Fourth of a five-part series about low body temperature.

by James Hubbard, M.D., M.P.H.

You’re on a hike. The temperature is in the 50s, and it’s a little windy. You slip and fall in a stream, get your pants wet. You start shivering. Your target location’s only half a mile away. Besides, a little cold never hurt anyone. I mean, it’s in the 50s.

If you’ve been reading this series on hypothermia, you know that’s not true. You need to head for home or your campsite and get out of those wet clothes. Do it right away because your next symptom could be confusion. Then you’re wandering, lost, getting colder by the minute. Maybe eat something to give your body a little extra fuel to keep generating that heat until you get there.

But what if you’re farther away or you’re already getting too cold? Or you’re inside, but there’s inadequate heat?

Treatment for Mild Hypothermia

With mild hypothermia, your body is still generating heat, so don’t let it escape. (Dress in layers, stay dry, stay off the cold ground.) Keep hydrated and eat something. Your body’ll do the job if you do yours. If you let the heat escape or run out out of fuel (food), sooner or later your body’s going to wear down. Then you’re in trouble.

Treatment for Moderate Hypothermia

How to Prevent Hypothermia

Of course, prevention is the best medicine. Take special precautions if you have risk factors for hypothermia:

  • Dress in layers.
  • Stay out of the wind.
  • Stay hydrated. Drink warm, noncaffeinated drinks if available.
  • Bring snacks. If your body is trying to stay warm, it’s easy to deplete your energy essential carbohydrates. Your body uses food like a fire uses wood, as fuel to produce heat.
  • Stay dry. One of the reasons to dress in layers is you can take some off if you start sweating.

There’s not some sort of distinct cutoff point going from mild to moderate hypothermia. The symptoms can overlap. But if you’ve tried the above treatment and there’s no improvement or, worse, more confusion and fatigue, you’re going to need to find a heat source outside your body.

Drinking warm liquids would help.

If you have heating pads, place them under your arms.

A last resort is sharing body heat. If you’re getting really, really cold, and there’s no other way, two or three people can get under blankets, take off their clothes, and get skin to skin. It’s worth a try. And no, not as a date ploy.

What if you need to treat someone else? It depends. You can do all of the above and:

  • Get them out of wet clothes if you have cover.
  • Cover them from head to toe.
  • Give them something to eat or warm to drink if you trust they are conscious enough to swallow and not choke.
  • Place heating pads under their arms. Hot water bottles are fine when you can get them.
  • When they’re in shelter, place more hot water bottles or heat packs on their groin areas. Put light cloth, mittens, etc., between the bottles and skin to avoid burns.
  • Warm the hands and feet in warm water or with hot packs.

Be gentle when treating someone else. At cold body temperature, your heart becomes very sensitive to jostling. It tends to go into bad rhythms.

If the person is confused, calm them by talking, and ask if they have any medical problems. Low blood sugar or a fall could be causing or contributing to the confusion.

Hypothermia Treatment: What Not to Do

  • Don’t drink alcohol. Alcohol dilates your surface vessels and brings blood to your skin at the expense of your vital organs. You feel warm, but your heart, liver, and kidneys are suffering. It also impairs your judgment. The combination of mild-altering drugs or alcohol and cold weather is a major killer every year.
  • Don’t rub your skin to warm up. Vigorous rubbing dilates those surface vessels like alcohol. It makes you feel warm at the expense of taking heat from your vital organs.
  • If you’re indoors, don’t start a fire or use coals or a fuel heater without adequate ventilation. Every year, people do this and die from carbon monoxide poisoning.

I’ll write about hypothermia treatment for an unconscious person in the next post.

Five-Part Hypothermia Series:

  1. Low body temperature: How cold is too cold?
  2. Risk factors for hypothermia (besides cold weather)
  3. Symptoms of hypothermia
  4. (This post) Hypothermia treatment, part one: How to treat a conscious person
  5. Hypothermia treatment, part two: How to treat an unconscious person