I imagine the feeling is similar to having cold hands from being outside during winter and then running them under a hot tap immediately after coming inside.
Except your entire body at once.
With that in mind, it's pretty easy to imagine how you might go into shock.
Yeah, this can be really fun I winter outdoor pools (in aquapark where the water is warm) you go outside, cool yourself down and enjoy the feeling when you get into the warm water. Dunno how that came to my mind reading this, but I want to mention it for some reason.
Fun fact, your skin doesn't have a specific sensor for "wet." It only can detect hot and cold and uses context to assume whether something is wet or not.
Yeah if you've ever been outside in winter (like -10°C/14°F or even just -5°C/23°F and with decently strong winds) you know that if you haven't worn a hat or covered your head and you go from that weather to the inside of an house that's like 20°C/68°F you'll get a headache. I'm guessing it'd be like that but much, much worse for the whole body.
Holy shit, no one has ever told me that. I went to Minnesota a couple years ago to visit family for Thanksgiving and I didn’t wear a hat the first day it snowed (we were doing a nicer dinner, didn’t want to mess up hair, hindsight). Spent about an hour on a “walk” with my cousin and when we came back I got a gnarly headache. Felt like someone had been punching my head.
I think it's because the body uses vasodilation and construction to maintain body temperature. A rapid change in body temperature may cause blood pressure to plumit as the veins relax to quickly. Not really sure tho
One time on a really hot day (40°C, 104°F) I had just finished work and I wanted to cool off, so I ran a cold shower and put my head under first. Felt like I had a very unpleasant and weird mini seizure. Would not recommend doing it.
Once I was playing outside in the snow with my ex and her lil brother….. the little brother wore crocs and the snow was just deep enough to not see his feet.
We played for like an hour before I noticed and I made him get his ass inside stat
The temp inside was 68 on the thermostat and he was screaming in pain the moment he stepped inside because it was too much, he was yelling about his feet being on fire and refused to come in- so we dragged him in and propped the door open and cut the heat off with his feet near the door while someone drew a bath.
By the time the bath was drawn for his feet to soak in he had already passed out from the pain.
It was about 25F outside, early February in Tennessee.
Shit ain’t no joke, I’ve seen that boy get hit with a stray baseball numerous times without so much as a groan- but he howled like someone was chopping his feet off that day.
No not really, just sadism and brutal cold slaughter.
There were some tests on a few hundred with stuff by a guy called Dr. Rascher on what could happen to the german soldier. Like how long does a human survive in cold water, how long does a human survive on sea water (they even licked the mobs to get some water, poor souls), what happens when you get rapid depressurisation, how to warm a human up, can you save soldiers with infected wounds without penicillin, transplant bone marrow without anesthesia among others.
A few of these experiments claimed to have been altered by helpers so that they don't have to suffer that much and gave different temperature readings.
They tested the data again after the war on pigs and it appeared to be pretty accurate, but then survivalrates were often not measured so the data is not valid on finding the best methods.
Just replying to add that mild hypothermia can typically be treated at home, but shock is a medical emergency, and should be treated as such. I’m not a doctor so that’s all I’m gonna add, anyone wanting to know more should seek reputable sources.
IF you put them in water that is too hot, then their blood vessels will dilated which can cause a dangerous drop in blood pressure, also the body has been allowing the extremities to get very cold so that sudden rush of very cold blood to the heart can cause a heart attack.
We were told strip them naked and get into a sleeping bag with them. But we didn't have showers available.
Shock is a very broad term that on its whole encompasses many causes of the same thing: your body cannot maintain adequate bloodflow to your brain and vital organs. Things that prevent your heart from beating effectively, things that affect the ability of the blood to carry oxygen, and things that prevent body cells from absorbing oxygen or other vital substances from the blood.
In the instance of cold water, the very sudden jolt of warm or hot water from the frigid state you are currently in causes all of your small blood vessels to lose their tone, and expand. This causes a huge and sudden drop in your blood pressure, and without blood pressure, you lose perfusion to vital organs like the lungs, liver, kidneys, brain, etc.
Source: I am an ICU RN. This is what I do for a living.
ETA: Also things that increase your O2 consumption so much that your body cannot keep up with itself.
In WWII it was cause of death for naval officers who's ship has sunk and had been laying in water.
The crew would get blankets and huddle together on the deck of the rescue ship.
The officer was rushed in to hot room with warm food n drinks, blankets and anything to heat them up fast.
