Sea kayak misadventure – Hyperthermia

Kayaking through wilderness and remote coastal areas, sea kayakers have a responsibility to know the dangers of hyperthermia, how to take sensible precautions against it and what to know if it sets in. 

Never be under any illusions about the seriousness of the condition hyperthermia is not a severe cold but a condition that regularly kills even the best-trained special-forces troops in sunny Devon, home of cosy thatched cottages and cream teas. Know about the risks, precautions, nature and treatment for hyperthermia and you can reduce the risk of ever having to witness the condition.

Prevention better than cure

Hyperthermia is the lowering of the body’s core temperature to below 35ºC and it is important to understand that hyperthermia does not set it immediately. Ordinarily it takes time for the body’s core temperature to fall to a critical temperature so it is important to take precautionary action if the weather closes in. Early prevention is vital because a paddler must be able to continue paddling until shelter is found onshore.

However, if a paddler is immersed in the Atlantic sea during spring or winter this will reduce the body’s temperature rapidly. Water conducts heat away from the body 25 times more quickly than air and this is why getting wet in any cold environment is dangerous. Cold climate, cold water and wet clothes are a dangerous combination.

Wear appropriate clothing for immersion and pack dry clothing in easily accessible dry bags in the boat. Many paddlers who get hyperthermia had not expected to capsize. When paddling in the Hebrides in winter or spring use appropriate clothing for sea kayaking in preparation for full body immersion in the Atlantic Ocean.

Fatigue and dehydration

Fatigue and dehydration will help to induce hyperthermia so it is important to keep energy and hydration levels up by taking on board plenty of liquid and by eating high-energy foods. Always rest and sleep where the opportunity arises. Eat properly, drink lots, avoid tiredness and avoid getting wet – have a plan B if you do get wet.

Cold hands

One of the body’s first lines of defence in avoiding any loss of its core temperature is the withdrawal of blood from the extremities such as hands, fingers, feet, toes, nose, lips and ears because these areas have less fat and are not so efficient at retaining heat. When the body does this it can become extremely hard to operate equipment and this can introduce further problems such as the inability to operate flares or radioing for help.

Signs of hyperthermia

The only way to know for sure if someone’s core temperature has dropped is with a rectal thermometer – not a standard procedure during a sea kayaking trip in polite company.

Furthermore, those suffering from hyperthermia often do not know that they are hypothermic so it is important for each member of the group to look out for their fellow paddlers. Warning signs that a body is hypothermic may include:

  1. Feeling cold
  2. Cold hands, cold feet, cold nose and ears do not mean the body is hypothermic. It is however a sign the body has enacted one of its defences against hypothermia. It means  the body is losing more heat than it is generating and is making adjustments to compensate – withdrawing warm blood from the body’s extremities reduces body heat loss. In this scenario the body is a step closer towards becoming hypothermic
  3. Uncontrolled shivering does not mean hypothermia has set. It is however a sign the body has enacted one of its defences against hypothermia. It means that the body is losing more heat than it is generating and the body is making adjustments to compensate – shivering creates heat. In this scenario the body is a step closer towards becoming hypothermic
  4. A lack of shivering does not mean that the body is not hypothermic since the body will even stop shivering below 32ºC
  5. Mild shivering and cold hands and feet do not mean that the body is hypothermic. It is however a sign that the body has enacted two of its defences against hypothermia (both described above).
  6. Stiff, weak and unresponsive muscles are not signs that the body is hypothermic. They are however signs that the body is less able to fight hypothermia should it be put at risk
  7. Mental disorientation, slurred speech and inappropriate behaviour are signs that the body is hypothermic. A sea kayaker in this condition must take immediate steps to get off the water and into shelter, they are a risk to themselves and to all those in their group

Mild hyperthermia

If the body core temperature falls to below 35ºC but above 32ºC the person has mild hypothermia. Symptoms may be uncontrolled shivering, loss of co-ordination and slurred words. This person should be put into dry clothes, out of the elements and in front of a fire. Small quantities of warm liquid should be given.

Severe hyperthermia

If the body core temperature falls to below 32ºC the person has severe hypothermia. All the symptoms for mild hypothermia may be experienced with further deterioration of mental abilities, speech and even unresponsiveness. The torso will feel cold to touch and the body stiff. Pulse and breathing may be reduced.

Treating hyperthermia

It is imperative that you shore immediately, even if the area is not ideal for setting camp. Continuing for an ideal camping site will put paddlers at even greater risk as their paddling abilities will be reduced as will their decision-making. Furthermore, continuing will in turn put healthy members of the group at risk.

  1. Get the patient off the water and into dry clothes, hat, gloves and coat
  2. Get the patent into a sleeping bag, insulated from the ground and under shelter near a fire
  3. Ensure the patient takes small, regular amounts of warm liquid
  4. Ensure that the patient rests

The body’s core temperature takes time to rise. The skin temperature may rise before the core and this can be misleading with regards to the patient’s recovery – warming skin does not mean full recovery. Patients with severe hypothermia should not be moved and should rest until help arrives.

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