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Hypothermia, a silent threat 

 With the colder time of the year approaching fast, we should familiarize ourself with the possible threat of Hypothermia. Besides shoulder or back injuries, Hypothermia is probably the greatest paddle-specific hazard, and responsible for more paddle related deaths (directly or indirectly) than any other hazard. Often hypothermia is not taken seriously and is treated lightly. It shouldn't be! Hypothermia can kill, and does so regularly.

I grew up in Europe close to the Alps, and went climbing and mountaineering all year round. For years I was unable to fathom people who died 100m away from a mountain hut, or Amundsen the polar explorer, who after such a long march died a mile away of his fuel & food depot. I always thought ha- if I have to, I always can walk another 100 meters, especially when my life depends on it! Wrong- you can't. What I didn't understand was how Hypothermia affects your thinking process and your ability to  make judgements or rational decisions. Then it happened to me: We (= me and 2 friends, both qualified as mountain guides) went on a 2 day hike through the snow in the upper German/Austrian Alps.


To cut a long story short, the conditions changed and we ended up on a 45° slope, about 100 meters high, covered in 2meters of powder snow. On the ridge above was the safety & warmth of a hut. We could see the lights, but had already been struggling with the weather conditions for about 10 hours. We had to get up to the hut, but for every step forward, we slipped 2 back. We were cold. We were hungry & totally exhausted. It was blowing a gale. We had only 100 steep meters to go. Uli and I made it about half way up, Robert 10m further, then we just collapsed in the snow. We could hear voices from the hut, and smell the fire. But we couldn't move. We were too exhausted and, ( although we were not aware of it) suffering from worsening Hypothermia. We just sat there, getting colder, but it didn't bother us in the least. The colder we got, the less we cared.

I got a bit tired but didn't feel that cold any more. We were totally lethargic, awaiting our fates,  sort of aware that we might die that night- but we couldn't have cared less! We giggled and laughed a lot. We actually sat there, laughing about the fact that we would die and not see the sun again, and found it funny. Suddenly after maybe one or one and a half hours Robert had sort of a “bright moment”,  got rid of his backpack, and started to crawl on all four up the hill, screaming “I'm not going to die today!”, and later for “Help!” He made it half way up the remaining slope, when somebody from the hut having a leak outside heard his fading screams, got his friends, and found him / us on the slope below.

They came to our rescue and dragged us into the hut to the fire, warmed & fed us. I was a very lucky H that evening!! They saved our lives! Today I find it hard again to understand how it could have come that far. But Hypothermia creeps up slowly. And the more it affects you, the more vulnerable you become, because you often don't realize it yourself. Hypothermia totally jeopardises your ability to make a proper, clear and logical decision. It's like being drunk ( in a bad way ).

Don't be fooled now and think: OK,  he was sitting in snow, and I live in Australia, the hottest continent in the world. Cool winter water and wind(chill) can easily create conditions, which can put paddlers in Australia at risk. What I'm saying is take hypothermia seriously, and check on your mates as well-  they might not be right. The typical victim is wet, hungry, cold and exhausted. If somebody shows early signs of hypothermia get him back to land, NOW- Right away!

The early signs are things like:
-Shivering
-Erratic paddling and a inability to maintain course or speed
-Lack of coordination, balance or articulation
-Uncontrollable shivering, blue lips, pale appearance as well as blurred vision
-Acting spacey or “slow” and being unable to perform even simple tasks.
More serious signs:
-Apparent inability to get warm
-Muscle rigidity, replacing previous shivering
-Incoherence or collapse, weak pulse and breathing
-Unconsciousness, and finally death

Treatment:
Get a hat on the victim ( one third of warmth is lost via the head alone), dry & dress him warmly , and make sure he doesn't loose any more heat. Pack the victim in a sleeping bag, blanket or what ever is available. When the victim can eat & drink give him some warm drink and energy food. A mate acting as a “warming bottle” by stripping most clothes off and cuddling up in the sleeping bag is of great value. Otherwise heat packs can be applied to the neck, the sides of the chest, or the groin area only. Never supply any form of alcohol.

A strongly hypothermic or even unconscious person is strictly a stretcher patient. Stop heat loss. Avoid any unnecessary movement or rubbing, as well as food or warm drinks. Avoid anything which might start the circulation in the patient's extremities. The cold blood of the extremities could run back into the body and drop the core temperature even further, causing heart failure. Never try to warm up a critically hypothermic person yourself. Get professional help as soon as possible!
Also keep in mind that it doesn't help anybody if you give the patient all your clothes, and as a result you become hypothermic yourself.

Prevention:
Dress right, wear a hat if it is cool, watch the wind if you're wet.
Put something on before you feel cold and start to shiver.
Eat and drink enough to feed your metabolism, and keep active; stop, and you cool down.
Always dress for submersion, not air temperature, it's easier to cool off (dip in), than to keep warm in the water. Remember, you can paddle yourself warm, but you can't swim yourself warm. If you are submerged in water (away from your kayak), move as little as possible, otherwise you'll loose your body temperature quicker, and burn important energy.
Survival Times in cold water:
Water has a 20times higher heat conduction ability than air. In water-temperatures over 20° Celsius you should be right for a while. Below that your survival times are:
-less than 12 hours at 15°-20°C
-less than 6 hours at 10°-15°C
-1 to  3 hours at 3°-10°C

Below 2° you've go less than 45 minutes. These are survival times with a lifevest keeping you and your head over water. Unconsciousness or inability to move will come much, much sooner, in water under 5°C actually within minutes.

In cold water (below 10°C) you've got an even deadlier cousin of Hypothermia: the Cold Water Shock, a physiological reaction to sudden submersion in cold water. It often kills within a couple of minutes to a maximum of half an hour, and leaves you unable to swim just 3meters to safety, or hold on to something. You can somewhat train your body to accept the cold water, but that is no guarantee that it won't happen to you, it just increases your chances.
So: Dress right and you'll be right!