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Dirty First Aid Series – Part 5

Welcome to Dirty First Aid Series – Part 5 which will focus on Hypothermia.

Paddlers, no matter the discipline or location can all suffer from Hypothermia – a condition brought about due to the lowering of the core body temperature. Its final stage is death. Hypothermia is caused when someone cannot produce enough heat themselves to fight the effects of cold. Immersion in colder water, cold air temperature or exhaustion are the usual suspects. The former is the one that we will look at now – principally because it’s the one that we come across most often as paddlers.

Dirty First Aid Series - Part 5

Immersion hypothermia can mean that the body hasn’t depleated all its energy reserves, meaning the casualty can possibly respond quicker and recover with simple #hacks #dirtywork.

Get the casualty warm, and get energy food in to them.


Remember what the core needs is heat, it doesn’t need the stored heat going outside the core. A group shelter, foil blanket, blizzard pack, SOL or similar is a real life saver here.

Even the most experienced can get in to trouble, as this story shows.

Derek and Mick are both skilled expedition kayakers, both work in the industry and both knew the river well. They set off in the thin dawn light to make a speed descent high in the Indian Himalaya. They had limited food, no shelter, no stove. They hoped to make the trip in 3 days, for a normally 5 day trip. The day started well, no scouting – they had loaded boats with a few donuts, a mars bar each and some cheese. They also had sleeping bags.

Dirty First Aid Series - Part 5

They wore drysuits and thermals, even pogies. Late in the afternoon of day one, Derek found his skirt was ripped and his boat taking on water, with the gorge walls he had no space to empty out. The pair paddled for hours as the cold glacier water dripped in the boat – the water just above freezing lapped at his nether regions. He was sitting in the cold puddle for hours. As night fell the pair decidedto find the first beach after the gorge opened out. Tired, drained, Derek got out of his boat, his fingers numb, his body shivering uncontrollably. He dragged his boat to the over hanging cliff, and took off the drenched suit. Mick, kept Derek talking, Derek was talking more rubbish than normal but Mick monitored his signs.

Derek stripped to his dry thermals, crawled inside his sleeping bag then got inside the bag Mick had. Mick kept his core warm with his down jacket – then they spooned – Derek was the little spoon even though he was bigger. #sweaty #dirty #manlove

Dirty First Aid Series - Part 5

Soon Derek found his core temperature warm and he could feel his fingers, his teeth stopped chattering. Feasting on the food, they both sat back against the rocks. Now content, no longer spooning. They spoke of what to do in the morning and how far to go. It was like a one night stand conversation – but without the regretted intercourse…


Images Pure Land Expeditions, from Tim Cain course.



Old man river Darren Clarkson-King (DAZ) will be supplying a series of ‘Dirty First Aid’ articles for river runners.

Darren offers in-house training in the Himalaya and is a consultant for Nepal Association of Rafting Agents (NARA) making a blue print for an Industry standard.

He also paddles a bit.


  1. route2013

    I always carry gel-based heating pads with me. Smaller ones and the Rubytec HITI ones. If it get’s cold I put them between layers (with some pads you have to wait for them to cool down a bit) of clothes at chest hight. This helps warm the core and makes cold situations more pleasant and really helps warming up after you pull out of wet gear or like this article when you put someone in the orange bag. If you use paddle mitts you also can stick the smaller ones on top of your hand (maybe a manufacturer can put in small pockets on the inside) even while paddling. These pads are only extra’s and should never replace decent gear like the orange bag and in this case a spare skirt (the reed ones are easy to pull over your head).

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