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Accidental
Hypothermia
The Cold Can Be Trouble for Older People
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.
National Institute on Aging
U. S. Department
of Health and Human Services
Public Health Service
National
Institutes of Health
1993
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