It’s a clear winter morning with temperatures forecasted for the mid-20s. Not bad, you think to yourself, and your mind wanders to the cathedral pines & soothing firs of one of your favorite trails.

With their solitude & grand perspective, those peaks and trails are where you do your heavy thinking. And you sure could use a dose of nature’s therapy right about now, so you grab your pack – and your snowshoes- and hit the road.

Once you hit the trailhead, you notice that the wind has picked up a bit, so you suit up & get rolling. It’s fairly quiet, with only one other car, so you know you’ll have the place (almost) all to yourself, if only for a little while.

As you set out, the snow alights on your shoes like powder while the wind whistles through the softwoods.

It doesn’t take long before your toes feel like toe-sicles, but you maintain a steady pace to stay warm. You stop occasionally to keep yourself on track & catch your breath, but you fumble with your water bottle as your exposed hands feel like steel against the brisk winds.

After you reach the peak, you stop to savor the view. From this vantage point, the world seems much softer, and you’re able to examine your troubles from a different perspective.

But soon your thoughts shift towards your shivering, which has become too much to ignore. And as much as you’d love to spend the rest of the day soaking in this view, it’s time to head to the heat & comfort of home.

As you stand, you stumble & lose your balance. You’ve always been clumsy – so it’s par for the course. You blame it on your snowshoes, get back on your feet & head towards the trail.

For a moment, however, you’re disoriented. You look for the landmarkers that should be all too familiar, but for some reason you can’t pick them out. You become frustrated with your confusion & start cursing yourself. But when you try to speak, your lips feel like Play-Doh that’s been left in the fridge for the last 40 years.

Stopping here, you may be fortunate enough to recognize the beginning stages of hypothermia.

Though it’s easy to overlook or shrug off as general clumsiness or simply “being cold,” knowing how to recognize it – both in yourself & others – can be the key to making it home safely.

Hello, Hypothermia

As homeotherms, humans have to maintain our body temperature within a narrow range to carry out our basic functions. Any variation from that range – even within a few degrees – and our bodies are about as happy as a nest of hornets that just got smacked out from under an eave.

Because humans evolved in much warmer climates, our heat loss mechanisms are top-notch. On the flip-side, our abilities to retain heat are a whole lot less impressive.

That’s why hypothermia can knock us out any time of year – and why the margin for error is so very narrow when we venture outdoors in winter.

Dodging the Beast

While recognizing the signs of hypothermia are key once you’re in the field, the first & most critical step (barring an accident or injury) is avoiding it altogether.

• Before you leave the house – make sure you appreciate the forecast both for the specific location & timeframe you’ll be visiting.  That also means recognizing that conditions can & often DO change rapidly in the mountains – especially if your hike will take you above treeline.
  • For example, if you’re planning to hike the White Mountains of New Hampshire, be sure to check the Mount Washington Observatory’s weather forecasting site before heading out rather than relying solely on the forecast from the local news or your favorite app.
  • TAKE IT SERIOUSLY! If conditions are forecasted to be unfavorable to treacherous and weather alerts are posted, don’t expect that your skills are somehow superior to the weather. They aren’t. They never will be. Nature will squash you like a bug on a windshield. When alerts are warning you to beware, always take them seriously & make alternative plans.
• Master the art of layering – depending upon conditions, you’ll want to aim for a base layer, a mid layer, and a shell.
  • The base layer is closest to your skin, so it will absorb the most sweat. As a result, it will need to wick moisture away from your skin to prevent you from losing heat through evaporative cooling.
  • The purpose of the mid-layer is to capture as much warmth as possible through trapped air. In colder conditions, consider adding another insulating  layer as well.
  • The outer layer may be soft or hard shell. Its primary purpose is to protect you from the elements & here you’ll need to consider breathability & water resistance.
• Stay hydrated – you should pack at least 16 ounces of water per hour that you’ll be outdoors. You might also consider bringing some warm water, hot cocoa, or decaf coffee or tea with you. Caffeine can be a diuretic (i.e. dehydrating), so you’ll want to be careful about drinking it while outdoors in cold conditions.
• Keep yourself properly fueled – the last thing you want is for your blood sugar to dip dangerously low during your hike, so make sure you have plenty of carb-fueled snacks with some protein & fats to keep you going.
• Plan for extra warmth – Consider stashing some hand, foot, toe, and/or body warmers in your pack.
• Avoid hiking in cold temperatures when hungover – the dehydration & groggy factor can create a potential disaster. The mountains will be there another day, so wait until you’re closer to 100% to tackle them on a cold day.
• Cotton kills – it’s a familiar saying amongst hikers, and for good reason. Cotton holds moisture that will pull heat from your body – which is the opposite of what you want when trying to conserve every last bit of body heat. Remember that it also holds true for bras, socks & underwear.

