Hypothermia - Intentional Hypothermia, Accidental Hypothermia
Hypothermia is the intentional or accidental reduction of core body temperature to below 95°F (35°C) which, in severe instances, is fatal. Because humans are endothermic—warm-blooded creatures producing our own body heat—our core body temperature remains relatively constant at 98.6°F (37°C), even in fluctuating environmental temperatures. However, in extreme conditions, a healthy, physically fit person's core body temperature can rise considerably above this norm and cause heat stroke or fall below it far enough to cause hypothermia.
History of medical use of intentional hypothermia
Intentional hypothermia is not a modern phenomenon. With it, ancient Egyptians treated high fevers; as did Hippocrates—who also understood its analgesic (pain-killing) properties; the Romans; and Europeans of the Middle Ages. Napoleon's surgeon general used cryoanalgesia when performing amputations. He discovered that packing a limb in ice and snow not only killed most of the pain, it also helped prevent bleeding. Today, intentional hypothermia is most commonly used in heart surgery.
Causes of accidental hypothermia
Although overexertion in a cold environment causes most accidental hypothermia, it may occur during anesthesia, primarily due to central nervous system depression of the body's heat-regulating mechanism; and in babies, elderly, and ill people whose homes are inadequately heated. The human body loses heat to the environment through conduction, convection, evaporation and respiration, and radiation. It generates heat through the metabolic process.
Conduction occurs when direct contact is made between the body and a cold object, and heat passes from the body to that object. Convection is when cold air or water make contact with the body, become warm, and move away to be replaced by more of the same. The cooler the air or water, and the faster it moves, the faster the core body temperature drops.
Evaporation through perspiration and respiration provides almost 30% of the body's natural cooling mechanism. Because cold air contains little water and readily evaporates perspiration; and because physical exertion produces sweating, even in extreme cold; heat loss through evaporation takes place even at very low temperatures. The dry air we inhale attracts moisture from the lining of our nose and throat so quickly that, by the time the air reaches our lungs, it is completely saturated. Combined, evaporation and convection from wet clothes will reduce the body temperature dangerously quickly.
When the body is warmer than its environment, it radiates heat into that environment. Radiation is the greatest source of heat loss, and the colder the environment, the greater the potential for heat loss. Most clothing is of little help because body heat radiates into clothing and from clothing into the atmosphere or object with which it comes into contact.
Preventing accidental hypothermia
Although profound hypothermia can be reversed in some instances, even mild states can quickly lead to death. However, through knowledge and common sense, hypothermia is avoidable. Two factors essential in preventing accidental hypothermia are reducing loss of body heat and increasing body heat production.
Appropriate clothing, shelter, and diet are all essential. Apart from new, synthetic fabrics which allow undergarments to "wick" perspiration away from the body while remaining dry and warm, and outergarments which "breathe" while keeping wind and moisture out, natural wool fibers contain millions of air pockets which act as excellent insulators. Even when saturated, wool maintains 80% of its dry insulation value. Because it provides no insulation and becomes extremely cold when wet, cotton is often called "killer cotton" by experienced outdoors people. As 60% of body heat is lost by radiation from the head, hats can be lifesavers. Fingers, toes, hands, and feet lose heat quickly, and excellent quality boots, gloves, and mittens are a must.
Regular consumption of high-energy food rich in carbohydrates aids the body in heat production, while 13-17 c (3-4L) of water a day prevents rapid dehydration from evaporation. Exercising large muscles-like those in the legs—is the best generator of body heat; however, overexertion must be avoided as it will only speed the onset of hypothermia.
Auerbach, Paul S. Medicine for the Outdoors: A Guide to Emergency Medical Procedures and First Aid. U.S.A./Canada: Little, Brown & Company, Limited.
Schönbaum, E., and Peter Lomax, ed. Thermoregulation: Pathology, Pharmacology, and Therapy.
Wilkerson, James A. Hypothermia, Frostbite, and Other Cold Injuries. Vancouver: Douglas & McIntyre, Ltd., 1986.
Marie L. Thompson