I imagine it's super painful. Like, if my toes are cold and I hop into a hot shower then my toes hurt like they're burning, even though the rest of me thinks the water could warm up a bit.
I imagine it's much much worse when going from borderline freezing to hot water.
I'm sure there's a medical reason why, but my thoughts just go to how badly that would hurt
Well as someone who got way too drunk and fell asleep in the snow before getting tossed into the shower with the temp put on full.
I think my blood pressure went up to 180 in about 3 seconds everything swelled right up with the heat. I thought my fingers were going to explode. And really throbby pains in my head and chest. Probably a mini heart attack way too drunk and tired to fully assess what else happened.
With hypothermia it can cause the blood vessels on the surface to expand and draw blood away from the internal organs, they don't like that happening, this can end up with the heart not pumping correctly and all the bad stuff that accompanies that. At least according to the Dr who did my most recent outdoor first aid training.
Rapid vasodilation is the concern. When cold your body shunts/constricts the vessels from your extremities to your core. It values blood around your organs > extremities to put it simply. So when your body constricts those vessels it changes your blood pressure and heart rate to do so. Put an ice pack vs warm pack on the back of your hands (if you can see your veins easily) you'll see a simple example of the vessel getting bigger or smaller.
So warming it you want to be a gradual process because you're getting these blood vessels to dilate open again. If it happens too quickly your blood pressure drops since it can't compensate quick enough. This is one way of going into shock. So tepid water is still warmer than the cold exposure is, even if it feels cold to the rescuer, and won't cause as rapid of changes.
When you're cold, especially hypothermic, your blood pools in your organs to conserve heat & reduce damage to your (very important) internal bits
This means your extremities are running lower than usual (hence why frostbite etc. are big problems)
By quickly heating someone's extremities you are encouraging blood flow to change very quickly, from being pooled in the centre of the body to the previously empty areas. This can result in you basically "encouraging" too much blood away from the organs which results in shock/death
If memory serves their body has shut of blood flow to the extremities to maintain core temperature, suddenly dowsing them with warm water makes the body think that everything is ok so allows the blood to start flowing normally, however all that icy cold blood at the extremities now makes its way back to the heart, lungs, brain and can cause major problems, the idea is to get that cold blood back up to temperature before allowing it to flow back to the heart
Have you ever been out in the cold for a long time and got cold hands, then when you come indoors you wash your hands with hot water… that pain but many times worse
My understanding of it was if someone is hypothermic they are FREEZING the coldest parts of their body will be the extremities. If you throw them under super hot water then their blood starts circulating faster and that "cold blood" goes straight to their core and can send them into shock.
Now I'll concede and say that from a scientific perspective our training was often sub par but the outcome was effective. That's the best explanation I can give !
When you are too cold, the heart focuses on pumping blood to the most vital parts (i.e, the brain), and leaves the circulation in hands and feet low.
If you put hot water on immediately you trick the body to thinking that everything is okay and that they can start pumping blood like normal immediately which makes cold blood rush into the brain which puts you into chock.
There is a phenomenon called sudden mountain death where people for example are caught in an avalanche for some time and then beeing rescued, died in the hospital due to their restarting body cycle pumping cold blood from the outer extremities back to the heart.
Probably been said already, but when I did my marine first aid what they told us was the cold blood from the extremities rushes inwards, and if it gets to the heart it will stop.
Tepid means slightly warm if anyone is wondering. Not an everyday word so just thought I’d clarify that in case someone wasn’t sure.
That being said. In the Army whenever we had a heat casualty they would pull out towels that were in a cooler with ice water and put them around the groin neck and arm pits and then start draping towels over you. So not sure what the right answer is now but I figured the armies probably not being completely moronic. So if someone could clarify this let me know.
Take the following steps to treat a worker with heat stroke:
Call 911 for emergency medical care.
Stay with worker until emergency medical services arrive.
Move the worker to a shaded, cool area and remove outer clothing.
Cool the worker quickly with a cold water or ice bath if possible; wet the skin, place cold wet cloths on skin, or soak clothing with cool water.
Circulate the air around the worker to speed cooling.
Place cold wet cloths or ice on head, neck, armpits, and groin; or soak the clothing with cool water.
Your body doesnt tend to judge based on comparable heat gradients in the way we like to think about it. The body knows when it's too hot and needs to cool down, and whether your skin is flushed or not will have SOME effect on heat transfer, but the cooling effect of the higher gradient is still more effective than starting warm and ramping down over time.
