Wilderness Medicine: Mild vs. Severe Hypothermia

Mild vs. severe hypothermia and key differences in recognition and treatment with Dr. Donner. This is video 4 of 7 in the hypothermia series.
See Dr. Donner's live speaking schedule at www.wilderness-medicine.com/
MedWild provides wilderness medicine, wilderness survival, and search and rescue instructional videos on a variety of topics: high altitude illness, traveler’s diarrhea, shoulder dislocation and reduction, shelter building, bushcraft, space blankets, hypothermia, medical kits, survival kits, frostbite, snake bites, fire craft, ropes and knots, orthopedic injuries and sam splints, cold water immersion and more.
Instructor: Howard Donner, MD
Co-Author “Field Guide to Wilderness Medicine”
Served as a physician for Denali National Park, Himalayan Rescue Association, and the 1998 NOVA Everest expedition. Served as a medical operations consultant for NASA for over 5 years. Whitewater rafting guide, commercial pilot, and certified flight instructor.
Recommended Audience: Outdoor enthusiasts and health care professionals including physicians, nurses, search and rescue teams, EMT, paramedics, ski patrol, corpsman, guides, instructors, wilderness first responders, and anyone else interested in educational and “how to” videos on wilderness emergency medicine, travel medicine, search and rescue, expedition medicine, backcountry first aid, wilderness survival training, and military medicine. Dr. Donner’s draws on his extensive backcountry and travel experience to highlight key signs, symptoms, treatments, and improvised techniques and skills.
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MedWild videos featured at: www.wilderness-medicine.com
Produced by Kyle Allred PA-C
Please Note: MedWild Videos are for educational purposes and not intended to replace recommendations by your health care provider.

[@MedWild]

See the instructor in this video (Dr. Howard Donner) present on hypothermia and other topics at the upcoming National CME Conference on Wilderness Medicine. All medical specialities are welcome! wilderness-medicine.com/cme-conferences/santa-fe/

[@quendelf]

Amazingly I got mild hypothermia as a kid from simply being out in the cold too long. It wasn’t in the wilderness at all. I was a skinny 13 year old. We had a huge snow drift in the U.K. that lasted over a week and kids had all gone out to play in the local fields. I didn’t realise how long I’d been out for and also how far I’d walked from home. There were no buses running and this was before I had a mobile phone. I realised I was getting too cold, even though I’d dressed warm. My friends wouldn’t leave. It was as if my body was just telling me “you need to leave”. By that time I’d been out in the cold for probably 4-5 hours. The walk home was about an hour. It was literally when I reach my street that I honestly thought I was dying. It was like my body was screaming at me. I was shivering, could barely speak and couldn’t think clearly. And for some reason all I wanted to do was sit down. I remember all I could do was internally shout to myself “another step, keep going”. My friend actually carried me for the last 10 minutes because I just couldn’t walk anymore. My mom just laughed when I got home and sat me by the fire with a blanket around me. But still to this day I think she underestimated how cold I actually was.

[@progamer_221]

Sis that wasn't hypothermia. If hypothermia was that easy to get, Jennifer Lawrence would prolly be already reduced to atoms. Edit: And not only her tho

[@bellapullman10002]

That is mild hypothermia. Did you not just watch the video? She was in a snow drift for hours shivering and losing motor skills/confusion

[@bellapullman10002]

@@progamer_221 mild hypothermia is easy to get. Severe hypothermia is less common because it involves extreme weather change or being in a cold environment (water, rain or snow) for a prolonged time. Mild hypothermia can turn into severe hypothermia.

[@bellapullman10002]

@@progamer_221 have you had hypothermia before?

[@bellapullman10002]

I had a similar experience with mild hypothermia when I was 15. I was on a mountain hike for a school trip where my 'buddy' ditched me. I ended up being alone on the mountain for about 8 hours in a rainstorm (3°c), I had no map or phone as my buddy had the map. I had not reached the location our class was meeting for lunch and had been walking for hours shivering and in pain. I ended up seeing one tourist who was telling me to go to the village for help cause I was lost and probably not making any sense at this point but I was determined to get to the lakes to meet with my class. After he left, I continued walking for another couple of hours shivering before I finally got to the intersection for the lakes and the village/hut. I turned to go to the lakes where it was steep rocks and hazy rain so I couldn't see anything. I walked for about half an hour until I started to think about death and the shivering was starting to stop. At this point I turned back and decided i had to get to the village for help but it was about 4 hours away and i barely had any energy left in me at this point. I had reached a river when a bunch of people were shouting out to me, I was in a pretty bad state at this point so I couldn't understand them and they were just blurry figures. I then realised they were some boys from my class who were asking if I was okay. They put the fire on and we sat around it for a while warming up and then we ended up walking to the village instead of the hut where we were staying because it had gotten dark and one of the guys had hurt his foot where we rang our teacher up and he came to pick us up.

