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We all have discussed and read Hypothermia quite a lot of times and are aware of general concepts about it. What made me wonder the most was an incident about a mountaineer on Mt. Everest. With the sort of wisdom I have, I still can't see why he is still alive (No offense, that is a great thing and I am awestruck as well as very happy for him) and how he made it.

That guy was stranded, it was a team of two if I got the whole documentary right. And they did summit and this fellow here, got stranded and had a Bivouac between Camp III and Camp IV. Later in the morning he was found undressing himself and standing at a cliff which seems like he is totally out of his mind. He was later rescued by a team who gave up on the summit attempt and chose to bring him down.

Looking at the situation, He should have died of the Hypothermia. Is Paradoxical Undressing a later stage of Hypothermia? Because the actions/symptoms speak absolutely otherwise.

Have anybody more study or information about this stuff? Yes, I can simply browse for it, but there is too much sci-stuff and physiology stuff said about it, and that didn't help much.

How can it be treated? Does the same treatment as Hypothermia helps to treat this thing?

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    He not only suffered from hypothermia, but also from a cerebral endema which caused illusions and desorientation in him. Maybe this could be the cause of the undressing? Commented Aug 18, 2014 at 14:47
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    It could have been HACE but it is also known that in the last stages of hypothermia the individual can start feeling too hot and undress because of the feeling. This is before terminal burrowing. All of this is also documented at low altitude.
    – ppl
    Commented Aug 18, 2014 at 15:11
  • @PaulPaulsen Very valid point. But shall we stick to the point about Paradoxical undressing? Or may be Paradoxical Undressing is entirely due to Hallucinations?
    – WedaPashi
    Commented Aug 18, 2014 at 15:29
  • @ppl what do you mean by Terminal Burrowing?
    – WedaPashi
    Commented Aug 18, 2014 at 15:34
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    According to some researchers, triggered in the final state of hypothermia and produces a primitive and burrowing-like behavior of protection, as seen in hibernating animals. It's on the Wikipedia page for hypothermia.
    – ppl
    Commented Aug 18, 2014 at 16:09

3 Answers 3

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Between the moderate hypothermia stage it has been noted that a body will trick your senses into thinking it is burning up. So you naturally begin to strip. Here is a more direct answer from Survivaltopics.com

A funny thing happens to people when they get hypothermia. Many of them strip off their clothes as one of their last acts before they die. This is common phenomena among fatal hypothermia cases and is known as “paradoxical undressing”. Why in the world would someone who is literally freezing to death take off their clothes?

Here’s the answer from SurvivalTopics.com:

Now the key to what causes paradoxical undressing. Vasoconstriction occurs when the smooth muscles within the vasculature contract. This effort requires a steady input of energy in the form of glucose from the body’s energy stores. However, due to a lack of blood now travelling to these muscles, they eventually tire. As the muscles of the constricted blood vessels run out of energy, they fatigue, relax, and open up. This is known as vasodilation.

With vasodilation of the blood vessels, an infusion of warm blood from the core of the body rushes into the peripheral extremities. This causes the hypothermia victim to feel overly warm and to start shedding layers of clothing, contrary to the reality that their body temperature is continuing to drop.

The victim’s warm blood rushing from their core, coupled with the removal of warm clothing, causes their body temperature to fall even faster. This serves to hasten death from hypothermia and results in another case of paradoxical undressing.

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  • Hi B.O.A and welcome to TGO. Good answer in my opinion, I think this explains the physiological reasons very well. So it's not something like HACE or confusion in general. This is a physical/biochemical phenomenon.
    – Wills
    Commented Aug 18, 2014 at 17:27
  • Correct! I have been on a S&R for an experienced hunting guide that I knew. He was very well minded and knew the outdoors well. Unfortunately he got an injury which slowed his return to camp. To add to his situation he was hit by freezing rain. When we found him he was naked and had crossed two major highways. Hypothermia is bad news and bad news fast! Sadly he did not make it.
    – B.O.A
    Commented Aug 18, 2014 at 17:35
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Erm yes and no. With moderate hypothermia you loose rational judegment and do unrational things, like remove your clothes. But removing your clothes is not a stage of hypothermia as such.

The symptoms of hypothermia are:

Mild hypothermia

The symptoms of hypothermia can vary depending on how low your body temperature has become. The early symptoms of hypothermia are often recognised by a parent or carer. This is because hypothermia can cause confusion, poor judgement and changes in behaviour, which means the affected person may not realise that they have it. Mild hypothermia

If someone has mild hypothermia (generally with a body temperature of 32-35˚C), the symptoms aren't always obvious but they can include:

  • constant shivering
  • tiredness
  • low energy
  • cold or pale skin
  • fast breathing (hyperventilation)

Moderate hypothermia

Moderate cases of hypothermia (generally with a body temperature of 28-32˚C) can include symptoms such as:

  • being unable to think or pay attention
  • confusion
  • loss of judgement and reasoning (someone with hypothermia may decide to remove clothing despite being very cold)
  • difficulty moving around
  • loss of co-ordination
  • drowsiness
  • slurred speech
  • slow, shallow breathing (hypoventilation)

People with a body temperature of 32˚C or lower will usually stop shivering completely. This is a sign that their condition is deteriorating and emergency medical help is required.

Severe hypothermia

The symptoms of severe hypothermia (a body temperature of below 28˚C) can include:

  • unconsciousness
  • shallow or no breathing
  • weak, irregular or no pulse
  • dilated pupils

Someone with severe hypothermia may appear to be dead. However, under these circumstances the individual must be taken to hospital to determine whether they have died, or if they are in a state of severe hypothermia. Medical treatment can still be used to resuscitate people with severe hypothermia, although it is often fatal.

From the NHS website

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  • So does it mean that undressing is entirely due to Hallucinations? Does the thermoregulation cone in picture et all?
    – WedaPashi
    Commented Aug 18, 2014 at 15:33
  • @WedaPashi it is due by either the brain misunderstanding the signals or possibly a surge of blood/warmth in the extremities which gives the impression of feeling too hot.
    – ppl
    Commented Aug 18, 2014 at 16:12
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Also, the portion of the brain partially responsible for the sensation of warmth is the sub cerebral structure producing met enkephalins. This flood of alkaloids is the bodys last ditch effort to induce a state of physical pain immunity and hopeful euphoria that may save the organism's(you) life.

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