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Hypothermia

Definition:-
Hypothermia  is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as 35.0 °C (95.0 °F). Body temperature is usually maintained near a constant level of 36.5–37.5 °C (98–100 °F) through biologic homeostasis or thermoregulation. If exposed to cold and the internal mechanisms are unable to replenish the heat that is being lost, a drop in core temperature occurs. As body temperature decreases, characteristic symptoms occur such as shivering and mental confusion.

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When your body temperature drops, your heart, nervous system and other organs cannot work correctly. Left untreated, hypothermia eventually leads to complete failure of your heart and respiratory system and to death.

Hypothermia is most often caused by exposure to cold weather or immersion in a cold body of water. Primary treatments are methods to warm the body back to a normal temperature.

Hypothermia is the opposite of hyperthermia which is present in heat exhaustion and heat stroke. The lowest documented body temperature from which anyone has recovered was 13.0 °C (55.4 °F), in a drowning incident involving a 7-year-old girl in Sweden in December 2010

Clasification:
Normal human body temperature in adults is 34.4–37.8 °C (94–100 °F). Sometimes a narrower range is stated, such as 36.5–37.5 °C (98–100 °F). Hypothermia is defined as any body temperature below 35.0 °C (95.0 °F). It is subdivided into four different degrees, mild 32–35 °C (90–95 °F); moderate, 28–32 °C (82–90 °F); severe, 20–28 °C (68–82 °F); and profound at less than 20 °C (68 °F). This is in contrast to hyperthermia and fever which are defined as a temperature of greater than 37.5 °C (99.5 °F)-38.3 °C (100.9 °F).

Other cold-related injuries that can either be present alone or in combination with hypothermia include:

*Chilblains are superficial ulcers of the skin that occur when a predisposed individual is repeatedly exposed to cold.
*Frostbite involves the freezing and destruction of tissue.
*Frostnip is a superficial cooling of tissues without cellular destruction.
*Trench foot or immersion foot is due to repetitive exposure to wet, non-freezing temperatures

Symptoms:-
The signs and symptoms vary depending on the degree of hypothermia and may be divided by the three stages of severity.

Mild:
Symptoms of mild hypothermia may be vague  with sympathetic nervous system excitation (shivering, hypertension, tachycardia, tachypnea, and vasoconstriction). These are all physiological responses to preserve heat.  Cold diuresis, mental confusion, as well as hepatic dysfunction may also be present. Hyperglycemia may be present, as glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity to insulin may be blunted. Sympathetic activation also releases glucose from the liver. In many cases, however, especially in alcoholic patients, hypoglycemia appears to be a more common presentation. Hypoglycemia is also found in many hypothermic patients because hypothermia often is a result of hypoglycemia.

Moderate:
Low body temperature results in shivering becoming more violent.(Shivering is your body’s automatic defense against cold temperature — an attempt to warm itself. Constant shivering is a key sign of hypothermia) Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim may appear alert. Surface blood vessels contract further as the body focuses its remaining resources on keeping the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may become blue.

Severe:
Difficulty in speaking, sluggish thinking, and amnesia start to appear; inability to use hands and stumbling is also usually present. Cellular metabolic processes shut down. Below 30 °C (86 °F), the exposed skin becomes blue and puffy, muscle coordination becomes very poor, walking becomes almost impossible, and the victim exhibits incoherent/irrational behavior including terminal burrowing or even a stupor. Pulse and respiration rates decrease significantly, but fast heart rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail. Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia, the body will actually take longer to undergo brain death.

As the temperature decreases further physiological systems falter and heart rate, respiratory rate, and blood pressure all decreases. This results in an expected HR in the 30s with a temperature of 28 °C (82 °F).

Paradoxical undressing:
Twenty to fifty percent of hypothermia deaths are associated with paradoxical undressing. This typically occurs during moderate to severe hypothermia, as the person becomes disoriented, confused, and combative. They may begin discarding their clothing, which, in turn, increases the rate of heat loss.

Rescuers who are trained in mountain survival techniques are taught to expect this; however, some may assume incorrectly that urban victims of hypothermia have been subjected to a sexual assault.

