Accidental Hypothermia
The Cold Can Be Trouble for Older People
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Introduction
Cold weather can
be risky for anyone, but especially for older people. Almost
everyone is familiar with winter hazards such as broken bones
from falls on ice or breathing difficulties triggered by cold
air. But the winter chill can also lead to a temperature drop
inside the body that can be deadly if not found quickly and
treated properly. This lowered body temperature, usually brought
on by staying in a cool place for a long time, is called hypothermia
(hi-po-ther-mee-uh). It is a special problem for older people,
who often have other illnesses or take medications that can
interfere with the body’s ability to regulate its temperature.
What is hypothermia?
Hypothermia is marked
by unusually low body temperatures, below 96° F (35.5° C) -
well below the body’s normal temperature of 98.6° F (37° C).
What may seem like a mere couple of degrees can have a devastating
effect. Severe hypothermia can cause an irregular heartbeat
leading to heart failure and death.
Body temperature
is a balance between how much heat is produced and how much
is lost. The brain acts as a thermostat, sending and receiving
signals to and from parts of the body that affect temperature:
the spinal cord, muscles, blood vessels, endocrine system, and
skin. The body has many different reactions to cold. Shivering
by the muscles, for instance, is one way the body produces heat.
Muscles shiver in response to messages sent by the nerves; shivering
increases muscle cell activity, which in turn produces heat.
What to look for
How can you tell
if someone has hypothermia? If a person says he or she is unusually
cold, check their temperature with a thermometer. Older people
may be reluctant to complain, or are unaware of how serious
the cold can be. Look for these signs of hypothermia:
- Confusion or sleepiness
- Slowed, slurred
speech, or shallow breathing
- Weak pulse; low
blood pressure
- A change in behavior
during cold weather or a change in the way a person looks
- Excess shivering
or no shivering; stiffness in the arms or legs
- Chilly rooms or
other signs that the person has been in a cold place
- Poor control over
body movements or slow reactions
To figure out whether
someone is suffering from hypothermia, take his or her temperature
with a thermometer. First shake the thermometer to below its
lowest point. Then, if the temperature appears to be below 96°
F (35.5° C) or it can’t be read on an oral thermometer, take
the person’s temperature again using a rectal thermometer for
a more exact reading. If the thermometer still does not show
the temperature or is below 96 degrees F, call for emergency
help. The only way to tell accurately if a person has hypothermia
is to use a special thermometer that can read temperatures below
94° F (34° C). Most hospitals have these thermometers.
Treatment and recovery from hypothermia
The most important
step in treating hypothermia is to make a person warm and dry.
He or she must be seen by a doctor, preferably one who knows
about the condition and who is located in a well-equipped hospital
emergency room. There, the doctors will warm the body from inside
out. For example, they may give the person warm fluids intravenously
(I.V.).
If you suspect that
a person has hypothermia and emergency help is not available
right away, move the person to a warmer location, if possible,
and wrap him or her in a warm blanket to stop further heat loss.
You can also use your own body heat to keep the person warm.
Lie close to the victim, but be gentle and do not handle the
person roughly. Rubbing the person’s arms and legs, as many
rescuers are tempted to do, can make the problem worse.
Chances for recovery
depend on how long a person was exposed to the cold and his
or her general health. If body temperature has not dropped below
90° F (32.2° C), chances for a total recovery are usually good.
If body temperature has fallen to between 80° F (26.6° C) and
90° F (32.2° C), most people will recover, but some lasting
damage is likely. If the temperature goes under 80° F (26.6°
C), most victims will not survive.
Some Safety tips!
- Guarding
against hypothermia
Living conditions,
illness, and some medicines (those affecting the body’s
ability to respond to cold) increase the risk for hypothermia.
- Environment
People who live
in poorly heated homes risk getting accidental hypothermia
when the weather is cold. Even mildly cool temperatures
of 60° F (15.5° C) to 65° F (18.3° C) can trigger the condition.
Homes can have inadequate insulation, or people with low
incomes and little savings may keep temperatures in the
dangerous range as they try to keep heating bills down.
Some help is
available. To improve insulation, some states fund programs
to help low income families “weatherize” their homes. You
can contact your state or local energy agency or the local
power or gas company for more information. Weatherizing
your home, or heating only one or two of the in-use rooms
of a house, will keep the heating bills down.
In addition,
some low-income families may qualify for help in paying
their heating bills. State and local energy agencies, or
gas and electric companies, have special programs. You can
contact them for details. Also, if a person cannot pay a
utility bill, many states and cities now have laws that
stop landlords from cutting off gas or electricity in cold
weather, at least until other plans are made. Do not wait
for winter to find out about these programs.
Check with your
local government about the laws that may apply, then pass
this information along to a relative or an older person’s
legal representative.
Older people
may be vulnerable to hypothermia even when they live in
nursing homes or group facilities. These institutions have
to be careful when lowering temperatures, because patients
who are already sick may have special difficulty keeping
warm.
Being knowledgeable
about the weather can help reduce risks too. For example,
brisk winds cause more rapid heat loss than calmer weather.
Weather forecasters call this the wind-chill factor. They
often suggest, even when the temperature itself is not very
low, that the wind-chill factor is low enough for people
to stay indoors.
- Health
Some illnesses
and medications place a person at risk because they affect
the way the body handles cold temperatures. Illnesses that
may blunt the response to cold include:
- Slow thyroid
(hypothyroidism) or other disorders of the body’s hormone
system.
- Stroke or
other disorders that cause paralysis and reduce awareness.
- Severe arthritis,
Parkinson’s disease, or other illnesses that limit activity.
- Any condition
that curbs the normal flow of blood.
- Memory disorders.
Certain medicines
also increase the risk of accidental hypothermia. They include
drugs used to treat anxiety, depression, or nausea, and
some over-the-counter cold remedies. Ask your doctor how
your medicines affect body heat. In addition to some medication,
alcoholic drinks lower the body’s ability to retain heat.
Stopping accidental hypothermia
Increased awareness
is the most effective way to prevent and treat accidental hypothermia.
Older people, their families, and friends should keep alert
for hypothermia risks and try to reduce them. Keep older people
warm and dry during cool weather. Doctors, nurses, and health
professionals - including those working in emergency rooms -
must remember to check for hypothermia.
Remember these important facts:
- Accidental hypothermia
is a drop in body temperature to below 96° F (35.5° C).
- Older people are
at risk of hypothermia not only in cold weather, but in mildly
cool temperatures as well.
- Hypothermia affects
older people more often than younger people.
- Alcoholic drinks,
certain illnesses, and some medications can affect the body’s
ability to regulate temperature.
- A person suffering
from hypothermia is often confused, sleepy, or can have slurred
speech.
- Hypothermia is
dangerous and requires immediate medical care.
October 1993
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