Hypothermia - "a decrease in the core body temperature to a level at which normal muscular and cerebral functions are impaired."
Conditions Leading to Hypothermia
Cold temperatures
Improper clothing and equipment
Wetness
Fatigue, exhaustion
Dehydration
Poor food intake
No knowledge of hypothermia
Alcohol intake - causes vasodilation leading to increased heat loss.

"Hypothermia" temperatures
Below freezing
40 degrees - Ex. Shenandoahs, wind and rain
60 degrees - Ex. Rayanna and hurricane
Any temperature less than 98.6 degrees can be linked to hypothermia
Signs and Symptoms of Hypothermia
a. Watch for the "-Umbles" - stumbles, mumbles, fumbles, and grumbles which show changes in motor coordination and levels of consciousness
b. Mild Hypothermia - core temperature 98.6 - 96 degrees F
Shivering - not under voluntary control
Can't do complex motor functions (ice climbing or skiing) can still walk & talk
c. Moderate Hypothermia - core temperature 95 - 93 degrees F
Dazed consciousness
Loss of fine motor coordination - particularly in hands -
can't zip up parka, due to restricted peripheral blood flow
Slurred speech
Violent shivering
Irrational behavior - Paradoxical Undressing -
person starts to take off clothing, unaware s/he is cold
"I don't care attitude" - flattened affect
d. Severe Hypothermia - core temperature 92 - 86 degrees and below (immediately life threatening)
Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases - because the heat output from burning glycogen in the muscles is not sufficient to counteract the continually dropping core temperature, the body shuts down on shivering to conserve glucose Person falls to the ground, can't walk, curls up into a fetal position to conserve heat Muscle rigidity develops - because peripheral blood flow is reduced and due to lactic acid and CO2 buildup in the muscles Skin is pale Pupils dilate Pulse rate decreases at 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate. at 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.

e. Death from Hypothermia
Breathing becomes erratic and very shallow
Semi-conscious
Cardiac arrythmias develop, any sudden shock may set
off Ventricular Fibrillation
Heart stops, death

Treating Hypothermia
The basic principles of rewarming a hypothermic victim are to conserve the heat they have and replace the body fuel they are burning up to generate that heat. If a person is shivering, they have the ability to rewarm themselves at a rate of 2 degrees C per hour.

1. Reduce Heat Loss
Additional layers of clothing
Dry clothing
Increased physical activity
Shelter
2. Add Fuel & Fluids
It is essential to keep a hypothermic person adequately hydrated and fueled.
a. Food types
Carbohydrates - 5 calories/gram - quickly released into blood stream for sudden brief heat surge - these are the best to use for quick energy intake especially for mild cases of hypothermia Proteins - 5 calories/gram - slowly released - heat given off over a longer period Fats - 9 calories/gram - slowly released but are good because they release heat over a long period, however, it takes more energy to break fats down into glucose - also takes more water to break down fats leading to increased fluid loss
b. Food intake
Hot liquids - calories plus heat source
Sugars (kindling)
GORP - has both carbohydrates (sticks) and protiens/fats (logs)
c. Things to avoid
Alcohol - a vasodilator - increases peripheral heat loss
Caffeine - a diuretic - causes water loss increasing dehydration
Tobacco/nicotine - a vasoconstrictor, increases risk of frostbite
3. Add Heat
Fire or other external heat source
Body to body contact. Get into a sleeping back, in dry clothing with a normothermic person in lightweight dry clothing.

Hook Removal

There are 3 techniques for fishhook removal. These inlcude: 1.push and clip technique. The barb of the hook is pushed through the skin. Once exposed, the barb is cut off and the hook is withdrawn. 2.needle over barb technique. A large bore needle, or one with a large opening, is passed through the entrance wound of the hook. The hollow tip of the needle is then placed over the barb, covering its sharp point. The hook is advanced slightly to dislodge the barb from the tissue. Then, the hook and needle are pulled out together through the entrance wound. 3.simple pull technique. This procedure is used for fishhooks that are barely hooked under the skin. A small incision is made to enlarge the entry wound at the site of the barb. The hook is pulled straight out.