One explanation for the effect is a cold-induced malfunction of the hypothalamus, the part of the brain that regulates body temperature. Another explanation is that the muscles contracting peripheral blood vessels become exhausted (known as a loss of vasomotor tone) and relax, leading to a sudden surge of blood (and heat) to the extremities, fooling the person into feeling overheated.

Terminal burrowing:
In the final stages of hypothermia, the brain stem produces a burrowing-like behavior. Similar to hibernation behavior in animals, individuals with severe hypothermia are often found in small, enclosed spaces, such as under the bed or behind wardrobes.

Cause:
Hypothermia occurs when your body loses heat faster than it produces it. The most common causes of hypothermia are exposure to cold weather conditions or cold water, but prolonged exposure to any environment colder than your body can lead to hypothermia if you aren’t dressed appropriately or can’t control the conditions. Specific conditions leading to hypothermia include:

*Wearing clothes that aren’t warm enough for weather conditions

*Staying out in the cold too long

*Unable to get out of wet clothes or move to a warm, dry location

*Accidental falls in water, as in a boating accident

*Inadequate heating in the home, especially for older people and infants

*Air conditioning that is too cold, especially for older people and infants

How your body loses heat
The mechanisms of heat loss from your body include the following:

*Radiated heat. Most heat loss is due to heat radiated from unprotected surfaces of your body. Your head has a large surface area and accounts for about half of all heat loss.

*Direct contact. If you’re in direct contact with something very cold, such as cold water or the cold ground, heat is conducted away from your body. Because water is very good at transferring heat from your body, body heat is lost much faster in cold water than in cold air. Water that is 65 F (18 C) — a relatively mild air temperature — can lead to hypothermia very quickly. Similarly, heat loss from your body is much faster if your clothes are wet, as when you’re caught out in the rain.Wind.

*Wind removes body heat by carrying away the thin layer of warm air at the surface of your skin. A wind chill factor is important in causing heat loss. For example, if the outside temperature is 32 F (0 C) and the wind chill factor is minus 15 F (minus 26 C), your body loses heat as quickly as if the actual temperature outside were minus 15 F (minus 26 C).

Risk Factors:
A number of factors can increase the risk of developing hypothermia:

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*Older age. People age 65 and older are more vulnerable to hypothermia for a number of reasons. The body’s ability to regulate temperature and to sense cold may lessen with age. Older people are also more likely to have a medical condition that affects temperature regulation. Some older adults may not be able to communicate when they are cold or may not be mobile enough to get to a warm location.

*Very young age. Children lose heat faster than adults do. Children have a larger head-to-body ratio than adults do, making them more prone to heat loss through the head. Children may also ignore the cold because they’re having too much fun to think about it. And they may not have the judgment to dress properly in cold weather or to get out of the cold when they should. Infants may have a special problem with the cold because they have less efficient mechanisms for generating heat.

*Mental impairment. People with a mental illness, dementia or another condition that impairs judgment may not dress appropriately for the weather or understand the risk of cold weather. People with dementia may wander from home or get lost easily, making them more likely to be stranded outside in cold or wet weather.Alcohol and drug use.

*Alcohol may make your body feel warm inside, but it causes your blood vessels to dilate, or expand, resulting in more rapid heat loss from the surface of your skin. The use of alcohol or recreational drugs can impair your judgment about the need to get inside or wear warm clothes in cold weather conditions. If a person is intoxicated and passes out in cold weather, he or she is likely to develop hypothermia.

*Certain medical conditions. Some health disorders affect your body’s ability to regulate body temperature. Examples include underactive thyroid (hypothyroidism), malnutrition, stroke, severe arthritis, Parkinson’s disease, trauma, spinal cord injuries, burns, disorders that affect sensation in your extremities (for example, nerve damage in the feet of people with diabetes), dehydration and any condition that limits activity or restrains the normal flow of blood.

*Medications. A number of antipsychotic drugs and sedatives can impair the body’s ability to regulate its temperature.

