Saturday, March 28, 2015
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Arctic cold in Midwest reminds us of hypothermia risks

By
From page B5 | January 11, 2014 |

Recently my wife and kids visited friends in Vermont. I remained in Fairfield due to professional obligations.

While checking the weather reports frequently, I wondered how they were getting along. That’s when I received an emailed video of my son sledding down a frozen hill, shirtless and wearing shorts, screaming in delight. Fortunately, humans are pretty tough and can tolerate cold exposure quite well, if they are young, healthy and well hydrated. When it comes to the ridiculously low temperatures, recently reaching 30 below zero in northern Minnesota, all bets are off. The medical term for low body temperature is hypothermia.

One of the premier medical textbooks addressing cold exposure issues is Auerbach’s “Wilderness Medicine.” This textbook divides cases of hypothermia into accidental, homicidal and suicidal categories, a common forensic classification approach.

More 600 Americans die annually due to hypothermia. Surprisingly, this condition occurs in all locations, even Florida. I recall treating a woman for hypothermia who fell into the San Francisco Bay years ago, and the weather was not particularly cold. Indeed, body temperatures may take a nosedive even on a balmy day in the 70s, particularly in persons who are chronically ill, very young or elderly. Thyroid disease, Parkinson’s disease, and infections, for example, may impair thermoregulation.

While practicing in a mental health facility, I often encountered cases of low or high body temperature attributed to chronic use of psychiatric medications. Evaluating a patient with hypothermia, therefore, may require detective work. A clinician must identify predisposing conditions, while simultaneously correcting the acute body temperature challenge.

Auerbach describes stages of hypothermia. Normal body temperature varies between 36.0 and 37.1 degrees Celsius, or 96.9 to 98.9 Fahrenheit, upon awakening in the morning (temperature rises in the afternoon). Medical science is moving increasingly toward the more rational metric system, but I will use Fahrenheit numbers more familiar to our readers.

Mild hypothermia, with body temperature above 91.4, may elicit shivering, poor judgment and maladaptive behavior. Loss of coordination of the hands may impair one’s capacity to take life-saving actions, such as lighting a camp fire. Moderate hypothermia, from 84.2 to 89.6 degrees, causes loss of shivering response, and decreased mental status or even stupor. Severe hypothermia, 71.6 to 82.4 degrees, may cause irregular heart beat patterns, such as life-threatening ventricular fibrillation. Profound hypothermia, with core temperatures below 68.0 degrees, is associated with an 80 percent likelihood of lacking a palpable pulse.

The lowest recorded body temperature associated with long-term survival was 48.2 degrees. Drowning patients, particularly children, can sometimes survive profound hypothermia with aggressive resuscitation. Core body temperatures are more reliable than oral temperatures in assessing hypothermia. Tympanic membrane monitors, for example, reflect core body temperature.

Emergency department evaluation of a patient with hypothermia typically involves blood tests, various warming modalities, correction of any metabolic conditions and addressing underlying contributory factors, such as diabetes, thyroid disease or infection. Indeed, emergency medicine is now a distinct field of medical specialization, and an acutely hypothermic patient might well be managed by an interdisciplinary team, also including intensive care specialists.

If possible, however, it is best to prevent hypothermia. Informing others of our travel plans, dressing appropriately and maintain emergency supplies in our vehicles and homes are all reasonable precautions.

Persons suffering from cold exposure may at times engage in “paradoxical undressing,” disrobing in the face of freezing ambient temperatures. Forensic pathologists are aware of this behavioral entity, which probably reflects central nervous system disruption.

NFL fans, particularly in northern climates, seem prone to similar behavior, removing their shirts and donning body paint, and goofy hats. Unfortunately, medical science cannot explain every phenomenon.

Stay safe, and warm, this winter season.

Scott T. Anderson, MD, PhD ([email protected]) is Clinical Professor of Medicine, UC Davis. This article is informational, and does not constitute medical advice.

Scott Anderson

LEAVE A COMMENT

Discussion | No comments

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

.

Solano News

Fraisure Smith hearing delayed twice Friday

By Ryan McCarthy | From Page: A1, 14 Comments | Gallery

 
Luncheon honors women for their work to help others

By Susan Hiland | From Page: A1, 1 Comment | Gallery

Sheepdogs, handlers flock to Rio Vista for trials

By Susan Winlow | From Page: A1, 1 Comment | Gallery

 
Solano Rotary clubs honor top firefighters from across county

By Bill Hicks | From Page: A3 | Gallery

 
Eatery to host event to support child with cancer

By Glen Faison | From Page: A3

 
Project begins to brighten downtown Fairfield

By Susan Hiland | From Page: A3, 19 Comments | Gallery

 
Fairfield police log: March 26, 2016

By Susan Hiland | From Page: A9, 1 Comment

Suisun police log: March 26, 2015

By Susan Hiland | From Page: A9

 
Going home to mother

By Murray Bass | From Page: B10, 2 Comments

 
.

