Hypothermia

Normal body temperature is about 37°C. If someone is exposed to very cold weather without adequate clothing, or is immersed in cold water for a period of time, the core body temperature may drop enough for hypothermia to develop (usually if the body temperature drops below about 35°C). One particular group in society is especially vulnerable to hypothermia: the physically inactive, elderly people living in houses without adequate heating.

Early signs of hypothermia include pallor, skin that is cold to the touch, severe shivering (which may progress into clumsiness and uncoordinated movements), slurred speech and confusion. Loss of consciousness may follow. First aid for a conscious casualty with hypothermia involves wrapping him or her up warmly and moving the casualty to a warm environment or other shelter, if the person is outdoors. Wet clothing should be replaced with dry if this is available; if not, it is better for the person to keep the wet clothing on, covered by a waterproof.

You should give the casualty warm sweet drinks, but never alcohol, and arrange for his or her transfer to hospital. Do not try to warm a hypothermic person by putting him or her into a hot bath – this can shock the system. Gradual rewarming is the key. If someone is both unconscious and hypothermic and also appears to be lifeless, do not jump to the conclusion that he or she is dead. People have been known to recover from hypothermia hours later. Particularly with the elderly, hypothermia may develop following immobilization caused by a fall, a heart attack, a stroke or other injury; so you should watch out for these complications. If the person has stopped breathing, start resuscitation and artificial respiration. Because there may be a faint heartbeat, however, continue to feel for a pulse for at least a minute before starting; external chest compression begun too soon may be harmful. Place the casualty in the recovery position when breathing has resumed and arrange for the person’s transfer to hospital. Elderly people living alone should, in cold weather, make sure that they heat at least one room to a temperature of 21 °C or above, and sleep and live in that room. They should also have at least one meal a day and plenty of hot drinks, including some in a vacuum flask to drink during the night. Many layers of thin clothing are more effective in retaining heat than wearing just one thick jumper. As with many aspects of first aid, prevention is better than treatment, and ‘good neighbour’ policies plus regular visits to elderly relatives by the younger and more able are of great value in making sure that an elderly person is keeping sufficiently warm.

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