Hypoglycemic Hypothermia

[Mistwalker]

Hypothermia, being a malady that involves the lowering of the body's core temperature, is usually thought of as being a danger only during cold weather or due immersion in cold water. For the most part this is true, and it's one of the reasons I chose to write this piece this season, when hypothermia can be a real danger to anyone in any cold environment. It's a little known fact that hypoglycemia can lead to deadly hypothermia when ambient air temps are in the 60s and well above freezing, with no immersion in cold water, so it can be a very serious danger in the cold season for those who are at risk. To put that into perspective, hypothermia sets in when the body's core temperature drops below 95F/35C. At 91F/33C the person can experience amnesia. At 82F/28C the person will likely lose consciousness. At 70F/21C it is considered profound hypothermia and is deadly.

For most of us, just taking along some extra warm clothing when we expect low temps will be enough of a precautionary measure. With the additional layers to insulate our bodies from the cold air, and hold in the heat we produce naturally, it will protect us from environmentally produced hypothermia in most cases. However for the people who suffer from blood sugar issues, malnutrition, and thyroid disorders (just to name the more common ones), the extra clothing may be little to no help during an episode of hypothermia brought on by hypoglycemic reaction from low blood sugar. During these episodes the body temperature isn't, at least not solely anyway, dropping due to the air temperature. It's dropping due low blood glucose levels being too low and their body is no longer producing heat of its own. Left unchecked and untreated their core temperature will continue to drop to the temperature of their environment. For someone undergoing hypoglycemic hypothermia the root cause, low blood glucose levels, needs to be dealt with in order to get their body to start producing heat again. But it may also be necessary to supply a warmer environment for them while that's underway, even if you have to improvise it. If you aren't familiar with it, Hypothermia's symptoms can include (but aren't limited to) shakiness, confusion, weakness, loss of color, incoordination, and blurred vision.

There are special kits which are made especially for this purpose that some who know they're at risk carry, but in a pinch it can be improvised. The SOP for elevating blood sugar levels in these cases is the 15/15 rule. Administer 15 grams of carbohydrates, and wait 15 minutes to gauge the progress. The goal being to raise their glucose level safely, without taking them in the opposite direction. Luckily in many cases, the overall atmosphere in urbanized areas is rife with ways to quickly raise a person's blood sugar levels during the holidays. If they have glucose tablets or gel tubes, you should just follow the directions. Otherwise a tablespoon of sugar or honey, a half cup of juice, soda, or other sweetened drink, candies, or cake icing can be used when nothing better is available.

As for supplying a warm environment goes, obviously in the cold season getting them in doors as quickly as possible will significantly slow the dropping of their core temperature. If you are outside and cannot get inside quickly, sharing your own body heat with them could save their life. This is also another case where a bivvy bag and hand warmers can come in handy, specifically to create a small warm environment on the spot. I've mentioned this before and I am sure I will mention it again in the future, because this technique can help save lives and doesn't take up a lot of space in a kit. If you don't have an emergency bivvy handy a couple of big trash can liners can be used to create the smaller environment.

In a worse case scenario, hand sanitizer can be burned to generate heat in a small space like an automobile, a closet, or a restroom. You will want to provide adequate ventilation of course, but it burns cleaner than a lot of solid fuels. Just the small dollop of sanitizer you see burning on the metal surface of the water bottle cap lasted for over five minutes, and produced a good amount of heat. A full bottle of sanitizer will supply enough fuel to do this several times and could warm up a small enclosed space fairly quickly. The ethyl alcohol in hand sanitizer is easily ignited using a lighter, a ferro rod, or even just the sparks from a butane lighter that is out of fuel. It just needs to be placed on a nonflammable surface. I picked up the metal cap for the Kleen Kanteen the day I bought the bottle. I wanted the Kleen Karafe version, but the store I was at didn't have it in stock so I did the next best thing. I noticed the concave surface and thought then it could also serve as a the base for an improvised alcohol burner with hand sanitizer, to improvise a small heat source.

