Paradoxical Undressing in extreme Hypothermia and how to prevent it
Why is paradoxical undressing so dangerous?
As I went through the stories and harrowing videos of the deadly winter storm that badly hit Texas in February 2021, bringing power outages to millions and causing billions of dollars in losses and hundreds of deaths, I came across a strange phenomenon called “paradoxical undressing.”
It was found to be the cause of 22 deaths, causing extreme hypothermia. Hypothermia is a medical emergency that occurs when our body loses heat faster than it can produce, causing body temperatures to fall dangerously below the average temperature of 95F(35C).
What is Paradoxical Undressing?
Paradoxical undressing is a phenomenon that occurs to the victims of extreme hypothermia in which they remove their clothes due to a sudden feeling of warmth in the body. In 20 to 50% of hypothermia-induced deaths, the deceased body is found either partially or entirely undressed.
As hypothermia sets in, a person starts shivering, slowing down, having movement problems, feeling dizzy, disoriented, or confused. When hypothermia becomes severe, heart rate can slow to a dangerous level, and a person can lose consciousness and may eventually die.
However, they may display bizarre behavior before losing consciousness, like paradoxical undressing and terminal burrowing in a last-ditch effort to survive.
“Terminal burrowing,” or ‘hide-and-die syndrome,” occurs when a person in the final stages of hypothermia enters a small enclosed space — such as under a bed or inside a wardrobe. This behavior is also seen in hibernating mammals who dig in a small burrow to survive the winter.
According to German researchers, it is an autonomous process of the brain stem triggered in the final stages of hypothermia. It produces a primitive self-protecting action like burrowing, as seen in hibernating mammals.
What causes it
During the final stages of extreme hypothermia, the body of a hypothermic person induces vasoconstriction. Vasoconstriction is the narrowing (constriction) of blood vessels by small muscles in their walls.
Muscles going through vasoconstriction get tired and fail in a matter of time, causing the sensation of increased body temperature, making victims feel as if they are burning from the inside and the desire to remove clothes.
Then they start removing their clothes, which, in turn, increases the rate of heat loss. That is why paradoxical undressing is so dangerous. It causes death to close in faster.
Extreme hypothermia victims can be found indoors or outdoors, and people who die from hypothermia and are found undressed are often mistaken as victims of sexual assault.
How to avoid death by recognizing the early signs
The best you can do is wear proper clothing, but don’t limit this to mittens, a hat, or a beanie, and use layered clothes. Synthetic and wool garments are better than cotton because they provide better wet and dry weather insulation.
Also, it is a good idea to wear windproof and waterproof clothes. Since heat is lost more quickly in water than in air, using waterproof clothes around water locations and wet weather along with the cold will help.
Moreover, secure the nearest shelter and stay warm in the case of approaching cold weather. While there are different types of covers, avoid metal, as it conducts heat away from the occupants. A small shelter is better than a spacious one, as it will help with the loss of heat due to dissipation.
Helping the affected person warm by maintaining the body heat till help arrives is the best course of action. If a hypothermic person is alert, giving them a warm drink helps. Please don’t give them alcohol and caffeinated drinks.
Alcohol is a big no-no during outdoor trips and power crises during a winter storm, even though it gives a temporary feeling of comfort. Alcohol consumption increases the risk of hypothermia in two ways: vasodilation and temperature controlling systems in the brain.
Vasodilation increases the blood flow to the skin, resulting in the loss of body heat, which produces the effect of feeling warm when one is losing heat. Alcohol also affects the temperature regulation system in our brain, decreasing the body’s ability to shiver, which usually helps the body generate heat.
So next time in winter, when planning an outdoor trip, ski party, or in the event of an approaching storm. Prepare the survival kit. Keep in mind that in freezing conditions, even if you feel hot, never remove your clothes!!
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