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Hypothermia: A Cautionary Tale from the Wilderness Medicine Institute

“I won’t do this anymore!” Jen screamed at me. “This is not safe!”

I disagreed. Teaching wilderness medicine courses is something I approach very cautiously, and the mock rescue scenario I created for my students this night was similar to dozens I had conducted before: a few “injured” people needed medical care and help returning to their camp from the rocky gully where I had staged them.

While I expected that working in the dark would be difficult for my class, I hadn’t seen the rainstorm coming. My mistake, sure, but so much the better. I want my students to train in the conditions nature presents. They sought out the Wilderness Medicine Institute of NOLS for that very reason, and now they were facing a cold, soggy, muddy and realistic test of their skills.

“Jen,” I said, “it looks safe to me.”

“Shut up!” she screamed. She was shivering and soaking wet, her lips purple. Then I noticed that she hadn’t even put on her rain jacket. “Do you have a rain layer to wear?” I asked.

“Shut up! Go stuff yourself,” she said, not really using the word “stuff,” and she stumbled off into the rainy forest. 

My training scenario might have been safe, but the number of patients just jumped up by one. Jen was cold and making choices that would only make her colder—besides her recent and uncharacteristic obscenity. Now her rescue team had to help her, too, sacrificing time, attention and resources that could have been devoted to the original patients.

Hypothermia, the medical term for low core body temperature, is a danger that sneaks up on us if we’re not careful managing our heat loss in the outdoors. Our bodies generate heat by burning calories through food and exercise. For us in the outdoors, then, staying well fed, well hydrated and active are the first steps in keeping warm. To retain the heat we’ve got, we need proper insulation and we need to keep it dry.

Hypothermia bookDr. Gordon Giesbrecht of the University of Manitoba is a leading researcher on extreme environments and their effects on human physiology, and he’s written an excellent article on how cold-weather clothing works. Once genuine hypothermia sets in, the less we’re able to realize it and take measures to get warm again. You can learn more about this in Dr. Giesbrecht and Dr. Wilkerson’s excellent book Hypothermia, Frostbite, and Other Cold Injuries, available at REI stores and online. You can also challenge yourself with an online case study on the WMI website to explore your decisions in a similar situation.

Just as they would have to do in a real-life rescue, the group zipped into action to help Jen out. A wool hat, a dry fleece top under a sturdy rain jacket, a pair of gloves, a hot cup of cocoa and about 200 jumping jacks later, Jen was back to her normal happy self. She thanked everyone who helped her get warm and lent her their extra layers.

Later, after all the patients had been rescued, I asked Jen if she learned anything. “Sure,” she said, “I guess. I would have been a lot more helpful to my team if I had brought more layers, put them on, ate some food and exercised all before I got too cold.”

“That sounds about right,” I said.

“I’m sorry, you guys,” she said. “But, John, did I really tell you to go stuff yourself?”

 Photo below by Brad Christensen/WMI of NOLS.

Posted on at 6:04 PM

Tagged: WMI, Wilderness Medicine Institute, Winter, hypothermia and snow sports

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