This week's question is from Yvonne Osborne. She asks:
One of my characters falls through the ice far from civilization and is rescued but not before hypothermia sets in. Would she be confused about where she is and who she is? Memory loss? I've heard (and have written it so) that the best way to warm a victim after such trauma is to get them out of the wet clothes immediately and into a sleeping bag or under blankets, ideally with a healthy, warm individual who could best share their body warmth by disrobing and lying with the victim. Is this an accurate assumption? It makes for a steamy situtaion but I don't want to be too far off the logical track.
Steamy, indeed! But before the romantic body warming begins, let's talk about hypothermia.
Being immersed in near-freezing water, a human's chance of survival decreases the longer they're in it. So your character, assuming she needs to survive this catastrophe, would have to be in less than 20 minutes for the best chances possible.
Diving into cold water causes the "Mammalian Diving Reflex" which causes the blood in the body to be shunted to vital organs, namely the heart and brain. The heart rate will decreases and the blood vessels to the limbs constrict, keeping the warm blood circulating in the center part of the body.
The symptoms of hypothermia depend on how severe it is.
In mild hypothermia (core temperature of 90-95 degrees F), she might have difficulty walking straight, uncontrolled shivering, fast breathing, difficulty speaking, and impaired judgement.
With moderate hypothermia (core temperature of 82-90 degrees F) she might have a slow breathing rate, sleepiness and grogginess, the inability to shiver, and something called "paradoxical undressing."
As for the treatment?
With mild hypothermia, passive external rewarming is the treatment. It includes taking off any wet clothes and just bundling up the person in warm, dry clothes and letting their own bodies rewarm themselves.
With moderate hypothermia, you can do active external rewarming, namely stripping the victim down to the skivvies, and having a warm person do the same (steamy moment coming soon...) and have them make a human burrito in a sleeping bag.
Fan yourselves, readers!
The key is to rewarm the person's core, before you work on their extremities. If you rewarm the arms and legs first, that cold blood has a lot of acid in it from the poor circulation, and flushing the heart with that cold, acidic blood quickly can cause fatal arrhythmias.
For severe hypothermia, there is also passive internal rewarming, using warmed IV fluids and flushing the stomach and colon with warmed fluids. I know, I know. I'll say if for you. Eww. They can even flush the cavity surrounding your intestines and lungs too.
So Yvonne, you're all set for the scene. Except for the memory loss, which isn't a usual symptom, everything else looks good to go. It makes the best sense to make the romance happen that way. Why, he's saving her life after all!
Excellent.
Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!
If you've got a fictional medical question, let me know! Post below or email me at
All I ask in return is that you become a follower of my blog and post a link on your blog when I post. Easy peasy.
Also, don't forget to check out Mental Health Mondays at Laura's Blog!
61 comments:
Wow, that's good to know about the limbs and acid and core. Thanks Lydia. Thanks Yvonne for asking.
brrrr...I wanna crawl back under my covers now!
Very interesting once again!
Lydia - isn't it also true that temporary confusion and memory loss can occur - though not permanently unless the hypothermia is so severe as to cause brain damage?
Still a great post! Thanks.
Interesting about the core vs the limbs, and how the body tries to take care of itself! Great question, and I love the idea of using fesearch and facts to give a story authenticity.
Love this! I am learning so much.
I've got a scene where a guy goes onto a hot attic in Florida to replace a fuse and becomes disoriented, sweaty,chilled and can't move much--am I close? I know people have died in attics here due to the extreme temps. I have him rescued and given water and cooling cloths.
You are so handy to have around, Lydia. Really, what a great premise for a blog, to help people in this way. Thank you!
More great info. I love Medical Mondays.
Awesome. I've heard that rewarming wrong could have dire consequences, but I never knew why before. :)
Wow, Lydia thanks for the expert info. That is the type of resource that makes blogging so wonderful.
Thanks Lydia for featuring my question. I had also wondered about our natural instinct to warm hands and feet which in this case (moderate hypothermia) would be a mistake, and I now know that if my guy is an outdoorsman (which he is) he would probaby know this. It is true that some confusion would result though, right? I like the idea of a human burrito. I'm going to print out your response to stick in my file. Awesome information. Now back to the warming process.....
Thanks!!
Hi Terri! That's a great question. I can tackle that next week if it's okay with you!
Hey Matthew,
It's true, if the hypothermia is relatively severe, you can get confusion and disorientation, and some memory loss would occur with that. But there ought to be no permanent damage unless the brain suffered signs of lack of oxygen for a long time.
Hey Yvonne,
Yes, definitely some confusion is on the menu. And an outdoorsman should know that keeping the core warm is the most important focus.
Hi Lydia....hypothermia is shown in hindi movies followed by a steamy scene. I always thought it was done to add a bit of a steamy situation. Now after reading this post I understand the scenario.
So cool! (No pun intended). I'm sure the medical background comes in very handy in writing. I know I use every bit of the psychology and theater from my past. Now I know where to go when I run into a medical dilemma in my WIP
That is absolutely fascinating!
Incredible!
Hey Lydia,
I have an award for you on my blog! stop by and get it. :-D
So fascinating!! I love Medical Mondays. Ever since I saw The Abyss I've been fascinated with Hypothermia--lol--also- have you seen The Abyss??
Could that situation really happen?
My only question is: what is "paradoxical undressing"?
