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How to handle hypothermia

We’re all familiar with the term hypothermia, but many misunderstand the condition. If you fall into cold water, your immediate battle will be with cold water shock rather than hypothermia.

A man standing wet and cold by the sea

Photo: Shutterstock

In our coastal waters, it will take over 30 minutes of immersion for a person wearing normal clothes to become hypothermic.

RNLI Casualty Care Trainer Richard Faulkner describes hypothermia: ‘It’s a condition where the body’s core temperature has fallen below 35°C (95°F). Normal body temperature is around 37°C (98.6°F).’ Hypothermia can strike whether you’re in the water, on it, indoors or outdoors, at any time of year in our part of the world.

At the Firth of Forth, near Dunfermline, late one April, Matt Nightingale and Lee Green were struggling in the water after the speedboat they were on broke down.

In a 1.5m swell and winds gusting to force 5, Queensferry lifeboat crew came to the rescue and hauled them aboard.

Lee, suffering from hypothermia, said: ‘I thought I’d had it.’ Then Matt and Lee told the crew there was another man missing – Richard Yanitsaro – who wasn’t wearing a lifejacket. Thankfully, the RNLI crew found Richard in the nick of time, just as he was disappearing under the water, debilitated by hypothermia.

Whether you’re on dry land, or out on the water, knowing the early signs of hypothermia and how to treat it can be a lifesaver.

A step-by-step guide from RNLI Casualty Care Trainer Richard Faulkner

1. Getting cold

As a person gets cold, they start to shiver but are aware of their surroundings. Hypothermia hasn’t set in, so help them warm up and give them a warm drink.

2. First signs

As their temperature drops, signs of hypothermia include confusion, loss of coordination, stopping shivering, and becoming rigid, sometimes in the foetal position.

3. Further help

Call for medical help and consider evacuating the person with hypothermia to safety.

4. Don’t

Don’t actively warm up a hypothermic person with warm drinks or a warm shower. Don’t give them whisky or similar, as alcohol lowers their core body temperature.

5. Wet clothes

Treat the person with hypothermia gently and remove any outer layers of wet clothing.

6. Cover up

Wrap them in blankets and a waterproof cover. Also cover their head.

How long have I got?

If you’re stuck in the cold water and you’ve called for help, to stave off hypothermia:

  • adopt HELP (heat escape lessening posture), with arms tucked across your body and legs pulled up in front of you
  • keep movement to a minimum
  • if there’s a few of you, huddle side to side in the water
  • if there are children in the group, put them in the middle as they’ll lose body heat quicker than you.

Take our Overboard quiz to see how well you'd cope if you go over the side

This story appeared in the Winter 2015-16 issue of Offshore magazine. Learn more about RNLI Offshore membership, for those who use the sea for fun.

Hypothermia features all too often in Saving Lives at Sea, a 12-part BBC series on the RNLI’s lifesaving work. Get more stories from the series here.