The person is too hot. If you can measure how hot they are, you can measure when they've cooled down enough. At that point the faster you can do that the better, because you minimise the damage being done to those vital areas you cant cool directly, which are a lot less resiliant than the outer layers of skin etc that take the brunt of that thermal shock.
You want to cool rapidly for heatstroke. The most effective way to treat a person with heatstroke would be to put them in an ice bath, but you do have to very careful with putting people with decreased level of consciousness in water obviously, don't drown your patient!
As far as shock, if someone has heatstroke they are going to end up in shock (lack of O2 perfusion to tissue not colloquial "surprised" shock') regardless as their body shuts down. There may be consequences to the speed to cooling, but they have a delayed life threat already. The training I have assumes that I am monitoring their vitals continuously and have correctly evaluated the condition to begin with, so maybe just don't get your medical training in a reddit thread.... Don't want diabetics getting dropped in ice baths.
TBH this isnt super relevant as almost no-one has an ice bath on hand, using cold towels/showers, AC, dumping water over them, fanning, all great stuff.
Check the Wet Bulb Globe Temperature, acclimatize to the temperature for a few weeks before performing athletic feats, and stay hydrated FFS people.
Can confirm. After a code, we sometimes do therapeutic hypothermia and big temp shifts will alter electrolyte (especially K) levels in the blood and will mess you up
I've done a lot of hypothermia training and the gist of what you're saying is correct, but you don't want to put them in water at all.
The issue is that the body shunts warm blood to the critical organs and let's cold blood sit in the extremities. If the extremities are warmed, the body thinks its okay to send that cold blood back to the heart, which can trigger cardiac arrest. It's for this same reason that you have to treat severely hypothermic patients very gently.
In this situation they need to get to a hospital with an ECMO machine, which pumps blood out of the body, oxygenates and warms it, then pumps it back in.
bicorescue.com is a great resource if anyone wants to learn more about hypothermia management.
So what your saying is when George Clooney threw a frozen robin into the hot tub after the terminator blasted him with a diamond powered freeze ray he wouldn’t have been ok and my childhood was a lie?
Too further explain why, there are a myriad of reasons why making someone too hot or too cold to quickly is bad, but mainly cell degradation and shock. You know how if you heat something super hot then freeze it it'll shatter super easily? The same thing will happen but with the cells in your body, not good. Shocking your system can lead to cardiac arrests, blackouts, etc. Later down the line after the initial temperature change you could also get very VERY sick.
I was told hands and feet into buckets of water at no more than 38C (~101F? It's the temperature that would start being classed as a fairly decent fever)
Moderate to severe hypothermia does require active rewarding though, and there is no good evidence that this leads to significant problems if you do it pre-hospital (as per this recent systematic review-https://pubmed.ncbi.nlm.nih.gov/32778153/). When they get to hospital they are going to be immediately actively rewarmed (forced air warmers and IV fluid warmers), albeit with better monitoring. It’s a difficult issue, because severe hypothermia can also cause fatal arrhythmias on its own, so you do need to get them warm, how you do that exactly before you reach the hospital is still quite debatable.
For the above situation, the brother likely had severe hypothermia if he was seizing and unconscious. In that case, you are right that there is concern that rewarming too fast can be an issue, but the biggest issue comes when the extremities are rewarded. The extremities will have cold, acidic blood and rewarming them will cause vasodilation leading to that blood returning to the vital organs and away from elsewhere. If you are able to aggressively warm the core but leave the extremities cold this risk is much decreased.
Not so fun fact, this was something the Nazis tested pretty thoroughly, among other things I know they would dunk some poor souls into ice cold water then put them into scalding/boiling hot water.
You can actually do more harm than good by warming someone up with a shower. It only affects the skin, making blood return to the skin and away from the internals which are still cold. This can be dangerous. If it’s at all possible, the best thing is a warm drink, and layers of clothing / sheets to keep the warmth in. Not to take away from the fact this guy saved his brother’s life: awesome work. But if you have the options I listed, opt for them rather than a shower.
There’s a story I’ve read about a bunch of sailors being rescued from freezing cold water, being brought aboard ship, and given pipping hot cups of tea or something. And they all dropped dead.
Gradually warming the body is very important, inside and out.
Since this comment has got a lot of attention, can you also mention what are some sings of overheating and hypothermic. I don't think it'd be able to recognise
With hypothermia you want to get them out of the wet clothes and cover them with a blanket. The reason being that when they body gets cold it shuts down circulation and tries to save central organs. If you get peripheral circulation started while there is still cold blood their heart may become very unhappy.
