Hypothermia Frostbite and other Cold Injuries:
Prevention, Survival, Rescue, and Treatment
This is a brief summary of some of the interesting information found
in the newly revised book by Gordon G. Giesbrecht and James A. Wilkerson,
second edition, 2006. I strongly recommend that anyone who's going
to go out in the woods or onto ice for winter training have a look at
this book for "how to get out of the water", how to save your
life, and how to rewarm after getting hypothermic. It's available
through The
Mountaineers Books, 1001 SW Klickitat Way, Suite 201, Seattle, WA,
98134, USA, for $17.95 US plus shipping.
Gordon Giesbrecht is also known as "Professor Popsicle", for
his many years of research into mechanisms of cold injury and cold survival.
When I recently heard Professor Popsicle interviewed on the CBC, I ordered
the book, and am currently having a good read.
A few short out-takes:
What to do if your car goes through the ice.
1 - GET THE HECK OUT - There are 3 stages to vehicle submersion, the
floating stage, the sinking stage, and the submerged stage. Essentially,
if you wait until the car is under water so that the pressure equalizes,
you're most likely dead along with your loved ones who are in the car.
Giesbrecht advises the following: during the FLOATING stage, "Seat
belts off; Children unbuckled; Windows open; Out, children first, through
windows as quickly as possible" THEN use your cell phone if
it still works. Giesbrecht told the story of many 9-1-1 phone calls
during which the rescue telephone operator listened as people died while
they were phoning from inside a submerged car - the fire department don't
have time to come and get you unless you're OUT of the car.
2. SEE "1", above.
Four stages of Cold Water Immersion (page 59 ff)
Cold Shock - kills within seconds to two minutes. Sudden large gasps
of breathing that may lead to hyperventilation. It's important to
keep your head above water because the gasp reflex can make you inhale
lots of water and drown right away if your head goes under.
Focus on getting past the first minute - SUPPRESS PANIC, AND GET BREATHING
UNDER CONTROL. Then you've usually got time to think and do smart
things to get out of the water. Face away from the wind and waves so that
your uncontrolled gasps are away from the splash.
Cold Incapacitation - Between 2-30 minutes. The body tries to conserve
core heat by cutting blood flow to the arms and legs. Muscles start
shutting down, and the colder the water, the faster the shut down.
One of the authors of the book managed to swim only 50 feet in ice water
(fully dressed in a snomobile suit) before he was incapacitated.
So - before you're incapacitated, do what you can to get out of the water.
(pull yourself out of the water, get to a life raft, inflate the pfd,
call for help, etc. HELP position and huddling may slow down heat
loss)..
Hypothermia - if you get past about 30 minutes in ice water, the core
temp starts dropping and you are in deep doo-doo... If you're in the water
with a good PFD you may last another hour before your heart packs up.
If your PFD is good and your head is out of the water, stay calm, reduce
heat loss, and maximize the time during which you may be rescued.
(This is heavily summarized).
Circumrescue Collapse - about 20% of people rescued alive from cold water
die within the next 24 hours because of a number of factors that are associated
with being rescued (being pulled out of the water and losing blood pressure
due to the loss of the pressure from the water on the body; being handled
roughly leading to ventricular fibrillation (heart failure); too much
relaxation due to rescue (i.e., reduction in stress hormones causing collapse)
and other factors.
If you've fallen through ice, TRY TO GET CONTROL OF BREATHING.
PUT YOUR ARMS ON THE ICE AND CALM DOWN. KICK LEGS UNTIL HORIZONTAL AT
THE SURFACE. KICK AND PULL YOUR BODY OUT OF THE ICE IN A HORIZONTAL
POSITION. ROLL CAREFULLY AND CRAWL AWAY TO SAFETY. If you have something
like a pocket knife, pen, ice pick, or something else, you can use that
to help dig into the ice while you try to crawl out.
I'm going to stop summarizing here - there are rewarming strategies,
detailed discussion of cold injury from immediate or prolonged cold exposure,
and much very useful information. The book is well written, in plain
English, and again, if you're planning to go on ice, or out in the wilds
of the western Canadian winter, you could benefit from absorbing the information
in a copy of Giesbrecht and Wilkerson (2006).
11759 Groat Rd. Edmonton, AB T5M 3K6
Office (780) 427-8154 | Fax: (780) 422-2663
E-mail: ARA
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