Recognise and Treat Hypothermia

Every January, over 1000 people fail to cross the finish line of Tough Guy. Normally, it’s because of the cold: even on relatively warm years, the combination of water, wind and exposure cripples hundreds.

“It’s not cold enough for hypothermia” St. John’s Ambulance service tells me every year. A few hours later, I’m hauling frozen bodies from the mud – people who can’t move or think – and getting them to shelter (on my shoulders, in a wheelbarrow, in the back of a Land Rover…)

This year, more people will run Tough Guy than ever before. There are only so many people that Ghost Squad can keep our eyes on, so it would help enormously if everybody knows what to look out for, regarding the cold.

Some people will run in full diving wetsuits* and thereby eliminate the primary obstacle of the entire race – the cold. For those of us braving the cold, here is a quick guide to hypothermia. It’ll help you spot the symptoms, know when it’s time to start worrying and, most importantly, understand how to avoid killing your mates in your efforts to help them.

What Does Hypothermia Look Like?


When hypothermia sets in it causes relentless shivering, fast breathing, and skin that is very pale and cold to the touch. People in this state normally feel even more knackered than they would do normally. In normal life, that’s a reason to stop what you’re doing immediately. At Tough Guy it’s scary, but it’s not the end of the world – you can push through and warm up relatively easily.

Confusion is the main indication that mild hypothermia is getting worse. The person stops being able to think properly and can’t pay attention to conversations or activities. Basically, they look and sound pissed: their speech is slurred, they’re mal-coordinated and can’t pay attention to anything.

Sometimes they do weird stuff like try to get naked.

If the person gets so cold that they stop shivering, it’s really bad news. That’s emergency time – they need help NOW.

How To Help Somebody With Hypothermia

The first and most important thing to remember when dealing with somebody in hypothermia, they need to warm up SLOWLY. This is fucking VITAL.

1. Get them out of the cold and – equally importantly – out of the wind. Ideally you should take them somewhere warm. Not hot, though – they need to warm up slowly.

2. REMOVE their wet clothing. Don’t just leave them sitting there in freezing cloth!

3. Dry them off and, starting with their chest and head, wrap them in whatever you can find that is dry.

4. If they can move around, get them to move around.

5. Give ‘em a warm drink. No booze though.

6. Check if they can swallow properly. If they can, let them eat a small amount of (preferably sugary) food.

7. Keep them warm and dry. Don’t send them back out.


All these things can cause their massively constricted blood vessels to surge back open, causing a huge drop in blood pressure to their vital organs. In short, you could kill them.

On Sunday, you will almost certainly experience somebody with hypothermia. It might even be you. So look out for each other and keep yourselves safe.

Other than that, have a kickass time.

If you have any questions or concerns about Tough Guy (or rum), you can always get in touch with Ghost Squad on Facebook

*I’ve edited this slightly so people don’t think I’m trying to ‘shame’ people into not wearing appropriate running gear. Wear whatever you want – it doesn’t matter to me. My personal opinion is that wearing something that removes the primary obstacle of the race (the cold) is a really strange thing to do, but that’s because I run Tough Guy to see how much I can overcome.

Personally, I’d rather fail to finish because the cold got me (like in 2014) than manage to finish because I removed the cold as an obstacle. But again – do whatever you want, it’s your race 🙂

About the Author
Ed Gamester is a silly man who lives in the United Kingdom. He is the harbinger of Ghost Squad, singer of Gay Bum and author of A Rum Run Awry. He fights, kills and dies for TV and films, and gallivants around the place wrestling, drinking and lifting things for glory and profit. Where Ed treads, there stamp the boots of the Guild. Ed does not wear glasses, but feels this photograph makes him look more intelligent and artistically talented than he is. Feel free to contact him: he is disappointingly affable.

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