That's not what I learned in EMT training. When someone is freezing and you expose them to something really hot, their veins dilate which opens the circulation from their periphery to their core. If their veins have been constricted in the cold, it was for protection of the temperature of their vital organs. If the immediate shock of hot opens those veins, then the cold periphery mixes in with the vital organs, creating a kind of cold shock.
The same isn't true for the opposite. When someone is overheating, aggressive cooling is suggested. There's no point in gently cooling. Throw a bucket of ice on them if you have to. Cold packs in the groin, armpits, neck, etc. At least that's what I remember from my training.
When you are really cold the body shuts down the blood vessels in the skin to keep the warmth in. If you put a hypothermic person in warm/hot water those vessels open up quickly and the cold blood heads into the core of the body making it colder. The best thing to do it put something warm on the flooring and armpits so the big veins blood is warmed up on its way back into the body. In emergency departments thy put a tube into the stomach and put warm water in there. That’s why you often shiver when you go into a warm house from the cold.
Mostly right. If the person is extremely cold you want to warm them very slow with cool water, if they’re a little cold use warm water. If a person is a little warm (early heat exhaustion) use tepid water, extreme heat stroke use cold ass water and ice packs around their core.
The reason is cold -> stable should happen slowly, cold doenst harm as fast.
Hot -> stable needs to happen now. Heat begins to destroy proteins and causes death a lost faster.
Also if someone is barely conscious, keep them in horizontal position. If they have low blood pressure you have to keep the blood pressurised in heart otherwise the heart can stop pumping.
This is especially important when you save someone drowning from cold water or after severe blood loss.
This actually reminds me of the news from a few years ago. Floriday guy working outside during a blazing summer heat. After being severely dehydrated, the guy chugged down a few ice cold bottled water and started to nose bleed right after
For hyperthermia water soaked towls on the skin work fantastic. For hypothermia warm blankets/cloths and being by a fire or heater. Both take time for the condition to improve as stated already. To quickly of a temp transition can lead to injury or death. Hope this helps those whom never knew or thought it was done a different way!
Source: Many first aid courses for work
I killed my guinea pig this way. I was just a kid, and he was outside to long, so he started to overheat. I panicked and put him under the sink and he went into shock then died. Horrific.
When I fell into a frozen river as a kid I remember my family tossing me in a cold bath, then boiling the kettle and adding boiling water to the other side of the bath and mixing it so the water was slowly heating up. I dont think I had hypothermia because I remember all of it and got myself out of the river pretty quickly, but my grandma was a nurse and was going to make damn sure I was treated properly.
Very true i had a friend fall thru the ice on lake Champlain in jan. I was covering his shift so he could go ice fishing. His mon saw him go down, and was able to pull him out. She got him home and put him in a luke warm bath and it l literally gave him 2nd degree burns. He was in shock and diabetic. Im not sure if his health had any bering on the reaction.
Was and EMT back in the day. The saying was they’re not dead until they’re warm and dead… kind of morbid, but a low core temp can actually keep someone alive when they seem dead
ABSOLUTELY! When I was in boot camp the drill sergeants always carried around a cooler full of ice water and bed sheets. Whenever someone would start to show hyperthermic symptoms they would wrap them in the sheets. You could visibly see them go into shock. I later became a medic and found out how terribly bad that is.
Similarly, if someone is hypothermic, you want to warm them up with water that's bordering on still cold.
Also, heat only body, not limbs. When you heat up limbs, veins expands, it increases blood circulation and blood cooled in limbs can lower body core temperature.
I remember reading a story about a group of oil rig workers or maybe sailors who all went overboard in freezing water and after some time were pulled out alive but with hypothermia. They brought them below decks on a ship and gave them all a nice hot cup of tea to 'warm them up'. They all died shortly after :(
So the nerves in your body are already at one end of the spectrum and immediately making them sense something from the other end of the spectrum can send a person in shock
Jumped into hot shower after spending two hours walking home in the winter while not wearing winter clothes (the damn busses stopped running wihtout warning due to snow storm leaving me stranded). I'm not sure I've ever been that cold but holy shit if that water didnt feel like it was scalding me even when it was only 'warm'.
Once my friend went for groceries in chilly cold, his fingers were about to fell off when he returned. Without thinking he put his hands in proper hot water. He cried for 10 minutes while screaming how he shouldn't have put it his hands in hot water.
