hey, umm, i wanna write fanfiction in the divergent fandom where the ofc is stubborn and somehow develop hypothermia (either from passing out from drinking outside in the rain, at night//or// jumping into an icy river to save a factionless against eric's orders) and eric had to warm her up. Can you give me a little bit of pointers or any specific thing I should have in that fic so that it's believable? thank you, i love ur blog.
Never read divergent,people keep telling me I should.
But anyway, good choice onhypothermia! I’m a fan of this one, so strap in…
Hypothermia occursclinically when the body’s core temperature drops below 35 C. It can take quitea while to get to this point, depending on the character and the reason for thehypothermia. A character can have symptoms of early hypothermia (shivering,increased heart rate) prior to this, but this is generally when it startsbecoming medically relevant.
Normally, the body triesreally hard to stay within its normal operating parameters of 36.5 and 37.5 C.Hypothermia can be caused either by a body having trouble regulating itstemperature (due to drug, disease or brain injury), or it can be due to extenuatingenvironmental factors, like you’re asking about. When hypothermia has to dowith the environmental factors, it usually occurs due to either exhaustion(where the body lacks the energy to keep up with maintaining body temperaturein a cold environment) or due to just straight up overwhelming cold (likefalling into a frozen lake for more than a few minutes).
Hypothermia is dividedinto 3 classes:
Mild hypothermia: Thebody’s core temperature has just started to drop, and the body is revving up tofight it. In this stage, a character would primarily exhibit shivering and anincrease in breathing, blood pressure and heart rate as the body tries to bringits own temperature back up. Slight confusion may be present as well, but wouldbe rare. The character also might have paler skin or bluish fingers and toesbecause of a process where smaller surface blood vessels constrict to preventadditional cooling of the blood from the skin.
Treatment: passiverewarming- warm drinks (with calories), blankets, dry clothing. Get the personout of the cold or wet environment and somewhere they can recover. Have someonestay with them if they are confused and/or to make sure they’re not getting anyworse. Usually this is enough, as the body is very capable of generating enoughheat in reasonable circumstances.
Moderate hypothermia: Thebody’s core temperature is two or three degrees below clinical hypothermia, andthe body realizes that just sorta shivering isn’t cutting it anymore (slacker!)and it starts expending tons of energy into saving itself. Your character wouldbe shivering violently, with markedly blue ears, fingers, toes and lips (bodyis again trying to keep core blood warm by not exposing it to skin where itcould cool, as well as planning for the worst and just trying to keep vitalorgans warm enough to function). She would be confused and uncoordinated, butstill alert.
Treatment: Everythingabove, including warm sweetened liquids (NO alcohol or caffeine) if the personcan swallow normally. In addition to this, place hot water bottles (or heatingpads, or water bottles filled with hot water) in the armpits and groin. Monitorvitals if possible. Have someone stay with the character until her temperature is normal for several hours and she has no more symptoms.
Severe hypothermia:Hypothermia presents a catch-22 for the body. It expends tons of energy onrewarming itself, which sometimes works, but not always. Eventually, if it doesn’t work, the body no longer has the strength to continue violently shivering,maintaining a high heart rate and constricting blood vessels. She would die veryquickly after this because the blood would rush back into the now really cold extremities, and circulate this cold blood to a no-longer-compensating body. This is when your character is in serious trouble and needsimmediate medical attention. She would no longer be shivering, or would beshivering very weakly. She would be drowsy and unable to stand/walk, and herspeech would be very slurred. Her temperature at this point would be around28-30 C. Heart rate would either remain high or drop into the 30′s. Breathingrate would slow considerably and skin would become very pale, puffy and blueall over.
Treatment: If there isaccess to emergency medical services, warmed IV fluid or flushing the abdominalcavity with warm fluids would be optimal. This is called active core rewarming.If not available, do everything you’d do for moderate, but monitor vitals every5 minutes or so. Resuscitation (CPR, code scene) may be necessary, and would beconducted normally once the character was rewarmed to about 32 C.
In fanfic there’s thispopular idea that you can’t warm someone who has hypothermia up quickly becausethey’ll go into cardiac arrest. This was probably due to an outdated article thatconnected active external rewarming and something called rewarming shock and is a load of horsehockey. A caregiver would always want to monitor for signs of shock,but barring that, definitely rewarm someone as quickly as they’ll rewarm.
Now, looking at yourspecific scenarios:
Alcohol complicates thingswhen it comes to hypothermia. Remember about how the body wants to tighten upthe blood vessels near the skin so the blood doesn’t lose as much heat by beingexposed to cold skin? Well, alcohol does the exact opposite of that and opens up the blood vessels, countering the body trying to constrict them. When the blood vessels can’tconstrict to the point they normally would, the body loses a major tool in keeping itself warm. This isactually a double threat as well, because since most of your character’s heatsensors are in her skin, as long as warm blood is getting to skin she won’t feel the cold as strongly. Not only will alcohol speed up the cooling process,but your character won’t notice she’s in trouble until much later.
Jumping into an icy riverwill also take an extra toll. Water sucks heat about 20-25 times faster than air, and verycold water ( 1 or 0 C) can kill in as few as 15-30 mins if the person is moving (which wicks heat much more quickly than if they’re staying still). I’m guessing the water here won’t be quite that cold, but it could still be cold enough to cause something called cold shock. Cold shock is not hypothermia, nor is it shock in the traditional (really low blood pressure) sense. Rather it is a response to the skin dramatically and abruptly losing heat. Symptoms of cold shock include uncontrollable gasping and rapid breathing, violent shivering and a massive increase in blood pressure and heart rate. Most people who die of cold shock (it can definitely kill, but not because of decreased core body temperature) do so within the first 2-5 minutes from either water inhalation (from the gasping) or a cardiac event (heart attack, arrhythmia) because of the increased blood pressure. Fortunately, if the person survives it, cold shock will end in about 3 minutes.
After your character gets out of the water, and gets dried off and safe, she’s not necessarily going to be out of the metaphorical woods. Temperature will continue to drop for up to several degrees afterwards. If she’s not monitored afterwards for worsening hypothermia symptoms, this could be very dangerous.
Here’s a great video about cold shock and how long it really takes (this is best case scenario- he’s not moving much) to get hypothermia.
You were probably hoping I’d recommend they’d have to share some body heat. This is only really the best option if body heat is the only source of warmth around (hey, could happen that a character is stranded somewhere with no way to build a fire…). Otherwise I wouldn’t recommend it. Just as whumpy, though, you could have one character assigned to take care of your character while they recover.
Anyway, that’s what I got! Thanks for the ask!