Diagnosis:-
Accurate determination of core temperature often requires a special low temperature thermometer, as most clinical thermometers do not measure accurately below 34.4°C (94°F). A low temperature thermometer can be placed rectally, esophageally, or in the bladder. The classical ECG finding of hypothermia is the Osborne J wave. Also, ventricular fibrillation frequently occurs at <28°C (82.4°F) and asystole at <20°C (68°F). The Osborn J may look very similar to those of an acute ST elevation myocardial infarction. Thrombolysis as a reaction to the presence of Osborn J waves is not indicated, as it would only worsen the underlying coagulopathy caused by hypothermia.

As a hypothermic person’s heart rate may be very slow, prolonged palpation could be required before detecting a pulse. In 2005 American Heart Association recommended at least 30 – 45 seconds to verify the absence of a pulse before initiating CPR.

Most physicians are recommended not to declare a patient dead until their body is warmed to a normal body temperature, since extreme hypothermia can suppress heart and brain function.

Treatment:-
Aggressiveness of treatment is matched to the degree of hypothermia. Treatment ranges from noninvasive, passive external warming, to active external rewarming, to active core rewarming. In severe cases resuscitation begins with simultaneous removal from the cold environment and concurrent management of the airway, breathing, and circulation. Rapid rewarming is then commenced. A minimum of patient movement is recommended as aggressive handling may increase risks of a dysrhythmia.

Hypoglycemia is a frequent complication of hypothermia, and therefore needs to be tested for and treated. Intravenous thiamine and glucose is often recommended as many causes of hypothermia are complicated by Wernicke’s encephalopathy

Rewarming
Rewarming can be achieved using a number of different methods including passive external rewarming, active external rewarming, and active internal rewarming. Passive external rewarming involves the use of a person’s own heat generating ability through the provision of properly insulated dry clothing and moving to a warm environment. It is recommended for those with mild hypothermia. Active external rewarming involves applying warming devices externally such as warmed forced air (a Bair Hugger is a commonly used device). In austere environments hypothermia can sometimes be treated by placing a hot water bottle in both armpits and groin.  It is recommended for moderate hypothermia. Active core rewarming involves the use of intravenous warmed fluids, irrigation of body cavities with warmed fluids (the thorax, peritoneal, stomach, or bladder), use of warm humidified inhaled air, or use of extracorporeal rewarming such as via a heart lung machine. Extracorporeal rewarming is the fastest method for those with severe hypothermia.

Intravenous fluids:
As most people are moderately dehydrated due to hypothermia induced cold diuresis, intravenous fluids are often helpful ( 250-500 cc 5% dextrose and normal saline warmed to a temperature of 40-45 C is often recommended ).

Rewarming collapse:
Rewarming collapse (or rewarming shock) is a sudden drop in blood pressure in combination with a low cardiac output which may occur during active treatment of a severely hypothermic person. There is theoretical concern that external rewarming rather than internal rewarming may increase the risk. However, recent studies have not supported these concerns.

Prognosis:-
There is considerable evidence that children who suffer near-drowning accidents in water near 0°C (32°F) can be revived over an hour after losing consciousness. The cold water lowers metabolism, allowing the brain to withstand a much longer period of hypoxia. While survival is possible, mortality from severe or profound hypothermia remains high despite optimal treatment. Studies estimate mortality at between 38% – 75%. If there are obvious fatal injuries or chest is too frozen, compression resuscitation is futile

Prevention:
The Government offers extra support for some of the most vulnerable people in the form of winter fuel payments, to help keep their homes warm.

Other ways to prevent hypothermia include:
•Stay indoors as much as possible and limit your exposure to the cold
•Eat regularly and include plenty of carbohydrates (the body needs a reliable and constant energy supply to generate heat)
•Keep as active as possible
•Avoid alcohol – it causes dilation of peripheral blood vessel, increasing heat loss
•Avoid caffeine – it’s a diuretic and increases the risk of dehydration, which aggravates heat loss
•Avoid nicotine – it constricts blood vessels and increases the risk of cold damage such as frostbite
•Wear multiple thin layers of clothing that help to trap air layers and hence traps heat, rather than one thick jumper
•If you go outside, always wear a hat (it can prevent as much as 20 per cent of heat loss), scarf and gloves
•Take a flask of caffeine-free hot drink with you, and click-activated heat pads you can keep in your pockets to set off when you need them

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/hypothermia1.shtml
http://www.mayoclinic.com/health/hypothermia/DS00333
http://en.wikipedia.org/wiki/Hypothermia

http://trialx.com/curebyte/2011/05/22/clinical-trials-and-images-of-hypothermia/

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Running Shoes May Damage Your Knees & Hips

Finally got that new pair of running shoes? Well, before you get down to taking them on the jogging track, here’s a piece of information—running shoes are likely to damage knees, hips and ankles.