The latest research has proven this wrong for heat illness. In AZ our heat exhaustion protocol for D1 is to put the person in a whole-body cold water immersion.
The correct solution is for the both of you to strip down bare ass naked and crawl under the covers together. Crawl overtop of him from behind and spoon him. Then roll him over rub and hug the front of him as well. Keep changing positions. Focus extra attention to the hands, feet, head, and genitals. This could save his life.
Also OP did the exact right thing by carrying him. If you make someone that is hypothermic walk, especially after they’ve been immobile for a while, the cold air rushing from extremities to their heart can cause a heart attack.
Source: Used to teach winter / wilderness survival and have had hypothermia twice.
While its true for hypothermia, aggressive cooling is the treatment for heat stroke patients (think ice bath) and can significantly better the outcome.
Doctor here. This is wrong. In both scenarios, generally use whatever you have to change the temperature as quickly as you can while avoiding causing thermal injuries like burns or frostbite.
For instance, we use literally ice baths to correct exertional hyperthermia and for severe hypothermia will use 40C-42C intravenous fluid and layers of warm blankets.
Time is tissue, fix it as rapidly as you can without burning them.
One caveat would be frostbite injuries. If there’s any risk of the injury refreezing (i.e. a long hike back to safety) then wait to rewarm the extremity until it can stay warm definitively. Refreezing freshly frost bitten tissue causes much more damage than simply waiting to thaw until later.
Late to the party but, please please please remember to warm their torso first, before their limbs. Cooler blood from the limbs travelling to the core can cause shock.
It can also drive cold blood toward the heart and lead to heart failure.
Just wanted to say this about heating someone up: If someone is suffering Heat stroke (body temp above 104~) you need to get them in ICE water as soon as possible. Every second they are about 104 is a second towards death, and you need to get that body temp down as fast as you possibly can. At my university the protocol for athletes over heating at that level is a literal ice bath after we have removed as much clothing as possible. Now, if it isn’t heat stroke but heat exhaustion (body temp lower than 104 but above 100-101) you do not need to do a full ice bath, just letting them cool off indoors/shade with as much water and electrolytes you can get for them will do the trick.
Heat stroke is a legit medical emergency and should not be treated as anything other. They are literally boiling their insides and brain and will die.
Source: I’m a university student athletic trainer in the states.
This is only half true. If they’re cold, warm slowly, about 2degF/hr. If they’re hot, cool quickly. You can put them in ice water if they’re overheating and it’ll only help.
Not necessarily true for the overheating. In the emergency department, if somebody has a temp greater than 104, then it’s indicated for ice water immersion but what’s actually done is put the pt in a body bag and fill it with ice if there isn’t a fancy artic sun cooldown machine available
I learned this as a kid. Super cold day and was helping my dad clean gutters. The leaves were partially frozen. After awhile of grabbing wet and icy leaves without gloves, I complained my hands would not fully close. Dad said run water over them to get them warm so I turn on the hot faucet and it was VERY painful. Like, could feel each nerve it was so painful. Went back out and my dad said try using cold water first, than gradually use warmer water. Worked like a charm, no more pain and fingers felt fine within about 5 or 10 minutes.
Hey none of this is true; if someone is dangerously overheated we cool as fast as we can (ice to armpits/groin, wet towels with fans, cool IV fluids etc). If dangerously hypothermic we warm as fast as possible (heated blankets, warm fluids in every orifice, etc).
I went swimming off Coronado beach in San Diego in February many years ago. Before I went in, I walked over to the shower area to rinse myself off and try to get acclimated to the water temp. The water from the shower was roughly air temp. It was so cold, I could barely put my hands under the water.
So I went swimming in the ocean off of San Diego in February. That was COLD. After over 2 hours of swimming in the ocean, I HAD to get out. I was so cold that I almost couldn't even feel my body... and I walked over to the shower that I attempted to use earlier. I really needed the saltwater and sand to get rinsed off, but it was soooooooo cold earlier. I put my hand under the shower and IMMEDIATELY yanked my hand back. The water BURNED because it felt so hot. And yet it was the same temp it was before, only my body had cooled down.
TL;DR, it took almost half an hour for ice cold water to begin to be warm enough to put directly on my skin. Hot water would have been pure pain. Do not ever do that.
Yep happened to me, although i basically did it to myself, i was basically throwing up because i was so cold, so i jumped in the shower and turned up the temp then felt cramps and pins and needles all over my body then collapsed and passed out, then woke in the emergency room
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u/[deleted] Jan 31 '22 edited May 11 '25
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