it far better than I have. But, novice groups like those from youth groups that are far less experienced, less well equipped and often have targets set on them such as getting to such a location to camp or to meet the coach home, are often the type of groups that see multiple cases of hypothermia including the person acting as group leader. They often don’t recognise hypothermia signs and this can be made worse with a drop in the groups morale and everyone climbs inside them selves and don’t speak to each other. The group will often spread out over a distance. Although training of these groups has become much better and with modern materials, clothing systems have become a lot better so hypothermia is becoming less of an issue for these sort of novice groups.

I am glad to hear you were taught not to perform chest compressions. I was starting to think the differences between our different protocols were miles apart. It seems they are not.

While I have not put one together yet...I was going with the Watertribe link when I do. All wrapped up in one package (maybe vacuum packed with LARGE tear strips). Vapor barrier to start heat retention, heat packs, gel shots, and probably a tea light with lighter or more probably easy to strike matches. All sized to fit in a cargo or life vest pocket.

In a dunking situation, getting the vapor barrier on is the largest step in recovery as it kills the evaporative cooling immediately. Heat packs are tear and use (i.e. immediate). Gel shots for carbs, and once you start functioning, a tea light between your legs (remember to vent your vapor barrier) for extra heat input.

All the insulation in the world only retains the little heat you are loosing. If you are dunked (cold water or not) it is far more efficient to use external heat to put heat back in your body, rather than rely on capturing your own heat.

Next step, add insulation on top of your vapor barrier.

Cavers routinely carry one or two lawn and leaf sized garbage bags in their helmet. Getting chilled, put one on, and in the old days, put your carbide lamp between your legs. Two layered works even better. Just remember to vent and be careful of the open flame.

Bill

Survival equipment is a compromise. If I had some one with hypothermia I would want the equipment and training to carry out extracorporeal circulatory rewarming, including peritoneal lavage, bladder irrigation and cardiopulmonary bypass; but this is totally impractical and well beyond my skill level. I have to make a compromise to try and stabilise the casualty until he can be evacuated to a facility that have this equipment.

Blizzard Survival bags are a compromise, with both advantages and disadvantages. It is a compromise of size, weight, ease of use and effectiveness. They are by far the best survival bag on the market out performing any other survival bag. Their size and weight allow a person to carry more than one.

The fact that so many organisation; who have independently tested them for their needs. Suggest your comments are way off the mark.

When you’re on a side of an exposed mountain with a temperature just above freezing and buffeted by 60 mph winds and driving rain. Exactly the conditions the Blizzard Survival bag was designed for. And there is no shelter available; there is an argument that you don’t remove wet clothing from the casualty. Because, by removing the warm wet clothing you are removing some valuable warmth from the casualty. By placing a person in wet clothing into a survival bag and place them into a sleeping bag if you have one is thought to be safer than removing the casualty’s clothes.

There are many people that follow this view but as many that don’t agree and until some scientific testing is done it will be an argument that will go on and on.

I am pleased with your comments on Bothy Bags they are an excellent piece of kit and I highly recommend them.

I also agree with your comments about some form of insulation to sit on or lie on, this is true for the Blizzard Survival bag too. You definitely need insulation from the ground.

Sorry to have to disagree guys, but if you have pulseless patient, you need to perform CPR which includes chest compressions:

See the Journal of the American Medical Assocation Recommendations and other hypothermia links:

"Basic Life Support
If the victim is not breathing, rescue breathing should be initiated. Cardiopulmonary resuscitation (CPR) in the pulse-less patient should be begun immediately, although pulse and respirations may need to be checked for longer periods to detect minimal cardiopulmonary efforts. The traditional recommendation that pulse and respiration's be checked for 1 to 2 minutes before beginning CPR is probably excessive. A span of 30 to 45 seconds should be adequate to confirm pulselessness or profound bradycardia, for which CPR would be required." From:


Hypothermia Guidleines - CPR


"Check breathing and heartbeat. In cases of hypothermia you should check very closely for as long as two minutes.
Start CPR if necessary." From:

Paddlers Web Site

"Due to the limited amount of oxygen the body needs when hypothermic, I want to stress the importance of starting and continuing cardiopulmonary resuscitation (CPR) efforts with all victims of hypothermia," Tveita said. Doctors typically cease CPR efforts in a normothermic patient after 30 minutes. But CPR should continue on hypothermic patients until after they have returned to normal temperature, Tveita advised." From:

Medical News Today



Pete

Thanks for that Pete. Clearly your protocols say to give CPR and because this is US forum I will stop confusing matters.

Last night i was going to PM you but apparently your folder is full.

Interesting, I check my messages and only had 5 out 25 permitted. I deleted some more, so hopefully it will work.

Pete

Okay, so I have a question: Is there ever a place for a thermometer in a hypothermia kit?

I realize, of course, that when someone has hypothermia then knowing their exact temperature is not the priority. I was thinking more along the lines of hypothermia being difficult to spot in oneself if it's a gradual onset.