…………..
In a study, researchers compared the effects on knee, hip and ankle joint motions of running barefoot versus running in modern running shoes.

They concluded that running shoes exerted more stress on these joints compared to running barefoot or walking in high-heeled shoes.

Sixty-eight healthy young adult runners (37 women), who run in typical, currently available running shoes, were selected from the general population. None had any history of musculoskeletal injury and each ran at least 15 miles per week.

All runners were provided with a running shoe, selected for its neutral classification and design characteristics typical of most running footwear. They observed each subject running barefoot and with shoes using a treadmill and a motion analysis system.

The researchers observed increased joint torques at the hip, knee and ankle with running shoes compared with running barefoot.

Disproportionately large increases were observed in the hip internal rotation torque and in the knee flexion and knee versus torques.

An average 54 pct increase in the hip internal rotation torque, a 36 pct increase in knee flexion torque, and a 38 pct increase in knee varus torque were measured when running in running shoes compared with barefoot.

The findings confirmed that while the typical construction of modern-day running shoes provides good support and protection of the foot itself, one negative effect is the increased stress on each of the 3 lower extremity joints.

These increases are likely caused in large part by an elevated heel and increased material under the medial arch, both characteristic of today’s running shoes.

“Remarkably, the effect of running shoes on knee joint torques during running (36pc-38pc increase) that the authors observed here is even greater than the effect that was reported earlier of high-heeled shoes during walking (20pc-26pc increase). Considering that lower extremity joint loading is of a significantly greater magnitude during running than is experienced during walking, the current findings indeed represent substantial biomechanical changes,” said lead author D. Casey Kerrigan, JKM Technologies LLC, Charlottesville, VA, and co-investigators.

Kerrigan concluded: “Reducing joint torques with footwear completely to that of barefoot running, while providing meaningful footwear functions, especially compliance, should be the goal of new footwear designs.”

Source :
The study has been published in the latest issue of PM&R: The journal of injury, function and rehabilitation .

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Throw Away Your Shoes

Wearing shoes alters the shape and normal functioning of the feet, researchers have found.
…………………..BARE FOOT WALKING
Barefoot walkers in south India, who have never worn a pair of shoes or sandals in their entire lives, are teaching a lesson or two about footwear — that constantly using shoes alters the normal form and function of the foot, and that this may even lead to the development of an undesirable peak pressure under the sole, which in some cases could become life threatening.

Nearly 100 barefoot walkers from the interiors of Mandya, Kolar and Bangalore districts in Karnataka, India, left a footprint in the world of academics when a multinational team of researchers from Belgium, India and the UK descended on them to record their footfall.

Team leader Kristiaan D’Aout, a biologist at the University of Antwerp in Belgium, had always wanted to study the changes that footwear brings to the human feet. The idea was to gain an insight into normal foot functioning, which has evolved over millions of years.

However, with no barefoot walkers in Europe, D’Aout was forced to keep the idea in cold storage until he met Vinaya Anand Suratkal, a doctor from the Bangalore-based Jain Institute of Vascular Sciences (JIVAS), at a conference in Vienna about two years ago. JIVAS, which is part of the Bhagawan Mahaveer Jain Hospital in Bangalore, runs a mobile clinic that travels to rural areas in and around Bangalore to screen and treat those suffering from foot ulcers associated with diabetes.

The study, which won this year’s Nike Research Award — instituted by the sports goods giant Nike — studied the morphology and biomechanical functions of the feet in three distinct healthy populations: barefoot walkers, habitually shod Indians, and Europeans who have always worn footwear. It found that barefoot walkers have a relatively wider forefoot and the pressure is distributed more evenly over the entire surface of the sole than in the other two groups.

