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Commercial Fisheries News
Volume 37 Number 10
June 2010
Hypothermic victims require careful handling
Hypothermia occurs when the body’s core temperature drops too low. It is a life-threatening danger that fishermen need to know how to recognize, treat, and prevent.
Submersion in cold water, typically as the result of man overboard (MOB) situations, is the major cause of hypothermia. That’s because water conducts heat away from your body 25 times faster than air of the same temperature. Hypothermia also can result even when you’re out of the water due to a combination of wind, cold temperatures, wet clothing, and/or unsuitable clothing for the weather conditions.
Normal core body temperature is 98.6°F. Hypothermia starts when your core temp goes below 95°F. In early hypothermia, the core temp is 91°F to 95°F. In this state, the victim experiences intense shivering, which can lead to violent shivering, confusion, slurred or slow speech, and poor judgment.
Moderate hypothermia occurs when the core temperature drops to the 86°F to 90°F range. In this state, the victim will have stopped shivering, have a weak or irregular pulse, slow shallow breathing, and dilated pupils. Unconsciousness can occur.
When the body’s core temperature falls below 86°F, the victim has severe hypothermia, which can lead to coma or death.
It is a good idea to add a hypothermia thermometer to your first aid kit. This kind of thermometer reads temperatures as low as 70°F.
Mild-moderate treatment
It is very important to treat anyone who has been exposed to the cold and/or cold-water immersion who displays the signs of hypothermia.
Immediately contact the Coast Guard for medical advice and possible medevac. And, because the body’s metabolism has slowed down, check for breathing and pulse for at least one to two minutes to help you determine how to proceed.
If the victim is breathing and you can feel a pulse, follow these steps:
Transfer him to a warm place.
Treat the victim gently. Avoid any sudden movement or physical activity because rough handling can cause deadly heart arrhythmia.
Remove or cut away wet clothing with a minimum of movement.
Wrap the victim in blankets or a sleeping bag for warmth and place a watch cap on his head.
Raise the feet above his head to promote blood circulation.
Moisten several towels and put them in a microwave oven for one to two minutes so that they’re warm, not hot, to the touch and place them around the victim’s neck, under the armpits, and in the groin area.
Re-warm the victim gradually to avoid shock to the system that could lead to heart attack.
Never put the victim in a hot shower or give alcohol. Give warm liquids only to people who are conscious and alert. And
Make sure to check for and treat other injuries and treat for shock.
Desperate measures
If the victim has irregular or no breathing and/or pulse, check the ABCs – airway, breathing, circulation – and administer CPR if necessary.
The victim’s low core temp makes it impossible for him to generate heat. But desperate measures can save a person’s life.
In addition to the above steps, these include having one or more people strip down naked or close to it and lay body-to-body to transfer heat through conduction.
Post-rescue collapse
Do not leave a victim alone because delayed reactions can occur. In fact, up to 20% of hypothermia deaths occur during or within hours of rescue.
While conducting man overboard drills, I tell fishermen about an incident where a ferry sank, leaving 16 people in the water for between 45 minutes and one hour before they were rescued.
All were brought on board and treated for hypothermia. They were allowed to become mobile, and all collapsed and died within the hour.
It is important to realize that anyone who spends a long period of time in cold water may be hypovolemic, which refers to slow blood flow.
Rough handling of the victim, which, at times, is necessary during rescue, as well as post-rescue stimulation or movement, can cause a dangerous condition known as after-drop.
This is when the cold blood from the skin and extremities is introduced into the warmer core circulation, which can lead to ventricular fibrillation of the heart. This after-drop was responsible for the post-rescue collapse of the 16 victims.
Making sure that crewmembers understand all of these factors puts them in the position to make informed decisions about the rescue, care, and transport of hypothermic victims.
Fred Mattera
NESTCo
A qualified Coast Guard-approved marine drill instructor, Fred Mattera is the owner/president of North East Safety Training Co. (NESTCo), which conducts fishing vessel drills and inspections and basic safety training workshops.
Mattera has been a commercial fisherman since 1972 and the owner of the Point Judith, RI-based 84' freezer trawler Travis & Natalie since 1984.
Since 1998, he also has been the president of the Point Club, a fishing vessel mutual insurance group, and has served on the board of directors for Sunderland Marine Mutual Insurance Co., the principal underwriter for the Point Club and more than 2,000 US fishing vessels, since 1998.
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