It is important to remember that when using this method in bright light, the pale blue flame will most likely be impossible to see. You'll need to look for the heat waves or feel for the heat radiating from the flames. It should also be noted that alcohol burns very hot. The heat from this flame was uncomfortably hot on my palm, even holding it a foot above it. If you're out of doors in a wilderness environment, the high heat of the burning alcohol also lets it serve as a very good accelerant for getting organic materials burning even under damp conditions, and in low temps a large fire could be necessary to keep the victims temperature from dropping too quickly.

We all always expect the holiday season to be a time of mirth and good cheer, and hope that it will be. Having a better understanding of the dangers that can present themselves this time of year can go a long way toward keeping things that way. I have seen this malady, and these fixes, in action twice in my life. The first time I was just a kid and got to learn the hard way on the fly, helping my diabetic friend's wife save his life with cake icing and our body heat on the side of the Chattahoochee River during a winter fishing trip. The first episode scared the crap out of me. During the second I was very thankful for the first. The more we all know about saving our lives, the better off all of us are.

 

[saucyCT]

Fantastic post. Really fantastic. I haven't commented in a while, but this brought me out of my hibernation. Thanks for posting this for others—with diabetes so prevalent in the country now it is vital that others know how to deal with hypoglycemia, on its own. Compounded with freezing temps, this info is a must for keeping someone alive in a crisis event. Thanks.

 

[lmalterna]

Being hypoglycemic, been there. I like the little cups of peanut butter available today. Hersheys kiss, peanut butter and gatorade put me right. The peanut butter gives a sustained burn that prevents a spike/crash.

Bill

 

[Mistwalker]

Fantastic post. Really fantastic. I haven't commented in a while, but this brought me out of my hibernation. Thanks for posting this for others—with diabetes so prevalent in the country now it is vital that others know how to deal with hypoglycemia, on its own. Compounded with freezing temps, this info is a must for keeping someone alive in a crisis event. Thanks.

Thank you! I am glad you liked the post! I had meant to write this one up sooner, but two years ago my already crazy life took a turn for the surreal and then took a while to re-stabilize again. Under all the stress of trying to hold my daughter's lives together some things kept getting buried. Specific blogs and articles meant for specific times or seasons were among them. Hopefully things are getting back on track now, if I can just get them rolling again I think we'll be okay.

Being hypoglycemic, been there. I like the little cups of peanut butter available today. Hersheys kiss, peanut butter and gatorade put me right. The peanut butter gives a sustained burn that prevents a spike/crash.

Bill

Thanks Bill, I appreciate the input from a personal perspective. I almost always have some peanut butter in my truck even if only some of the packets from MREs. And almost always have gotorade in my truck cooler in the warmer months just for me. I love the peanut butter for quick energy and carbohydrates on long grueling days, but because of my only personal experiences with people in crisis I had never even considered it for this application. Ironically enough, my friend I learned this from was named Bill Roberts, we fished commercially together in south Alabama in the 70s and 80s. I had no idea what was going on then. All I knew was that he suddenly blacked out standing next to me by our very large and very hot camp fire, with a bed of coals over three feet long and a foot deep, between two large pine logs we had kept going constantly for days because it was a colder than usual January. I think this being January was what reminded me. Anyway he just slowly tarted falling forward and I thought at first he was just leaning over the fire to warm his face. He had just come back from a few ours on the water baiting his trot lines, and he was very cold. But then he just kept falling forward. I barely managed to catch him by the hair of his head, thank goodness his hair was long enough for that, when his face was barely a foot away from the flames. Luckily I was already back in camp, my father and our other two friends were still out on the water miles down river. Luckily too Linda, his wife, knew exactly what was going on and brought a tube of his emergency glucose quickly and we each laid against him sharing the warmth on our clothes from the fire with him till his body started doing things on its own again. I was 15 and the whole thing scared the crap out of me. I'll keep this in mind for situations that haven't deteriorated to unconsciousness in the future. Thank you!

 

[VANCE]

as others have stated...
very good post Mist

 

[Mistwalker]

as others have stated...
very good post Mist

Thank you Phillip, since I finally have more of my life back for my own uses I have been working on several pieces at once that I hope everyone here enjoys reading

 

[Fiddleback]

Great Post! Can't wait to see the new stuff you're doing.

