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Stages, Symptoms and Treatment of Hypothermia

Hypothermia progresses from mild to severe. The time it takes to go from one stage to the next depends on the temperature of the water and the degree of protection the victim has against the cold.

Stage 1 - Initial Reaction

When first hitting the water, the victim automatically gasps and then starts breathing four to five times faster than usual. His blood pressure and heart rate both go up. Holding his breath is also more difficult. This stage normally lasts from 2 to 3 minutes, however, hyperventilation could last up to 10 minutes. Dying during this first stage is possible, especially if the victim is underwater when he automatically gasps or if he has a stroke, heart attack, or loss of consciousness and subsequently drowns.

The symptoms of Stage 1 are:

  • Feeling cold.
  • Shivering violently.
  • Slurred speech.

If someone is suffering from Stage 1 hypothermia, get him immediate medical attention before anything else. If this is not possible:

  • Move him to a warm place.
  • Remove his wet clothing.
  • Give him warm non-caffeinated drinks (no alcohol).
  • Keep him warm for several hours.

Stage 2 - Short-Term Immersion and Swimming Failure

During Stage 2, a victim's breathing returns to normal and she starts shivering. Her body pulls the heat from her arms and legs to keep her core warmer. As a result, her muscles begin to fail and she can no longer swim, maintain the HELP position or hang onto the boat or other floating debris. Most people who are not wearing a PFD die from drowning during this stage, before their body reaches 95 degrees.
The symptoms of Stage 2 are:

  • Losing some muscle control.
  • Feeling drowsy.
  • Feeling exhausted.

If someone is suffering from Stage 2 hypothermia, get her immediate medical attention before anything else. If this is not possible:

  • Move her to a warm place.
  • Remove her wet clothing.
  • Cover her with warm clothing and blankets.

Stage 3 - Long-Term Immersion

During Stage 3, the core temperature of the body falls below 95 degrees. The victim feels disoriented and starts acting irrationally. He might appear drunk or distant. He stops shivering when his core temperature drops below 91.4 degrees.
The symptoms of Stage 3 are:

  • Collapsing or losing consciousness.
  • Having trouble breathing.
  • Shivering decreasing or stopping.
  • Appearing to be incoherent or irrational.

Stage 4 - Post Rescue Collapse

If a victim has hypothermia when pulled from the water, she has an 80 percent chance of surviving. About 20 percent of immersion deaths occur during or within hours of the rescue. When pulled from the water, the heart has to work even harder as the cold blood from the arms and legs moves back into the warmer core of the body. Rescuers will try to lessen the effect by handling the body as gently as possible.

If someone is suffering from severe hypothermia:

  • Carefully take the victim from the water and maintain her position so that if she was floating horizontal, she should be kept horizontal. Moving her vertically could cause the blood to rush to other areas of the body and lead to a heart attack or stroke.
  • Do not to attempt to provide care. Do not touch or stimulate her arms or legs in any way.
  • Get her immediate medical attention.
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