Habitually shod Indians wear shoes less often than Westerners do. Also, their shoes are less constraining. Yet, the scientists found significant differences when compared to their habitually barefoot peers, both in the foot shape and pressure distribution.

“The evolutionary history of humans shows that barefoot walking is the natural situation,” D’Aout told KnowHow. While the use of shoes remains a necessity when one walks on unsafe surfaces and in athletics, footwear fails to respect the natural shape and function of the feet.

The researchers hope that the findings will not only help clinicians who treat foot ulcers, but will also lead to the designing of better footwear that will not hamper the feet’s biologically normal functions.

D’Aout’s chance meeting with Vinaya, who was in Vienna to present a paper on the work being done at JIVAS, seemed like a golden opportunity to the Belgium biologist. Realising that many in India still do not wear shoes for religious or financial reasons, he decided to collaborate with the researchers at JIVAS. “Kristiaan approached us with his idea and we thought it was fascinating,” says Kalkunte R. Suresh, director of JIVAS. “When our mobile van goes into the villages, the patients generally do not come alone; they are accompanied by a few other healthy relatives. We requested these healthy individuals, who have never worn shoes or sandals in their life, to participate in the study and walk on a foot scanner,” says Suresh.

D’Aout is not saying that people shouldn’t wear footwear. “Footwear is a wonderful invention. But the human foot is adapted to barefoot walking,” he says.

The study has shown that wearing shoes lifelong leads to an increase in peak pressure under the sole. “This is certainly bad in some people (it causes ulceration in diabetes patients), and it remains to be seen whether it is a real problem in healthy people. It does make sense to have low pressures though, but nobody knows exactly if there is, for example, a threshold value of pressure that should not be exceeded,” he explains.

“We have shown that footwear does change the foot, and so it makes sense to walk barefoot every now and then (at least for healthy people and, of course, ensuring that the walking surface is safe),” adds D’Aout. This, he says, will keep the feet in shape and the muscles trained.

According to D’Aout, people in India have better footwear habits than those in the West. They often wear open shoes and wear them less often (for example, many prefer to walk barefoot in the house). Besides, children too mostly walk barefoot.

The study also found that wearing shoes throughout makes one’s feet narrower and leads to poor load distribution. Besides, it is better not to wear shoes that constrain the toes (like do some fashionable women’s footwear) or are overly protective (like mountaineering boots) for everyday use.

So be careful about what footwear you use, and when to fling them off. Go ahead, just do it.

Source:
The Telkegraph (Kolkata, India)

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Pigeon Pose (Yoga Exercise)

Yoga Pigeon Pose Stretches Hip Muscles After Workout:

If you perform regular squats and lunges in your workouts, be sure to include a hip stretch at the end of your routines. This popular yoga position, the pigeon pose, will help loosen your hips and keep your buttock muscles flexible. If you’re very tight in your hips, use a yoga block to support your weight; it will make holding the stretch more comfortable.

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Yoga Pigeon Without Block: Begin on your hands and knees. Bring your right knee forward to the floor near your right hand and bring your right heel to the floor in front of your left hip. Keep your hips level and squared to the front. Press down into your hands and slide your left leg behind you with your left knee facing the floor. Lower your groin toward the floor. Raise your chest away from the floor and relax the right side of your buttocks as you hold this position for 20 to 30 seconds. Repeat on the other side.

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Yoga Pigeon With Block: Begin on your hands and knees. Bring your right knee forward to the floor near your right hand and bring your right heel to the floor in front of your left hip. Place a yoga block under your right hip. Keep your hips level and squared to the front. Extend your left leg behind you with your left knee facing the floor. Place a towel under your knee for extra cushioning. Raise your chest away from the floor and relax as you hold this position for 20 to 30 seconds. Repeat on the other side.

Sources:Los Angeles Times

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Hypothermia

Definition:
Hypothermia is a condition in which an organism’s temperature drops below that required for normal metabolism and bodily functions. In warm-blooded animals, core body temperature is maintained near a constant level through biologic homeostasis. But when the body is exposed to cold its internal mechanisms may be unable to replenish the heat that is being lost to the organism’s surroundings....click & see

Hypothermia is the opposite of hyperthermia, the condition which causes heat exhaustion and heat stroke.