Recognizing Hypothermia

Despite your best efforts to avoid it, mistakes or accidents can happen. In those cases, it is essential that you can recognize the signs of hypothermia both in yourself & in others so you can get yourself to safety as soon as possible.

It is also important to recognize them in case you encounter others on the trail who may be behaving in ways that seem “off” or irrational. While it’s possible that other factors may be at play (i.e. a medical condition, drugs, mental illness), please know that if you observe someone who is fumbling, stumbling, seems incoherent or confused or otherwise irrational, it’s possible that they are struggling with the later stages of hypothermia.

Stage 1: Mild Hypothermia

• Shivering begins (not yet uncontrollable)
• Clumsy, fumbling fingers, hands & feet becoming numb
• Confused & sluggish thinking begins

Stage 2: Moderate Hypothermia

• More intense shivering becomes apparent, lack of coordination & more stumbling
• Irritability, confusion, sluggish thinking, difficulty speaking
• As they approach the upper reaches of moderate to severe hypothermia, shivering becomes more violent, they may develop amnesia, become depressed & withdrawn

Stage 3: Severe Hypothermia

• Shivering may cease as the body has depleted its energy
• Any exposed skin may be blue or puffy
• May have little to no coordination, lack the ability to walk or remain upright
• Likely to be incoherent and irrational
• In late stages may remove clothing
• Radial pulse may become barely if not entirely undetectable

Now what do I do?

If you recognize signs of mild hypothermia, take a moment to add some layers, make sure you’re hydrated, drink something warm if you brought it & eat something if you can. If you have any body, foot, or hand warmers in your pack, it’s time to put them to work.

And if you’re in a position to cut your hike short, now’s the time to do so. Remember that the mountain will be there tomorrow – but your chances to climb it again may not.

At this stage, hypothermia is manageable & there’s no need to put yourself in more danger. If you’re already at the peak, take the route that will get you back to the car in the most reasonable amount of time given the conditions & your knowledge of the trails. Often that’s the shortest route, but if the shortest is the steepest & most treacherous, then the longer route may be the better option.

If you haven’t reached the peak yet – or any other point you had in mind – it’s better to save it for another day.

For moderate to severe cases of hypothermia, the first step is to call for a rescue, as it is a medical emergency requiring immediate help. Though remember that “immediate” in the backcountry is a relative term, as rescues typically require several hours at a minimum.

Emergency personnel may be able to provide treatment instructions over the phone in these cases, but for the most comprehensive training around wilderness medicine & first aid, consider taking a course from the National Outdoor Leadership School (NOLS) or Stonehearth Open Learning Opportunities (SOLO).

There you can become certified in Wilderness First Aid or as a Wilderness First Responder, depending upon your interests, budget & time availability.

Takeaways

The bottomline is that hypothermia is no joke, and if you’re headed outdoors in winter, you need to cross your t’s and dot your i’s to make sure that you make it home safely.

As always, nature takes no prisoners, and when you venture out to enjoy the fresh powder, sun stars, and invigorating winds of winter, remember to respect the outstanding power that she holds in her hands.