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Frozen Z.  Photo by Dale Jancic.  

If you're out in the cold and notice stumbling, mumbling, fumbling and grumbling, there's a chance hypothermia is setting in. More....

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- by E. A. Zimmerman

On cold winter nights, Chickadees and Downy Woodpeckers conserve energy by lowering their body temperature by 10 to 15 degrees F.  While this may seem counterproductive, “nocturnal hypothermia” probably reduces energy expenditure by as much as ten percent.

In severe frostbite, the affected area turns dry, hard and black within 9-15 days.  Lasting effects can include chronic pain, sensitivity to cold, and loss of feeling. Bet Zimmerman photo.

When humans are working or playing outside, they need to be aware that their body’s natural response to cold, rain and wind can prove deadly.  When the body loses heat faster than it can be generated, and core body temperature dips below 95F due to the cold, hypothermia sets in.  The “umbles”- starting to mumble, stumble, fumble and grumble – are classic warning signs.   For example, the person may be unable to touch their thumb with their little finger.  Other symptoms of hypothermia may include uncontrollable shivering, slow and shallow breathing, and cold, pale dry skin. 

As hypothermia worsens, victims may display “cold stupid” behavior, acting confused, sleepy, or disoriented, with slurring their speech.  Eventually shivering stops, pupils dilate, muscles stiffen, heart rate slows, and lethargy, apathy, amnesia and delirium are evident.  Even in the midst of a freezing snowstorm, some victims rip their clothes off in a bizarre response called “paradoxical undressing.”  An estimated 20-50% of hypothermia deaths are associated with paradoxical undressing.  People at this stage will not survive without intervention, even though they may also try to fight those who try to help or warm them.  

Finally, when the core body temperature drops to 75-90 degrees F, the victim lapses into a coma and dies.  About 700 people succumb to this fate each year (Source:  CDC).  Some individuals are more at risk of hypothermia than others, including babies; the ill (e.g., diabetic), injured or exhausted; the elderly, and people who are malnourished, drunk or on drugs.  Even though women like me may whine more about the cold, most people who die from hypothermia are male.  

Hypothermia usually happens during prolonged exposure, but can occur even when temperatures are above freezing.  For example, a runner sweating profusely in the cold rain can go hypothermic. Frostbite occurs when the skin freezes from low temperatures, wet clothes or fierce winds.  The most dangerous conditions are when temperatures drop below 14 F. At -50F, exposed skin freezes in a matter of minutes.  Extremities such as fingers, toes, earlobes, cheeks, chins, and the nose are most likely to suffer damage.  

That damage happens in degrees, from frostnip (superficial freezing) to deep frostbite.  Early warning signs are a cold, painful feeling, and reddened and then white skin.  This is followed by a “pins and needles” prickly feeling, as ice crystals begin to form around cells.  Skin feels waxy and stiff  “like a block of wood.”  Because of numbness, the victim may not even notice what is happening until a companion points out skin turning white, yellowish or grayish/purple.  Next, tissue starts to die.  Blisters filled with dark fluid and skin that turns dark blue when thawed are a bad sign.  In severe frostbite, the affected area turns dry, hard and black within 9-15 days.  It may become infected or have to be amputated. Aching and throbbing pain can persist for weeks or months.  Lasting effects can include chronic pain, sensitivity to cold, and loss of feeling.

Frostbite and hypothermia have historically been a big concern in the military.  Hannibal lost half his army while crossing the Alps in 218 BC.  More than 10% of all American casualties during World War II and the Korean War were due to cold injuries.  In 1942, over 15,000 cold-related amputations were performed on Germans fighting on the Russian Front.  (Source: Medscape Today)  Today, the homeless and people participating in outdoor sports in nasty weather are most at risk.  Next week’s article will provide the cold, hard facts on preventing hypothermia and frostbite. It will also explain why some conventional wisdom on treatment is dead wrong.
Originally published in the Villager newspapers on December 5, 2008

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