Hypothermia occurs when the body’s core temperature is lowered due to exposure to cold. It can occur even at mild temperatures if exposure is prolonged.

The body’s natural defences against the cold consist of restricting the flow of blood to the skin so as to prevent heat loss, along with shivering and releasing hormones to generate heat.

These measures are limited and are usually inadequate to maintain body temperature in cold environments.

Causes:
The causes vary, and include increased susceptibility to flu and other viruses.
However, hypothermia is one of the most deadly cold-induced conditions and, if not caught and treated early on, can lead to a rapid decline in the body’s ability to function normally.

Unlike other warm-blooded animals that have a layer of fur or blubber to keep them warm, you need an extra layer of clothing to keep you warm when it’s cold outside. Without that extra layer of clothing, more heat escapes from your body than your body can produce. If too much heat escapes, the result is hypothermia. Exposure to cold water and certain medical conditions also can cause hypothermia.

Your normal core body temperature is usually right around 98.6 F. In hypothermia, your body fails to maintain a normal temperature. An internal body temperature of 95 F or lower signals hypothermia.

The cause of hypothermia usually is extended exposure to cold temperatures or a cool, damp environment. Other contributing causes include inadequate clothing and neglecting to adequately cover your extremities, particularly your head — a disproportionate amount of heat is lost through your head.

Hypothermia in milder weather

Hypothermia can happen not just in cold winter weather, when there are low temperatures or low wind chill factors, but under milder conditions as well. A rain shower that soaks you to the skin on a cool day can lead to hypothermia if you don’t move inside to warm up and dry off. If you stay outside, evaporation of the water from your skin further cools your body, lowering your internal temperature. A wind blowing over the wet parts of your body greatly increases evaporation and cooling.

An accidental fall into cold water is especially likely to lead to hypothermia. Hypothermia may develop within minutes of being exposed to cold water, or it may take several hours, depending on the water temperature. Water doesn’t have to be icy cold to cause hypothermia. Your body loses heat more quickly in water than in air. Any water temperature lower than your body temperature causes your body to lose at least some heat.

Click to see:->How We Lose Heat to the Environment

Symptoms:
Symptoms take effect in three stages.

Normal body temperature in humans is 37°C.

The first stage – mild hypothermia – is characterised by:

* Bouts of shivering;
* Grogginess and muddled thinking.

In stage 1, body temperature drops by 1-2°C below normal temperature (35-38°C). Mild to strong shivering occurs.The victim is unable to perform complex tasks with the hands; the hands become numb. Blood vessels in the outer extremities constrict, lessening heat loss to the outside air. Breathing becomes quick and shallow. Goose bumps form, raising body hair on end in an attempt to create an insulating layer of air around the body (which is of limited use in humans due to lack of sufficient hair, but useful in other species). Often, a person will experience a warm sensation, as if they have recovered, but they are in fact heading into Stage 2. Another test to see if the person is entering stage 2 is if they are unable to touch their thumb with their little finger; this is the first stage of muscles not working.

Indicators of moderate hypothermia are:

* Violent shivering or shivering which suddenly stops;
* Inability to think and pay attention;
* Slow, shallow breathing;
* Slow, weak pulse.

In stage 2, body temperature drops by 2-4°C. Shivering becomes more violent. Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim may appear alert. Surface blood vessels contract further as the body focuses its remaining resources on keeping the vital organs warm. The victim becomes pale. Lips, ears, fingers and toes may become blue.

Severe hypothermia has set in when:

* Shivering stops;
* The patient loses consciousness;
* There is little or no breathing;
* Pulse is weak, irregular or non-existent.

In stage 3, body temperature drops below approximately 32 °C (89.6 °F). Shivering usually stops.[1][2] Difficulty speaking, sluggish thinking, and amnesia starts to appear; inability to use hands and stumbling is also usually present. Cellular metabolic processes shut down. Below 30 °C (86.0 °F), the exposed skin becomes blue and puffy, muscle coordination becomes very poor, walking becomes almost impossible, and the victim exhibits incoherent/irrational behavior including terminal burrowing or even a stupor. Pulse and respiration rates decrease significantly but fast heart rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail. Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia, the body will actually take longer to undergo brain death.