[@justinljr3798]

Had a scare while hiking 1 week on the CDT 2 years ago. My 110 lb 20 year old daughter and my best friend with her 100 lb 17 year old son were with me. We hit a peak late in the day but could not find a good spot to camp. As we watched nasty clouds approach, we all decided to 'take a chance' and get to the other side vs going back down the way came to camp. Bad choice (lesson learned), the kids were over and on the other side waiting for us old ladies for at least an hour. It hailed, snowed, blew, sleet...you name it. When I got to the kids, my Godson was nearing severe hypothermia. He & my daughter were huddled under a poncho waiting for us. My daughter told us that a group had gone by, stating that a trail crew was not far up the trail with hot drinks & warm shelters. Now.....my first instinct was to set up his tent, get him inside, get his wet clothes off, get hot drinks in him. However....I made the WRONG choice of going to find this trail crew. BAD BAD mistake. 'Not far up the trail' ended up being many more miles, in bad weather, on an unmarked trail. We got lost multiple times. Once we found the trail, the other two were in mild hypothermia. I immediately set up our tents.... threw everyone in, got a fire going, hung up their clothes, hot drinks in them, etc. It was THEE scariest thing ever! The next morning, nothing was dry (of course) everyone but me was sick and cold. We were startled to find that I had picked a camp next to a cliff in the pitch black of the night. I left camp while they packed their gear and fast walked to the trail crew (around 1.5 miles) and got us a ride out. They all recovered nicely on the slow, but warm & sunny hike behind me. Now, besides my two obvious mistakes of camping sooner; what else could I have done if it had 'gone south'?

[@thestillthrill1166]

Paramedic school said dont go skin to skin. If I was in a rescue situation I would not want to transfer my heat to someone else and then we are both cold. Heat will move from an area of high heat to an area of low heat till the two heat sources are equal.

[@warreningram6039]

I just wanted to say thank you for these videos. I make my living as a paramedic. It is great to see so many videos with useful information that is easily filtered down to such an understandable, useful level. Now I love in East Tennessee near the Cherokee national forest. So the frost bite isn't something we see a lot of but the hypothermia, among other things, are sometimes overlooked. Great videos from a knowledgeable, down to earth MD!

[@MedWild]

Thanks for the comment, glad the videos are helpful for your life/ career in TN

[@2AKgym]

When I was about 9 , I fell through the ice at a river(It was a small river) and it took me quite a while to get out. I was so terrified. I thought, I would freeze to death. The best strategy is to slowly move towards the shore, and take the wet clothes off, once you get there.

[@amv062184]

I had severe hypothermia several times when I was a teenager, each time I suddenly stopped feeling cold entirely and felt like there was nothing wrong with me.... Now I know why I wasn't allowed to warm up in the van with the rest of the kids when we all got back from hiking, at the time i was angry, I thought that they were being assholes lmao they were actually saving my life.

[@XOXO-mb2vh]

Why didn't they let you warm up?

[@amv062184]

@@XOXO-mb2vh You can't recover from stage 3 hypothermia quickly. It has to be done very slowly over time. Otherwise it will kill you.

[@rhondahoward8025]

Sometimes the hypothermic person will suddenly feel "warm" too (they're not) and start stripping or have a desire to strip. Obviously, this is dangerous. It's kind of similar to how people "feel" warm after drinking alcohol even though alcohol will actually make the problem worse, not better.

[@thomasmorey3936]

I have experienced hypothermia myself. After I stopped shivering I begun to have problems speaking properly and when I got colder I even had problems forming coherent thoughts. I eventually blacked out and those that were around me told me I just stopped. I were apparently given a cup of hot coffee and told to walk in circles, something I can't remember at all (: At the local medic ward they measured a core temp of 32.4ºC or 90.3ºF. I feel I learned a lot experiencing it myself.

[@rhondahoward8025]

I read that caffeine isn't a good choice to give a hypothermic person.

[@Ihlion]

@@rhondahoward8025 Huh, you're right. I didn't know that.

[@XOXO-mb2vh]

Out to lunch. Hmmm. All those off the wall definitions weren't clear.

