Strange death from hypothermia

[gitfiddle]

In the book A Walk in the Woods Bill Bryson relates a story (Chapter 15, I believe) of sixteen men that give a mayday call because their vessel is sinking. They are forced to abandon ship into the freezing water of the North Sea. They floated for an hour and a half, and miraculously they were all rescued. They were wrapped in blankets and taken below, but as soon as each one took a sip of their warm drink, every single one dropped dead. Why is that? Was the warmth a shock to their freezing body?

[Qadgop_the_Mercotan]

Sounds a bit like urban legend to me. Hypothermia shouldn’t be treated by immersion into hot water, as that dilates all the constricted blood vessels rapidly, causing a possibly fatal drop in blood pressure. But hot drinks would be an ideal way to start the warming process slowly.

QtM

[evilhanz]

I don’t know about the particular case Bryson describes. I’ve heard a similar tale about Danish fisherman from a sunken trawler or evacuees from an oil platform. However, death after rescue is a real concern for victims of hypothermia. I know of two possible causes:

[evilhanz]

oops, hit enter too soon.

1. Improper rewarming can cause after drop where cold blood from the extremities returns to the core bringing it below the temperature necessary to sustain life.

2. Rough handling or moving the victim into a vertical position can cause stress on the heart which is in a hyperexcitable state. The result is either ventricular fibrillation or a fatal decrease in blood pressure.

I had not heard the warm drink element of the story. Ironically, that is a very good treatment for someone one who is mildly hypothermic. There’s a lot of literature on the subject of immersion and non-immersion hypothermia, so I’ll let it go at that. I know of at least one paper that deals specifically with “death after rescue”, but the details elude me at the moment.

[Duck_Duck_Goose]

Here’s the context of the story, from a review.

http://www.columbusalive.com/1998/19980820/biblio.html

Bryson shares his fears about what he anticipates on the trail. His pre-trip worries were many. He called Lyme disease a “fiesta of maladies.” Two hikers had been murdered recently on the trail so he shoved that into his anxiety closet. He thought a lot about the book and movie Deliverance. Hypothermia and the story about the 16 sailors—who fell into the North Sea, tread water 90 minutes, were rescued and given blankets and a warm drink, then promptly died, every last one of them—crowded his thoughts.

It sounds like “afterdrop” to me, too.
http://www.gulftel.com/~scubadoc/hypoth.htm

4. Gentle handling is a must. As the body rewarms it gets colder first for a short time; this is known as afterdrop.

Why is ‘afterdrop’ so dangerous?

During this period the heart is very vulnerable to developing life threatening rhythm disturbances. Immediately after rescue the victim should be removed horizontally from the water and kept that way. A litter or stretcher should be used to carry the victim since unnecessary exercising, jumping, climbing or exertion may trigger the heart rhythm disturbance.

Victims may deny they are ill and want to decline medical care, or want to climb into ambulances or helicopters on their own. Remember their judgement may be clouded, and yours should prevail.

Afterdrop can be worsened by certain types of “field treatments”, such as a cigarette, a hot cup of coffee and a drink of alcohol, all time-honored treatments. These all prolong the afterdrop and may not help the hypothermic victim recover. They should not be given to hypothermic individuals with core temperatures below 95 degrees F.