Immersion Hypothermia
Hypothermia of both the extremities and body core continues to be a major limitation to diving in cold water. Cooling in the extremities is often the limitation to operations. The fingers decrease dexterity due to pain or numbness, safety, work capacity, and increase the risk of developing nonfreezing cold injury.

In divers breathing heliox below 100 meters wearing hot water suits, the inspired gas must be heated or the symptoms of hypothermia can set in without the divers realizing it.

Other predisposing factors leading to immersion hypothermia include dehydration, inadequate rewarming with repetitive operations, starting operations while cold, wet dry suit undergarments, sweating with work, inadequate thermal insulation (ex. thin dry suit undergarment), lack of heated breathing gas with deep heliox diving, and poor physical conditioning.

Risk factors:
Being in extreme cold, wearing wet clothes — especially in the presence of wind — and being in cold water can all play a part in increasing your chances of hypothermia. In addition, other factors make you more vulnerable:

* Advanced age. People age 65 and older are especially vulnerable because they may have other illnesses or take medications that can interfere with the body’s ability to regulate temperature.
* Very young age. Children usually lose heat faster than adults do. Children have a larger head-to-body ratio than adults do, making them more prone to heat loss through the head. Children may also ignore the cold because they’re having too much fun to think about it. And they may not have the judgment to dress properly in cold weather or to get out of the cold when they feel cold. Infants may have a special problem with the cold because they have less efficient mechanisms for generating heat.
* Mental impairment. People with Alzheimer’s disease or another illness that causes mental impairment may not be aware of the risks of being out in the cold. Wandering is not uncommon among people with Alzheimer’s, and some affected people may stray away from home and be unable to find their way back on their own. Being stranded leaves them vulnerable to the weather.
* Alcohol and drug use. Alcohol may make your body feel warm inside, but it lowers your body’s ability to retain heat. Both alcohol and drugs such as marijuana can keep your blood vessels dilated, restrict your shivering response, impair your judgment and alter your awareness of weather conditions.
* Certain medical conditions. Some health disorders affect your body’s ability to respond to cold or to produce heat. Examples include untreated underactive thyroid (hypothyroidism), stroke, severe arthritis, Parkinson’s disease, trauma, spinal cord injuries, burns, blood vessel or nerve disorders that affect sensation in your extremities (for example, peripheral neuropathy in people with diabetes), dehydration and any condition that limits activity or restrains the normal flow of blood. Older adults are more likely to have one or more of these risk factors.
* Water conditions. Factors contributing to your risk of hypothermia in cold water include the temperature of the water and the length of time you spend in it. Rescue time is crucial when a person accidentally falls into cold water. Chances of survival are affected by how cold the water is: The colder the water, the less the chance of survival.

Treatment:
The first step is to contact the emergency services as extreme hypothermia requires urgent professional attention.

All cold, wet clothing should be replaced with warm, dry clothing to prevent further heat loss immediately.

If breathing has stopped or there is no pulse, cardiopulmonary resuscitation (CPR) should be attempted until the emergency services arrive.

Rapid rewarming with hot water or massaging cold extremities should be avoided as, if done improperly, it could lead to serious tissue damage.

Do not give alcohol or nicotine products to someone suffering from hypothermia.

Complications:
Complications depend on how low your body temperature falls. If you’re in water, you may lose consciousness and drown before your temperature drops low enough to cause death by hypothermia. Other complications of hypothermia may include:

* Frostbite
* Loss of limbs
* Coma

The lower your core body temperature, the greater your chance of complications and permanent damage.

 

First aid to Hypothermia patient…...click & see

.Prevention:
The key rules are to wear many layers of clothing, drink plenty of fluids and hot drinks (but not alcohol) and keep well nourished.

Wearing cotton in cool weather is a particular hypothermia risk as it retains water, and water rapidly conducts heat away from the body. Even in dry weather, cotton clothing can become damp from perspiration, and chilly after the wearer stops exercising. Synthetic and wool fabrics provide far better insulation when wet and are quicker to dry. Some synthetic fabrics are designed to wick perspiration away from the body. In air, most heat (20 to 40 percent) is lost through the head; covering the head and neck is quite important in reducing the likelihood of hypothermia.