 

[Mistwalker]

Great Post! Can't wait to see the new stuff you're doing.

Thank you. Some of it is stuff I have had the inspirations to do for some time now, as with this one but they're more complicated to illustrate. It's hard to be out and about in cities at night, or at certain venues within them, when you are financially destitute and responsible for the care, well being, and lives of a four year old and a thirteen year old at the same time. The same goes for being out in woods or on the edge of a river in the cold pouring rain, especially for the night shots.

 

[Mistwalker]

Compounded with freezing temps, this info is a must for keeping someone alive in a crisis event. Thanks.

One of the inspirations for this piece happened a few months ago. I just happened to be at the site of a crisis out on the sidewalk downtown, at a bench near a bus stop, but I didn't have to get involved in it, I just watched quietly from a distance to see how it would go. The person accompanying the person in crisis was well versed in the situation, obviously experienced and well prepared to deal with it. So other than the tension during the first few minutes of the crisis and administering the glucose and waiting on the girl to respond, it went really smoothly. The woman dealing with the situation clearly didn't want to draw any more attention to the situation than was necessary, probably trying to avoid embarrassment for her friend/sister in crisis. A few minutes later all was back to normal, and the passersby had no clue what was happening as they passed. Other than the dazed look on the woman's face as she sat there it was hard to even notice a problem. She was really quiet, and in the light rain with her fain coat on and being hit by rain drops, her shaking was barely perceptible. It struck how had she been all alone, people would have likely kept walking right on by and she may very well have sat there and died of hypothermia in plain sight on a busy sidewalk. I have some really close friends who have diabetes, who add a great deal to the overall quality of my life, and it's hard for me to imagine my life without them in it. So I find the notion that they could some day die just sitting in plain sight on a busy sidewalk while people just walk right by without even noticing pretty frightening, and that's why I wanted to go ahead and get it published here even if it isn't published on the website yet.

 

[Mistwalker]

Being hypoglycemic, been there.

Bill

Hey Bill, have you ever blacked out? What is your personal preference for emergency administration in these cases? I asked because during my learning episode of this with my friend Bill 30 yrs ago, he was upset with Linda for using the actual medicine because it makes him want to vomit and preferred the little tubes of cake icing for dissolving in his mouth in those episodes as he had had a few over the years apparently. But I know there are more choices available these days and it's time to restock some things in my pocket emergency kit I carry when I am out and about.

 

[lmalterna]

Mist,
I have never completely blacked out. I have collapsed but was not out and have on a number of occasions had to sit or lie down as I knew I was going to hit the floor. So, in my cases, I have always been able to swallow-- which changes what I use. My go to is quick dissolving sugar, backed by protein. This can be chocolate, soda, powdered sugar, honey-- then milk, peanut butter, gatorade.

I am usually my own worst enemy, I might grab a snack of sweets with soda or coffee on an empty stomach. That is like throwing flash tinder on a spark and walking away- brilliant burst of energy, followed by nothing in the tank= crash and burn. We are combustible engines and need sustainable fuel.

Packet of jelly or honey from fast food places are good to carry. Paired with a travel cup of peanut butter, I would be comfortable. I carry a bag in each car of the listed snacks and has come in handy a number of times.
Bill

 

[Mistwalker]

Thank you Bill. I appreciate your input very much. I almost always have a pack or two of honey in my kits and in my glove compartment just for moments like this, and because it is my favorite sweetener. And chocolate in the winter, when it won't melt so easily, for quick energy. But then one person asked me, "what if the person was allergic to honey and wasn't able to tell you?" which made me try harder to remember all of the things Linda kept on hand for Bill. But that was over thirty years ago, so not only hard to remember small details from discussions, but hopefully their are likely other better options available today. I'll grab some jelly packs next time I'm out, and look for some chocolate that doesn't easily melt...maybe a tube of M&M minis, and see if I can find some packets of powdered sugar. Mos quick dissolve sweeteners are sugar substitutes and I have no idea how those may or may not work as I have zero experience with them in this case.