Jan 19, 2015


Announcer: Medical news and research from the University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Host: Did you know that you could get hypothermia when it's 40 degrees outside? I'm with Dr. Troy Madsen, emergency room physician at the University of Utah Hospital. Let's talk about hypothermia. Is there a comparison to be drawn between heat exhaustion and heat stroke here?

Dr. Troy Madsen: Absolutely. Heat stroke is when the body temperature gets really high. Hypothermia is when it gets really low.

Host: Okay.

Dr. Troy Madsen: Neither of those is good. So think about it this way. Probably the easiest way to compare this is to your car. If your car's really hot, it doesn't run well. But then think about these cold mornings we're having now, going out there, trying to start your car up. You're just trying to get that engine going. It just starts to turn over a little bit, and once it gets going, it doesn't work well.

Host: Yeah. And then even you try to shift it into gear, the transmissions sloggy.

Dr. Troy Madsen: Exactly. It just does not work well. That's exactly what the body does. You know, your heart's kind of the engine of your body. If it's cold, it does not work well. You know, at high temperatures, same thing with your heart. Absolutely. There's definitely a comparison there.

Host: So 40 degrees, it could start happening. Is it normal at 40?

Dr. Troy Madsen: Not normal at 40. The big thing in the 40's is if you're in damp weather, if it's raining on you, you've got cold clothing, you can get hypothermia. So people who are outside maybe. You know, it's a little late in the year for people to be hunting, but maybe for outdoor activities, you may think, "Hey, its 40 degrees outside. I should be fine." But you could or your children could be experiencing hypothermia if you start to get cold or you just don't have the right clothing on.

Host: What temperature does it normally happen? When do you really need to start worrying about it?

Dr. Troy Madsen: This last winter, I saw several cases of it in the ER because we had some really cold days. But usually, once you get these temperatures down in the teens and the single digits at night, we see it a lot in people who are homeless, who are out on the streets, who don't have any place to go or may have not gotten into the place, into some of the resources that we have available. Or people who may be intoxicated, who may not be aware exactly what's going on, that their body temperature's dropping. That's where we really start to see some serious cases in the ER.

Host: So generally, it's not somebody that's doing some outdoor activities such as snow shoeing, skiing, that sort of thing?

Dr. Troy Madsen: Typically not. You know, I think most of us, we know when we're getting cold. It's not, like, you're walking out to your car in the morning and you get overcome suddenly by the cold. It's usually people who are in some other situation. They may be out skiing. They may be out in the back country where they just can't get to where it's warm soon enough. But for most of us, in our day-to-day activities, it's not a big issue.

Host: So frostbite's probably a little bit more predominant though? Because I can be out doing an activity and not have gloves on.

Dr. Troy Madsen: Right.

Host: I could be warm enough, but my extremities are not?

Dr. Troy Madsen: Exactly.

Host: Okay.

Dr. Troy Madsen: And that's one, too. You know, the big thing with skiing is usually these temperatures are in the single digits, and those can be some pretty cold days. When you're snow shoeing or hiking or whatever, when it kicks up, you've got part of your face exposed. You can get some frostbite on your face or on your nose. Certainly on your hands if you don't have the right equipment on. And when it gets cold like that, your body's going to pull blood from your hands, from your feet to your core to keep it warm. That's when you get some issues in your hands, some frostbite in your hands and fingers.

Host: So if my face gets frostbitten. What does that mean?

Dr. Troy Madsen: Basically, what it means is you got dead tissue there. You got tissue where there's just not enough blood supply there because the blood has been pulled away from it, and the temperatures have gotten so cold in that part of the body that the tissue actually dies. So, real cases of frostbite, that's dead tissue. Oftentimes, if it's severe enough, you know, we'll have cases of people who come in with frostbitten toes. I've seen cases, interestingly, of just people who are just out working, just out shoveling their snow. I've had a couple cases of that. They had some other medical problems that I think made things worse, but they've had amputations of some of their toes because of that, because the frostbite was so bad.

Host: So frostbite can cause things to have to be amputated?

Dr. Troy Madsen: It can. It can. You know, usually, it may cause some cosmetic issues. Certainly if it's on your face, that can be a problem. But in some cases, you actually have to have an amputation.

Host: What are the symptoms of either one of these that I need to watch out for? You know, because I've been really cold before.

Dr. Troy Madsen: Yeah.

Host: So cold that I think, "My toes are going to fall off."

Dr. Troy Madsen: Right.

Host: But was I really in danger?

Dr. Troy Madsen: I think the first one with hypothermia, you know, if you're shivering, that's a good sign. So you think the normal body temperature's 98.6. Once it starts to drop down around 97 or 96, you're going to start shivering. And that's just your body's way of trying to produce heat. You shiver. It produces heat. It tries to warm up the core. But the really concerning thing is if you stop shivering. That's when your body temperature gets less than 90 degrees, and that's where it becomes life threatening. Your heart just starts to do weird rhythms. It gets really slow. And certainly, if you're with someone and they just are not shivering and you're really cold, and they're just not shivering at all, and they are not really responding to you, those are signs of severe hypothermia.

Host: Is there anything that you could do for them at that point if you can't get them to help?

Dr. Troy Madsen: It's not everyone's ideal scenario or consideration, but if you have to, the best way to get someone warm is number one, make sure they're dry. Number two, if you've got a sleeping bag or something to insulate you, strip them down. Strip yourself down. Get your body heat next to them. That's the best way to warm them up.

Host: And that's about all you can do at that point?

Dr. Troy Madsen: That's about all you can do besides trying to get help. You know, obviously, if you can make a fire or whatever resources you have there, but that's going to be the quickest way to warm someone up.

Host: Any other thoughts?

Dr. Troy Madsen: Yeah. I think the number one thing is just preparation. Make sure you know where you're going. Know what the temperatures are. Make sure you're prepared for that, so that doesn't happen to you.

Host: And bundle up when you're shoveling your driveway.

Dr. Troy Madsen: Exactly. Stay bundled up.

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