Accidental hypothermia - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Hypothermia is defined by a core body temperature <95°F (<35°C).
Classified as mild, moderate, or severe according to clinical features.
Core temperature measured in the lower third of the esophagus correlates well with pulmonary artery temperature and is preferred in patients with a secure airway. A low-reading tympanic thermistor-based thermometer is a less invasive alternative.
Initial management should focus on stopping further cooling. This includes removing the patient from the cold environment, careful removal of wet or cold clothing, insulation, warming the body, securing the airway, monitoring breathing and circulation, and maintaining circulation using warm intravenous fluids.
Patients who have sustained a hypothermic cardiac arrest should ideally be rewarmed in a specialist center using Extracorporeal Life Support. Management strategies and criteria for termination of resuscitation in hypothermic cardiac arrest must not be extrapolated from those used in normothermic arrest.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

A 12-lead ECG obtained from a hypothermic patient; note, Osborn waves (arrows), which have an extra deflection at the end of the QRS complex

Citations

Key Articles

Paal P, Gordon L, Strapazzon G, et al. Accidental hypothermia - an update. Scand J Trauma Resusc Emerg Med. 2016 Sep 15;24(1):111.[Abstract][Full Text]
Mallet ML. Pathophysiology of accidental hypothermia. QJM. 2002 Dec;95(12):775-85.[Abstract][Full Text]
Horn EP, Bein B, Böhm R, et al. The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia. 2012 Jun;67(6):612-7.[Abstract]
Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society clinical practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2019 update. Wilderness Environ Med. 2019 Dec;30(4 Suppl):S47-69.[Abstract][Full Text]
Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-S468.[Abstract][Full Text]
Lott C, Truhlář A, Alfonzo A, et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation. 2021 Apr;161:152-219.[Abstract][Full Text]

Other Online Resources

CDC: Prevent hypothermia and frostbite

Referenced Articles

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