Treating Hypothermia in Wilderness Survival Situations




Treating Hypothermia in the field

© copyright 2004, by Gary Benton



While the weather was cool, the sun was shinning brightly. There was not a cloud in the sky and the wind was very light. A figure soon appeared moving slowly over the distant skyline, down a tail that meandered from the pass. If you looked closely, you could see his camouflage clothing, his rifle, and his awkward movements. The man was swaying at dangerous angles as he walked through the woods. He appeared to be intoxicated as he bounced into trees and large rocks. His rifle fell from his shoulder, but the man did not seem to notice as he continued walking. After moving a few more feet, he took off his coat and discarded it in the bushes along the trail. He may have noticed his vision was blurred and he had a slight headache. As the man continued down the tail and out of sight, he was totally unaware that he was suffering from hypothermia.


Hypothermia is an injury not related to the most common injuries we think of when we go outdoors. Those of us who spend time with nature rarely consider this injury. But, it is a potentially deadly situation that can usually be easily prevented, if you know what it is, and how it kills. Hypothermia is the lowering of the body’s core temperature. Most of us lets say have a body temperature of between 97 and 99 degrees. When our temperature drops internally to below this normal range hypothermia sets in. If the core temperature is not brought back up, death usually occurs. We have all felt the beginning stages of hypothermia when we start to shiver.


Now, some of you are thinking, “I don’t live in very cold climate. I don’t need to read any of this.” Well, you may be wrong. Hypothermia can happen in almost any temperature rangeand even indoors! Keep in mind, most high temperature range hypothermia will occur with the elderly, but it can still hit others at any time. When your internal temperature drops to below 90 degrees you are in severe hypothermia. Confused? Well, now that you know what hypothermia is, let me share some other interesting information with you.


Your body heat can be lowered by any number of reasons, exhaustion, exposure to the element’s, lack of food, poor diet, immersion (if your boat turns over or you fall into a stream), wet or damp clothing, and the list goes on. That is one of the reasons in my articles I often remind you to keep your clothing clean, in good repair, and dry. Most of us have experienced the beginning of hypothermia while hunting, fishing, hiking, or camping. We start to shiver and shake. Usually, we just add a sweater or jacket, or we just move closer to the fire. But, what happens when we fail to get warm? What happens in extreme cases?


Well, the symptoms of hypothermia are in stages and there are many sites online that offer additional information to those of you interested in learning more. I suggest you visit some of those sites and take a look at what they have to say. Keep in mind to stay with sites that know what they are talking about (see my recommendations at the end of this article). While I am not a doctor and other than some survival medicine classes I have attended, I cannot claim to be an expert on the subject. But, I do know the symptoms, and they may start with a sudden burst of energy, then….


  • A feeling that “everything is alright”

  • The removing of clothing in cold or wet weather

  • Shivering

  • A slow response

  • Uncontrolled shivering

  • Loss of motor skills (lack of coordination)

  • A headache

  • Blurred vision

  • Irrational behavior for the individual

  • Abdominal pain


If these symptoms are noticed or felt, regardless of the ambient air temperature, treat for hypothermia. This treatment may be as simple as just warming the person up. This warming up may just require an additional layer of clothing, a hot drink or maybe a fire. In more advance cases, other steps may have to be taken. Advanced treatment may require:


  • Undressing the victim and place them in a sleeping bag with another individual, cuddle and use body heat to assist in warming the victim. (Some disagree on this step, but I believe the additional body heat can help).

  • Finding shelter in a warm building.

  • Use warm (not hot) rocks and apply warmth to the pit of the stomach, small (lower) back, armpits, back of the neck, wrists, and between the thighs.

  • Give the victim warm fluids and, if possible, increase sugar intake—but only if the victim is conscious.

  • Avoid alcohol! Alcohol causes vasodilatation (increase in surface blood flow), which leads to increased heat loss.

  • Seek medical treatment immediately if it is possible in your situation.


Ok, now that we have a basic understanding of what hypothermia is, as well as some treatment, how do we determine at what stage a victim is? I suggest the old survival method I was taught:


With Mild Hypothermia


  • Shivering (We have all had this from time to time)

  • Goosebumps

  • Hands may feel numb

  • Hands shake badly enough that some tasks cannot be accomplished.


With Moderate Hypothermia


  • Severe Shivering

  • Stumbling

  • Poor motor skills (poor coordination)

  • Movements are more difficult to do and take longer

  • Some confusion

  • Difficulty speaking

  • If the person cannot pass a sobriety test, i.e., walk in a straight line for 30 feet or so, they have hypothermia.

  • And, in some cases the victim becomes depressed and withdraws.