Hi Olleymae,
I always thought that Abyss scene was fascinating. Drowning yourself on purpose? It was (literally) a heart-stopping scene. I think in real life, it's possible, but incredibly risky. There's a huge chance that she might have just died. And there'd be a fear of permanent brain damage from the lack of oxygen.
Hi Giles,
Paradoxical undressing is when the person, who is clearly cold, feels the need to shed their clothing instead of put more on to stay warm. It's a sign of confusion. Sounds weird, huh?
Thank you so much for this post, Lydia! I have always wondered about the validity of those cuddly and steamy scenes, and this post definitely answers the question. :)
I tried to tell her it was "paradoxical undressing", but she didn't buy it.
So awesome!!!! Your posts teach and entertain me at the same time!
Since undressing is an important part of recovery from hypothermia, it sounds more like an instinctual reaction, rather than mental confusion.
It reminds me of an episode of House where a woman with scurvy craved orange juice, even though she didn't know she was sick, and she wasn't aware that citrus could cure scurvy.
How far off base am I?
Hey Giles!
Yes, maybe the instinct originally comes from the need to take off the wet clothing, though that instinct loses it usefulness if they're redressed in warm dry clothes. Although, if the clothing is wool, and it's in a remote area, you'd be better off keeping the cold clothes ON since wool insulates even when wet...
Rambling thoughts, forgive me!
Love the rocket pop.
LK - you are noted in the opening line this week -
Munk
warming one's core. lots of literary value in that.
Love these posts!
And that sounds like the beginning of one steamy scene!
oh my gosh! so interesting!!
So that explains why I stay warmer with layers -- the core is warmed, and that makes my hands and feet stay warmer. Veddy interesting!
Makes me want to write a scene of my own just to see how steamy we can really make hypothermia...what a "sexy" near death experience! :)
Fascinating! I like the steamy implications =P I guess I won't be falling into icy water around my crush, though.
Human burrito...HA!
I just have to reiterate the ewwwww!
this was extremely interesting, Lydia, thanks Yvonne for such a charming question :)
I just love Medical Mondays! Thanks to both for the great question and interesting answer!
This was a very interesting answer. Good to know! :)
You are one brilliant blogger, Lydia!
Yvonne - sounds like it's going to be a fun scene! Can't wait :)
Lydia - awesome information - thanks!
Yvonne has a book that sounds like a lot of fun!
I think soon I'll be asking a question over here Lydia you are too awesome with all the facts!
I am new to Medical Mondays and am thrilled to have found them. Learning is always good. Can't wait to see where Yvonne goes with this...you know, when that book is a best seller!
Wow, what a fascinating blog segment and what a great service to provide for your fellow writers, you rock!
Looking forward to seeing what you cover next time.
~bru
Why am I suddenly a bit chilly? Love your illustrations, and thanks for sharing the info!
Happy Monday:)
Karen
Wow! What a good question and thorough answer.
I may need to send you a question about my current WIP. You'll be more helpful than the Internet.
I love reading this medical stuff, it's so helpful. Thank you for all the information!
This is very cool. You are so smart. :)
Amy
That was another great post! And the comment discussion is fabulous, too. I once did a news story on a guy who rescued some people on a mountain who were suffering hypothermia--and now I know, paradoxical undressing. They starting shedding clothes and laughing as he was trying to get them to get up and start down.
Great post! I might have to give you a buzz when I need medical facts checked in my WIP. One of my character's is a surgeon.
Hi Lydia! Thanks for joining my blog, I'm now a follower here too.
I've been fascinated by this post in particular as it's always interesting to learn more medical facts that might help in other writing projects.
I had a medical question regarding heat stroke. How long does it generally take for the symptoms of heat stroke to show themselves. I know that in lots of people it's immediate but is it possible for the symptoms to not become obvious for an hour or two hours? Or that someone (another family member) might not notice the symptoms?
Jai
Nice tips! Might have to work that in one of my stories somehow! ;)
That was AWESOME, thanks so much!
For this and so many other reasons I gave you an award on my blog. I think you already have it, but damn, you are good, girl!
Medical Mondays...what a wonderful idea for a blog post. It's generous of you to be sharing your expertise with everyone, so thank you very much. I'll be back to visit your blog often, I think!
I also wanted to say thank you for dropping by my blog and for your support for my novel in the contest that I'm in. I really appreciate it.
Hey Jai! Looks like you and Terri have related questions. I'll tackle them for next week's post!
With the current east coast heatwave, hypothermia almost sounds refreshing :)
Hey, I just gave you a blogger award in my latest post; congrats!
Interesting! Human popsicle, that's me. I'm usually freezing!
Wow this is a great, informative post. Thank you Lydia! You rock.
Best.Post.Ever.
(steamy scene now fully created in my mind, thankyouverymuch) ;)
Yvonne, good luck with the scene!
Lydia, you have a great blog! I'm glad I found you. :)
Cool! Looking forward to reading it.
Jai
I'm going to have to bookmark this for future use. I have a situation coming up in one of my books where I'll need this… Thank you!
I've been at a handful of codes, and had to keep working on a patient who was hypothermic because as the saying goes, they aren't dead until they're warm and dead. I haven't seen it in awhile though, so maybe medical advice is changing regarding that? I had codes at two different hospitals like that, so it wasn't just one doctor.
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