“Hey Dad, there’s no shelter here.”  This was the report of my oldest daughter, Hannah, after checking out the area where we had planned to camp for the night after an eleven mile hike with three of my children and two of their friends (some 15 years ago).  The temperature was in the low 40’s, a light rain was beginning to fall and it was starting to get dark.  This was not a happy moment.  As it turned out, we had an outdated map which showed shelters at Birch Spring Gap which had in fact been torn down.  Now there were only tent platforms and, you guessed it, we had no tents since we were counting on the shelters.

Soooo, we started hiking on the double trying to get over to Fontana to find some warmth and dryness.  We eventually made it but found only a shelterless parking lot and more rain, dark, and cold.  We had four of the teens huddle for warmth while Hannah and I hiked off into the rain looking for shelter.  Along the way (the eleven mile hike turned into a twenty mile hike for the two of us), Hannah began to shiver uncontrollably with chattering teeth.  Fortunately, she was still able to function, walk and talk fine.  But hours of cold and wetness were taking their toll.  Thankfully we finally came upon a public phone and got ahold of a hiker shuttle that picked us up and got us all to a warm, dry place.  It took a while, but Hannah slowly re-warmed and was none the worse for the wear.

Hannah had started down the path toward hypothermia.  Having spent some years in Vermont and upstate New York, the threat of hypothermia while spending hours or days out of doors was familiar to me.  Here in east Tennessee we are less exposed to this threat.  Still, for the outdoorsy among us, this time of year still deserves a bit of caution in terms of proper dressing and planning.  And, if fact, more people die of hypothermia indoors than outdoors as inadequate household heating is an experience not well tolerated by the elderly.  Over a thousand people die yearly in the U.S. from hypothermia.

Hypothermia is a condition in which the body’s core temperature drops due to prolonged exposure to cold and/or wet conditions.  Initial symptoms can include shivering, tiredness and difficulty with talking and coordination.  If hypothermia progresses, shivering may cease and the person develops very slurred speech, difficulty walking, exhaustion, and apathy or lack of concern.  This can end with confusion, combativeness and eventually, loss of consciousness and death.  During the state of confusion a person will often want to just stop and sleep, which can be deadly.  The confusion will paradoxically sometimes also cause them to want to take off layers of clothing.  Hypothermia is particularly a risk for infants as they lose body heat more rapidly and are unable to shiver.

Heat is lost more rapidly in water than in air, so exposure to cool or cold water can cause hypothermia more quickly.  Likewise, sleeping outdoors in the cold carries risk if inadequate equipment isn’t used and getting stranded in a car in the cold is yet another hazardous situation.

So, what if you notice signs of hypothermia in yourself or someone you are with?  Until medical help arrives, the following can help:

  • Move the person to a warm, dry place if possible, or shelter them from the elements
  • Removing wet clothing if dry alternatives are available
  • Cover the whole body and head with blankets
  • If outdoors, start a warming fire if possible
  • CPR if breathing stops
  • Provide skin-to-skin contact, if possible, by removing clothing and wrapping yourself and the individual in the blanket to transfer heat
  • Provide warm drinks, if the individual is conscious, but no alcohol as this gives a sensation of heat but actually causes more heat loss.

So let’s enjoy the relatively mild Tennessee winter, but take precautions when you’re in the cold, and, yah, if you’re hiking, get a map that’s up to date.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835