Hypothermia and heat illness

Aging,  April-May, 1984  by W. Moulton Avery

• E-mail
• Print
• Link

The Stress of Hot and Cold

Summer's heat and winter's chill are physically stressful. Tens of thousands of older Americans have died from heat and cold related medical problems in recent years, and the message, Hot and Cold Weather Spell Danger, has become the cornerstone of a national campaign initiated by the Administration on Aging and the American Gas Association to educate older Americans about ways to prevent heat and cold stress.

Cold stress can worsen many pre-existing conditions, such as arthritis, and compromise an older person's ability to live at home. Cold can result in serious injury from frostbite and death from hypothermia. Heat stress is equally dangerous. It can cause a number of medical problems, such as heat exhaustion, heat stroke, heat-induced heart failure and stroke. Our Natural Defenses

The human body has a remarkable system for defending itself against environmental stress, but many older people lack the physical stamina to fight the battle for an extended period of time. Furthermore, many disabilities, diseases and prescription medications can compromise or weaken the body's natural defenses and increase their vulnerability to heat or cold stress. When natural defenses are weak, exposure to even relatively mild heat or cold can be lethal.

Greater public awareness of hypothermia, heat illness, and the techniques of prevention could save thousands of lives each year becuase medical problems caused by heat and cold stress are preventable. Hypothermia and Cold Exposure

The term hypothermia means low body temperature (medically defined as below 95 [deg.]F). Hypohtermia is not contagious. It is an accidental and preventable illness which is caused by exposure to cold. The average normal body temperature 98.6 [deg.]F (36[deg.C) measured with an oral thermometer. A high body temperature (eg. 104 [deg.]F) is well known as a fever. In many ways, hypothermia is just the opposite of a fever.

Hypothermia occurs when body heat is lost to a cool or cold environment faster than it can be replaced. As the body temperature falls, judgment and physical coordination are impaired and the heard becomes weak and vulnerable. Most people would consider an 85 [deg.]F summer afternoon to be comfortably warm, but an 85 [deg.]F body temperature is very dangerous because of the great potential for sudden heart failure.

We often hear of people "freezing to death," but temperatures do not have to fall below freezing to cause hypothermia. Most elderly victims become ill in their own homes at temperatures between 50 [deg] and 65 [deg]F, as a result of exposure to relatively mild cold which would only produce discomfort in other people.

Mild cold exposure cannot cause hypothermia in most people because the body meets the challenge of cold with a vigorous defense which produces and conserves enought heat to keep warm. For many older people, however, this natural defense system is weak, and their bodies have less ability to sense exposure to cold and to produce and conserve body heat. Recognizing Hypothermia

Hypothermia is impossible for the victim to detect because it dulls the mind, and prevents the person from recognizing the danger in time to seek help. When the body temperature falls, judgment and mental clarity fall as well. Outside help is necessary to spot the problem and reverse the downward trend. It is precisely for these reasons that awareness of the potential danger of cold stress and knowledge of the techniques of prevention are so important.

Hypothermia is not easy to recognize. Family members often report that the only "unusual" thing they noticed was a growing lack of energy and confusion on the part of the victim, which developed gradually over one-half to two or three days. Many older people die in their own homes without ever reaching the hospital, because hypothermia is often overlooked or dismissed as simple disorientation, lack of coordination or confusion. What to look for

Look for changes in appearance and behavior during cool or cold weather. Use the following checklist:

If an older relative or friend develops the following signs over a period of several hours or days--especially if temperatures have been cool or cold -- it could mean that they are suffering from hypothermia.

* Confusion

* Difficulty Speaking

* Shivering

* Slow Breathing or Heart Rate

* Sleepy and Hard to Wake Up

* Cold, Stiff Muscles

* Poor Coordination

* Puffy Face

* Stomach Cold to touch

* Forgetfulness

* Trembling on One Side of the Body or in One Arm or Leg Measuring Body Temperature

The only sure way to tell if someone has hypothermia is to take the body temperature. Most people are familiar with using thermometers to determine if someone has a fever, but few people are aware that "fever thermometers" are not designed to detect and monitor hypothermia. The accurate detection and monitoring of a hypothermia victim's low body temperature requires a special thermometer. Hypothermia thermometers are specifically designed to detect low body temperatures, and they are inexpensive and relatively easy to obtain. Giving Proper First Aid