With Severe Hypothermia

  • The victim is in a stupor

  • Skin color may become blue or puffy

  • Irrational behavior for that individual (remember the persons normal behavior)

  • Shivering stops, but muscle coordination and motor skills are very poor.

  • Pulse and respiration rate drop

  • Overall confusion

  • Inability to walk, even a short distance

  • The victim may be unconscious

  • Heart and respiratory failure.

  • Death


Some things to keep in mind with hypothermia. Do not give your victim food, but instead give them waters and sugars. The stomach is not capable of processing foods at this point. Every fifteen or twenty minutes give the victim a warm drink. Also your victim will need to urinate. If the bladder of the victim is full, the body will use some of its heat to keep the urine warm and not the body. Get your patient to urinate so the body can go back to keeping the major internal organs warm again. Have them urinate often.


Use carbohydrates to provide quick energy in mild cases of hypothermia. Or, you can use proteins and fats to assist as well. Both proteins and fats release energy slower than carbohydrates, but the heat generated will last longer overall. Use what you have and that may be limited by where you are.


Do not give your victim alcohol, caffeine or tobacco. All three are to be avoided in any survival or emergency situations, because they either increase heat loss and they dehydrate. So, remember in the old movies where a very cold or injured person is given a shot of whiskey to fight off the cold? Well, that is dangerous and foolish. Avoid alcohol, caffeine, or tobacco, at all times when treating hypothermia.


Wrap the victim, once you have them dry, in layers and do not allow them to get wet. Keep them dry. I suggest using more than one sleeping bag, blankets and a “casualty” or “space” blanket. Remember that both the casualty and space blanket have a reflective side that can be placed toward the victim to reflect body heat and to prevent heat loss. In all cases, keep your victim warm and dry.


Do not just warm the outer portions of your victim and think it will work as a treatment. It is the inner core you should work on. Placing the victim too near a fire may only compound your problems in treatment. The warming of the outside of your victim may actually cause un-warmed, cold, blood to start flowing. This flowing of cold blood may case further chill to the inner core of your victim and lead to death. Warm the victim from the inside out and do it slowly in most cases.


Well, now we have an idea of what it is and how to treat it, how do we avoid hypothermia to begin with?


  • Dress for the weather . Keep in mind that you should dress in layers so that you get heat from the trapped air pockets. Air equals insulation, which equals warmth.

  • Drink lots of hot fluids . In a survival situation find wild plants from which you can use to make a tea with. I use a “pine needle” tea. Yes, you guessed it, made from pine needles.

  • Increase your food intake . Keep in mind the positive aspects of carbohydrates, proteins, and fats in the treatment of hypothermia.

  • Limit your exposure to the elements. If the weather turns bad, seek shelter. Do not force march or hike. Intentional exposure is usually a foolish idea.

  • Avoid shivering . If you start to shiver, use common sense. Add additional clothing, have a hot drink, seek shelter, and start a fire.

  • Carry high-energy food bars and hard candy in your survival kit.

  • Avoid exhaustion when moving by taking frequent breaks.

  • Be aware that anxiety, stress, or injuries may increase the potential for hypothermia.


Hypothermia is only one danger a person in the bush may have to face. Nonetheless, it can be a real killer to those who have no idea of what it is or how it works. By knowing the symptoms, proper treatment, and how to prevent it, the injury can be avoided in most cases. In some extreme situations, like a boat turning over in cold or cool weather, you will have to use speed and common sense in treatment. While hypothermia is potentially very dangerous injury, for most of us it is caused by a lack of knowledge. Now that you know a little about the subject, I suggest you do some additional research on his potentially deadly injury. (When I typed in hypothermia I got 307,000 sites.)


Good luck and I hope to see you on the trails of America.


Please note . This article is provided as a motivational tool to stimulate the reader to conduct additional research on this subject. While I have prepared this article to the best of my ability, I am not a doctor or a competent medical authority by profession. The procedures I have used in this article are those taught to me, in basic first aid and survival medicine during my U.S. military survival training, and what I have learned conducting personal research.


Hypothermia is a serious injury and requires serious research. When I typed in “hypothermia” to conduct an online search, I got more than 307,000 sites (and that was using only one search engine). As you conduct your first aid research, I recommend you concentrate on approved North American Medical Sites, U.S. Military Survival Manuals, or perhaps the medical departments of larger North American Universities. Remember, Knowledge is Survival.





Gary Benton has over 45 years of outdoor experience in camping, hiking, fishing, and other activities. He's no armchair survival man, he's walked the walk from the arctic to the desert and all the area in between. Gary has an associates degree in Search and Rescue, Survival Operations, a B.S. in Industrial Occupational safety, and all but his thesis completed for a M.S. in Counseling Psychology.
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