General cooling of the entire body is caused by continued exposure to low or rapidly dropping temperatures, cold moisture, snow, or ice. Those persons exposed to low temperatures for extended periods may suffer ill effects, even if they are well protected by clothing, because cold affects the body system slowly, almost without notice. As the body temperature drops, there are several stages of progressive discomfort and disability. The first symptom is shivering, which is an attempt by the body to generate heat. This is followed by a feeling of listlessness, drowsiness, and confusion. Unconsciousness may follow quickly. You will have already noted signs of shock. As the temperature drops even lower, the extremities (arms and legs) freeze. Finally, death results.

TREATMENT.

Hypothermia is a MEDICAL EMERGENCY. THE VICTIM NEEDS HEAT. Rewarm the victim as soon as possible. It may be necessary, however, to treat other injuries before the victim can be moved to a warmer place. Severe bleeding must be controlled and fractures splinted over clothing before the victim is moved.

When the victim is inside a warm place and is conscious, the most effective method of warming him is immersion in a tub of warm water (100F to 105F [38C to 41C]) or warm to the elbow-never hot). When a tub is not available, apply external heat to both sides of the victim, using covered hot-water bottles or, if necessary, any sort of improvised heating pads. Do not place artificial heat next to bare skin. When immersion is used, only the body, not the limbs, should be immersed. Immersion of the arms and legs causes cold blood to flow from them to the body core, causing further detrimental cooling of the core. Dry the victim thoroughly when water is used to rewarm him. The most frequently recommended field treatment is "buddy warming." Since the victim is unable to generate body heat, merely placing him under a blanket or in a sleeping bag is not sufficient. For best results, the nude victim should be placed in a sleeping bag with two volunteers stripped to their shorts to provide body-to-body heat transfer. This technique can be used by untrained personnel in a tent in the field and WILL SAVE LIVES!!!

When the victim is conscious, give him warm liquids to drink, Hot tea with lots of sugar is particularly good. No alcoholic beverages, please.

As soon as possible, transfer the victim to a medical facility, keeping him warm in route. Be alert for signs of respiratory failure and cardiac arrest during transfer.