Beware Nature's Quiet Killer

Note: This information about hypothermia, soetmes called the "quiet killer", has been provided by doctors who are expert in the subject. It is reproduced in good faith,without amendment, by Beijing This Month as an advisory to readers who may personally experience the condition, or encounter it in someone else. This maganize can accept no responsibility for any medical eventuality that may arise as a result of the following article.

People dying from hypothermia (subnormal body temperature) during winter is fairly common in northern Europe and the United States especially, but there are no statistics on the incidence in China. Victims are usually elderly, tending to forgetfulness and living alone in premises partially or wholly unheated. Often they have no contact with family or neighbors, and tend to be overlooked by the rest of society when winter sets in.

Some 80 pensioners a year succumb to hypothermia in Britain, despite increased efforts by social-service workers in regularly checking the circumstances of their local senior citizens. Meanwhile, all British pensioners receive an ex gratia "extra heating allowance" of GBP100 (1,300 yuan) each winter from the government. This enables them to buy extra fuel, including coal and electricity. Even so, many still slip through a safety net which includes neighbors who are regularly urged to check old folks' wellbeing.

Hypothermia is caused by exposure to cold and aggravated by wetness, chilly winds and exhaustion. The moment your body begins to lose heat faster than it produces it, you are undergoing exposure. You either voluntarily take exercise to stay warm or your body will make involuntary adjustments to preserve normal temperature in the vital organs, which is when you will start shivering. Never ignore severe or persistent "shakes", for they are a clear warning that you are on the verge of hypothermia.

If exposure continues until your energy reserves are exhausted, the cold will reach your brain and deprive you of sound judgement and reasoning power, though you are unlikely to realize this is happening. You will also begin to lose your motor-coordination skills.

This is the stark reality of hypothermia, the so-called "quiet killer" because it is painless. Unchecked, your internal temperature will slide downward. Untended, the slide invariably leads to stupor, collapse and death.

A prevailing myth is that hypothermia only occurs in situations where the victim is exposed to freezing temperatures for an extended period. The truth is that any temperature less than 98.6 degrees Fahrenheit (37 degrees Centigrade) can be linked to hypothermia. Conditions that lead to hypothermia also include low temperatures, unsuitable clothing, fatigue, dehydration, poor food intake and high alcohol consumption.

Tell-tale signs of impending hypothermia include uncontrollable fits of shivering, memory lapses, incoherence and lengthy periods of drowsiness. Another indicator is what doctors call "umbles" ?stumbles, mumbles, fumbles and grumbles which reflect changes in motor coordination and levels of consciousness.

Often it is helpful to ask a seeming victim a question that requires higher reasoning, for example counting backwards from 100 by "nines", i.e. 91, 82, 73, 64 etc. If hypothermic, the person will be unable to do so. The first step in treating hypothermia is to counter the victim's heat loss by adding additional layers of dry clothing, increasing his/her physical movement, and seeking shelter if you are outdoors or exposed to extreme conditions.

The body produces heat by the digestion and utilization of food and liquids, its main fuel sources. By eating easily digestible food frequently throughout the day, such as carbohydrates, the body can maintain its normal heat production. Keep your body hydrated. Force yourself to drink fluids on cold days. The body cannot effectively use its food without the proper amount of fluid in the system. Do not drink alcohol, as it lowers body temperature by two to three degrees by dilating blood vessels.

The human body also has mechanisms to conserve heat. Shivering is a natural mechanism that creates involuntary exercise and produces heat. When the skin, the body's largest organ, senses cold temperatures, the body begins pulling blood away from the surface, and bringing it to the core where it can be used to keep vital organs at their normal temperature. This reduced blood flow to the body's shell causes decreased function to the extremities, often resulting in a slight loss of coordination and dexterity.

Many people associate hypothermia only with severe weather conditions, a mindset that has led to the death of many in relatively mild winter temperatures. It should not be forgotten that wet clothing, combined with a breeze, can make anyone a prime target for hypothermia. The best prevention is the Boy Scouts' motto of "be prepared" for the worst conditions, no matter what they are at the time you look out of the window before setting off on your hike or whatever.

In short, the best defense against hypothermia is to understand it.

Fueling the body
It is essential to keep a hypothermic person adequately hydrated and fueled with food and liquids. If, unaided, you have to treat a victim, try to follow these guidelines:

* Feed him/her with carbohydrates such as noodles, potatoes and tinned baked beans. Carbohydrates are quickly released into the bloodstream and provide a sudden, brief heat surge. Such foods are easily digestible, thus ideal in providing almost instant energy, especially in mild cases of hypothermia and its shivering.

* Proteins such as eggs and milk slowly release heat over a longer period.

* Fats and sugars are slowly released, but good because they release heat to the body over a long period. However, it takes more energy and water to break down fats into glucose, leading to increased fluid loss.

Things to avoid
* Alcohol, which lowers body temperature two to three degrees by closing blood vessels.

* Caffeine, which causes water loss and thereby increases dehydration.

* Tobacco/nicotine. Usage increases the risk of frostbite.

Exposure
Stay Dry: When clothes get wet, they lose about ninety percent of their insulating effectiveness. Wool loses less insulation than most fabrics, as do many modern synthetics. Cotton, and down which is wet, have virtually no insulation value.

Beware Wind: Strong wind forces cold air under and through clothing, and can refrigerate wet clothes as moisture evaporates to the surface.