Heat loss on land is very difficult to predict due to multiple variables such as clothing type and quantity, amount of insulating fat on the victim, environmental humidity or personal dampness such as after exertion, the circumstances surrounding the hypothermic episode and etc. Heat is lost much faster in water, hence the need for wetsuits or drysuits in cold-weather activities such as kayaking. Water temperatures that would be quite reasonable as outdoor air temperatures can lead to hypothermia very quickly. For example, a water temperature of 10 degrees Celsius (50 F) can be expected to lead to death in approximately 1 hour, and water temperatures hovering at freezing can lead to death in as little as 15 minutes. But in water, even a temperature as high as 80 degrees Fahrenheit may eventually lead to hypothermia.

Alcohol consumption prior to cold exposure may increase one’s risk of becoming hypothermic. Alcohol acts as a vasodilator, increasing blood flow to the body’s extremities, thereby increasing heat loss. Ironically, this may cause the victim to feel warm while he or she is rapidly losing heat to the surrounding environment.

The United States Coast Guard promotes using life vests as a method of prevention against hypothermia through the 50/50/50 rule: if someone is in 50-degree water for 50 minutes they have a 50 percent better chance of survival if they are wearing a life jacket

Maintaining movement to keep circulation up is also advised.

Age Concern advises keeping at least one room well-heated during the winter months.

Is help available?
Age Concern runs a Be a Good Neighbour scheme during winter.

The scheme calls on people to be aware of elderly people living nearby and to help out with routine tasks.

Dr Simon Fradd, of the Doctor Patient Partnership, said: “Helping collect prescriptions, getting prescriptions or just making time for a chat are a few simple ways we can help.”

More details can be obtained from Age Concern’s freephone line on 0800 00 99 66.
Benefits
There is considerable evidence that children who suffer near-drowning accidents in water near 0°C (273 K) can be revived over an hour after losing consciousness. The cold water considerably lowers metabolism, allowing the brain to withstand a much longer period of hypoxia.

Medically induced
Induced hypothermia (also known as therapeutic hypothermia) is the intentional induction of hypothermia for medical purposes. Such practice has been shown to reduce brain damage in infants and increase survivability in certain cases of cardiac arrest. The method also has applications in cardiac surgery and stroke recovery.
Hypothermia being induced by using water circulated through heat-conducting pads

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Hypothermia may be a consequence of anesthetic induction drugs and occurs to some extent every time an anesthetic is given. Anesthetic drugs produce two different effects that lead to hypothermia during surgery: they increase the width of blood vessels, vasodilation, allowing blood to flow easily from the body’s inner organs or core to the periphery or skin. This allows heat to be easily lost or radiated from the body. The temperature control center situated in the hypothalamus is also affected by drugs causing the normal temperature control limits to be increased, compromising the body’s normal cold response system.

Paradoxical undressing
20% to 50% of hypothermal deaths are associated with a phenomenon known as paradoxical undressing. This typically occurs during moderate to severe hypothermia as the victim becomes disoriented, confused, and combative. The hypothermic victim may begin discarding the clothing he or she has been wearing, which in turn increases the rate of temperature loss. There have been several published case studies of victims throwing off their clothes before help reached them.

Rescuers who are trained in mountain survival techniques have been taught to expect this effect. However, the phenomenon still regularly leads police to assume incorrectly that urban victims of hypothermia have been subjected to a sexual assault.[citation needed]

One explanation for the effect is a cold-induced malfunction of the hypothalamus, the part of the brain that regulates body temperature. Another explanation is that the muscles contracting peripheral blood vessels become exhausted (known as a loss of vasomoter tone) and relax, leading to a sudden surge of blood (and heat) to the extremities, fooling the victim into feeling warm.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://news.bbc.co.uk/2/hi/health/medical_notes/276284.stm
http://en.wikipedia.org/wiki/Hypothermia
http://www.mayoclinic.com/health/hypothermia/

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