[@theburpman8006]

One time when I was at risk of suffering from hypothermia and another time when a friend was at risk of suffering from hypothermia. The time I was suffering from hypothermia, I was 14 years old, I was snorkelling in the sea. I was snorkelling in the sea in Spain on a school water sports trip and my snorkelling mask was not secured and slipping off which was getting a lot of sea water in me. I quickly swam to the rocks but I lost control and hit a wave which totally got me wet and I was shivering and struggling to the rock. The woman in a kayak or motorboat came along and got me in the boat and I was shivering so much, the woman undressed me, put a hoodie on me and a towel around my legs. The other occasion I was 15 years old, we was in Norfolk on a field trip for school, me and my friends went for a boat ride. Unfortunately, one of my class peers named Luca, fell into the sea and we all had to help him out of the sea and back into the boat. Luca started getting cold and Charlie, the student driving the boat and managing the situation, ordered me to undress Luca. A lifeboat came out to sea to rescue us and we were in trouble with our teacher and we hung out the town at night when we were not supposed to and got drunk.

[@securemindsetofficial]

As a dutch sar volunteer thank you for sharing your knowledge!

[@runninggirl2765]

I decided to go on a 10 mile run/walk the other day. I am past middle-aged, but have been fit all my life and a life-long runner, etc. It was 28 F and sunny when I headed off with a slight tail wind. Halfway through, the sun went behind the clouds and my hands got very cold. No biggee, my hands get cold a lot and I just rolled my long sleeves over my half gloves. About a mile from home, I started to stumble a little and felt nauseous. Had my end in sight, so no worries, right? Turned my doorknob in to my house with my forearms and sat down. I thought I would warm up quickly, but I didn't. I stumbled to my bed and wrapped up in 4 blankets and shivered hard for 40 minutes, all the while my respiration was up and down, fast and slow. I NOW know I was going from mild to moderate hypothermia. Had NEVER had this before even though I have been on outdoor adventures with -70F temps. Be careful folks. Thanks for the video. Very short and consise. Unlike my notes here.

[@Delfinmar]

These are excellent pieces of info and instruction. Thank you!

[@MedWild]

+Delfinmar Thanks for the comment

[@Delfinmar]

I just re-certified my EMT after 30 year lapse for the exact same reasons...enjoy up country horse camping and life in the wild!

[@fredprobst199]

I just ran across your channel, which is now in my favorites list. Great information. This question may have already been covered and if so, my apologies, but here is the question. I have been told that one way to check for hypothermia is to touch your thumb to your pinkie. If you can't touch them together you are in a state of hypothermia. Is this a good test, and if so, would it be the mild or severe stage? Thank you. - Fred

[@Minnie_Bear]

+MedWild Does muscle pain go along with hypothermia? I remember having a hard time speaking and it seemed like any task that took more then one step (such as pulling out my key, unlocking my door, and turning the knob) seemed to take longer. But I also remember the muscles in my legs hurting so bad I felt like they were going to give out at any second.

[@MedWild]

+MinnieBear Thanks for the question- yes- the peripheral vasoconstriction (reduction of blood flow to your arms and legs to help limit heat loss to the environment) also typically makes extremity use and dexterity more difficult.

[@jeroenvanbroekhoven7325]

MedWild A couple of years ago I was pulled from a military exercise due to hypothermic symptoms. I could not stop shivering, could not pronounce my name and had to think long to remember and pronounce where I was. I had a lot of trouble talking for the next 24-36 hours.. Are those still considered mild symptoms? I'm just curious as to what really was going on. Thanks!

[@MedWild]

Jeroen vanBroekhoven Thanks for the comment. Significant mental changes are more severe symptoms of hypothermia

[@amv062184]

Out to lunch means mental dissasociation.

[@progamer_221]

Actually most doctors don't recomend putting hypothermic persons in hot tub.

[@AirPowered]

So what’s the proper treatment of severe hypothermia...?

[@IceAge20017]

Warm the person slowly. As in don't stick them in a hot tub and don't give them hot liquids. What you should do is get them to a warm area not in water or add extra insulation to them and let their body warm up naturally. If you warm them up too fast it may kill them, and if you try to give them hot liquids they may choke due to the inability to swallow properly.

[@IceAge20017]

95 degrees, not 90.

[@progamer_221]

It's correct 90. Below 90 is severe hypothermia, and between 95 and 90 is mild. I casually have temperatures of 96-97 and that's not hypothermia because I don't have any simptoms. I assume the normal body temperature kind of dropped during human evolution, 98.6 is already fever for me.

[@mrbstube]

Yes i have been snowbording