US / World

 
Jury says Silicon Valley firm did not discriminate

By The Associated Press | From Page: A3

 
Public defender: San Francisco jail inmates forced to fight

By The Associated Press | From Page: A4

 
Gov. Brown signs $1 billion water plan for dry California

By The Associated Press | From Page: A4 | Gallery

 
Fetus debate looms following charges in womb-cutting case

By The Associated Press | From Page: A5

NY mayor: Someone may have ‘inappropriately’ tapped gas line

By The Associated Press | From Page: A5 | Gallery

 
Feds: Baltimore jail illegally keeping juveniles in solitary

By The Associated Press | From Page: A5

Autopsies determine children found in freezer were slain

By The Associated Press | From Page: A5

 
 
Nelson set to return to role as Coach

By The Associated Press | From Page: A7

 
‘Sopranos’ star’s apartment destroyed by blast

By The Associated Press | From Page: A7

Pilot who scared passengers sues airline

By The Associated Press | From Page: B7

 
‘Mad Men’ costumes, props head to Smithsonian

By The Associated Press | From Page: A7

US economy showing signs of durability

By The Associated Press | From Page: B7, 1 Comment

 
Mexico City businesses cite losses during Bond filming

By The Associated Press | From Page: A7

 
German airline could face ‘unlimited’ damages for Alps crash

By The Associated Press | From Page: A10

Co-pilot appeared healthy, but may have hidden illness

By The Associated Press | From Page: A10

 
About 4,000 fishermen stranded on Indonesian islands

By The Associated Press | From Page: A10, 1 Comment

Warships move in key strait as airstrikes widen in Yemen

By The Associated Press | From Page: A11 | Gallery

 
Iran says nuke talks focused despite Yemen crisis

By The Associated Press | From Page: A11

Amanda Knox murder conviction overturned by Italy high court

By The Associated Press | From Page: A12

 
At least 9 dead as militants attack hotel in Somali capital

By The Associated Press | From Page: A12

.

Living

Books as decor: Versatile but meaningful design elements

By The Associated Press | From Page: HSR1Comments are off for this post | Gallery

 
Community Calendar: March 28, 2015

By Susan Hiland | From Page: A2

Today in History: March 28, 2015

By The Associated Press | From Page: A2

 
Horoscopes: March 28, 2015

By Holiday Mathis | From Page: B6

My elderly mother is so stingy I’m finding excuses not to visit her

By Kathy Mitchell and Marcy Sugar | From Page: B6

 
The newest fitness trend: Mixing it up

By The Associated Press | From Page: B10

.

Entertainment

Larry David Broadway role handed to Jason Alexander

By The Associated Press | From Page: A7

 
‘Stomp’ stopped by NYC blast

By The Associated Press | From Page: A7

Mannequin museum show hits New York

By The Associated Press | From Page: A7

 
TVGrid

By Daily Republic Syndicated Content | From Page: B7

‘Teen Mom’ star charged in picture posting case

By The Associated Press | From Page: A7

 
People: Zane Malik

By The Associated Press | From Page: A7

.

Sports

 
Curry, Thompson lead Warriors in rout over Grizzlies

By The Associated Press | From Page: B1 | Gallery

Evans helps desperate Pelicans end skid vs. Kings, 102-88

By The Associated Press | From Page: B1

 
Ranuado goes 6 for Rangers’ but A’s rally for 7-6 win

By The Associated Press | From Page: B1

Notre Dame beats Stanford women 81-60, advances to Elite Eight

By The Associated Press | From Page: B1

 
Logano wins Martinsville pole; Elliott to start 27th

By The Associated Press | From Page: B2

A-Rod’s cousin pleads guilty in Florida steroids case

By The Associated Press | From Page: B2

 
Durant to have another surgery, miss rest of season

By The Associated Press | From Page: B2

Chicago rooftop owner charged with trying to defraud Cubs

By The Associated Press | From Page: B2

 
Gift returns: Sterling wife wants house, $1 million

By The Associated Press | From Page: B2

 
Shaq acknowledges regret about decision to leave Magic

By The Associated Press | From Page: B2

NASCAR topic: Cheating with tire pressure, or just hot air?

By The Associated Press | From Page: B2

 
Hot Rod Hundley, former NBA player and Jazz announcer, dies

By The Associated Press | From Page: B2

Area resident Jimmy Walker takes lead in Texas Open

By The Associated Press | From Page: B2

 
This date in sports history for March 28, 2015

By The Associated Press | From Page: B3

 
.

Business

.

Obituaries

.

Comics

Sally Forth

By Daily Republic Syndicated Content | From Page: B5

 
Zits

By Daily Republic Syndicated Content | From Page: B5

Rose is Rose

By Daily Republic Syndicated Content | From Page: B5

 
Get Fuzzy

By Daily Republic Syndicated Content | From Page: B5

Baldo

By Daily Republic Syndicated Content | From Page: B5

 
Baby Blues

By Daily Republic Syndicated Content | From Page: B5

Dilbert

By Daily Republic Syndicated Content | From Page: B5

 
Pickles

By Daily Republic Syndicated Content | From Page: B5

For Better or Worse

By Daily Republic Syndicated Content | From Page: B5

 
Beetle Bailey

By Daily Republic Syndicated Content | From Page: B5

Blondie

By Daily Republic Syndicated Content | From Page: B5

 
Garfield

By Daily Republic Syndicated Content | From Page: B5

B.C.

By Daily Republic Syndicated Content | From Page: B5

 
Frank and Ernest

By Daily Republic Syndicated Content | From Page: B5

Wizard of Id

By Daily Republic Syndicated Content | From Page: B5

 
Word Sleuth

By Daily Republic Syndicated Content | From Page: B6

Bridge

By Daily Republic Syndicated Content | From Page: B6

 
Cryptoquote

By Daily Republic Syndicated Content | From Page: B6

Sudoku

By Daily Republic Syndicated Content | From Page: B6

 
Crossword

By Daily Republic Syndicated Content | From Page: B6

.

Home Seller 3/28/2015

Books as decor: Versatile but meaningful design elements

By The Associated Press | From Page: HSR1Comments are off for this post | Gallery

Real estate transactions for March 28, 2015

By Daily Republic | From Page: HSR2