Cold weather care - Rx for the Arctic.

• Author: Berger, Michael
• Position: Health care for cold weather ailments

Less than 2 percent of Alaska's health care providers specialize in cold weather medicine, but their skill saves growing numbers of lives each year.

Jack London's story, "To Build a Fire," tells the tale of a man and his dog facing the rigors of travel in the Alaska wilderness. Inexperienced and ignorant of the rugged terrain's many dangers, the man falls through a thin sheet of ice covering a stream. He scrambles to build a fire and dry his clothing to prevent dying a frosty death. But as the fire flickers out, the dog watches the man die from the cold.

The outcome of that story could have been different if the traveler had learned more about what to bring on a trip and how to handle life-threatening situations that arise from sub-zero temperatures. In Alaska, emergency training has become a necessity and the rescue/medical community has assumed the responsibility of educating people before they are faced with a cold-weather crisis.

"Because the wilderness can basically begin in your back yard in Alaska, it is very important to be ready for any emergency," says wilderness emergency medical technician (EMT) Sandra Call of Emergency Medical Training of Alaska (EMTA). "You never know when a serious injury could take place. The weather does not have to be below zero for hypothermia to set in. If a person gets wet and their body temperature drops below 90 degrees, they are in danger of freezing in their core organs (heart, lungs, and brain). But when the weather is below zero, the proper training becomes even more important."

Hypothermia is described by Dr. Will Jackson, in Sea Kayaker magazine, as mild (core temperature above 90 degrees) or severe (core temperature below 90 degrees). The longer one is exposed to the cold without proper care, the greater the severity of the hypothermia. If the core temperature drops into the mild range, limbs will become progressively colder and will feel stiffer because muscle and nerve efficiency is decreased.

"In addition, shivering will be present and become uncontrollable in most cases, adding to poor manual dexterity," Call says. She describes people suffering from the loss of motor and mental skills as acting like "dumb sheep" or getting the "umbles" (stumbles, fumbles, grumbles and mumbles).

Call and her husband Scott, also a wilderness EMT, teach beginners that there is always some risk in any cold weather undertaking. Their classes, geared to form the basis for a "risk management" plan, include...