One last word on hypothermia

Published 12:00 am Sunday, November 17, 2002

One thing that most recreational boaters have probably noticed while roaming the waterways of Hampton Roads is that as the temperature decreases the number of recreational boaters also dramatically drops. The same holds true for the inland rivers and lakes. The presence of a good stiff cold breeze isn’t appealing.

Because of the sudden onset of cold weather, I devoted last week’s column to examining hypothermia, which is one of the biggest dangers facing &uot;off-season&uot; (aka cold weather) recreational boating. It’s a serious issue.

The next step, when writing about hypothermia, is to review approaches to initial treatment of hypothermia. Before I go any further I need to make two things crystal clear. First, I am not a medical doctor. Second, this column is provided for discussion purposes. It is essentially a starting point. When faced with an actual maritime hypothermia situation get a hold of medical professionals as soon as possible and follow their recommendations.

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With the legalese out of the way what is the best way to look at treating hypothermia. I consulted several Web sites, including one from Canada’s British Colombia (they know cold water!) and some safe boating bulletins. The following suggestions are made for treating different types of hypothermia, ranging from mild to extremely severe:

For mild hypothermia (the victim is shivering but coherent). The first step is to move the individual to a warm place. Remove their wet clothes, give them warm, sweet drinks; no alcohol or caffeine. Keep the individual as warm as possible for several hours. In a maritime situation, this would mean turning the cabin area thermostat up high and getting the individual inside quickly. As a precaution everyone riding a recreational boat during the off-season months should have a complete second set of clothes. In addition to a second set of clothes, I can’t reinforce enough the need for boaters in cold weather to wear a Protective Floatation Device (PFD). Studies have shown that your survival rate increases dramatically in cold water with a PFD. For example, www.walrus.com reports, &uot;An ‘average’ person, wearing light clothes and a PFD, may survive 2.5 to three hours in 50-degree water by remaining still.&uot;

For moderate hypothermia, in which an individual’s shivering may decrease or stop altogether, the approach is even more specific. In this situation the patient may seem irrational with deteriorating coordination (They can appear almost rubber-like which unfortunately can cause even more injury as they impact decks or tables. Don’t laugh. I’ve seen people afflicted with moderate hypothermia and it is not pretty.). The treatment approach is same as above, but no drinks – especially alcohol. Victims should be kept lying down with torso, thighs, head and neck covered with dry clothes, coats or blankets to stop further heat loss. Seek medical attention immediately.

Severe hypothermia, which is usually indicated by an individual who had shivered and has now stopped and could potentially lapse into either an unconscious or semiconscious state. The response here needs to be immediate. Once the person is removed from the water, they should be kept prone, on back and very immobile. Make sure that you are handling them with as much care as possible. Cover torso, thighs, head and neck with dry covers to stop further heat loss, but ensure that an auxiliary heat source is available as soon as possible. It is further recommended that legs and arms should not be stimulated in any way because of the potential to induce a heart attack. These items are presented for your consideration and may be of value.

What can you gain from this week’s discussion? Actually, it’s pretty simple. Hypothermia can kill, plain and simple. If you do boat during the off-season (and I hope you do because it really is a different experience) remember to be prepared for cold weather. Above all else, keep close eye on weather, dress appropriately including PFD whenever exposed out on deck or in an open boat, and have some reliable means of communication distress (VHF, EPIRB). Next week I’ll continue our look at hypothermia by discussing some concerns when recreational diving. Until then – Boat Safe… and Boat Smart!

LCDR Joe DiRenzo III is a resident of Suffolk and a regular columnist for the Suffolk News-Herald.