Hypothermia

Hypothermia is a medical condition in which the victim's core body temperature has dropped to significantly below normal and normal metabolism begins to be impaired. This begins to occur when the core temperature drops below 35 degrees Celsius (95 degrees Fahrenheit). If body temperature falls below 32 °C (90 °F), the condition can become critical and eventually fatal. Body temperatures below 27 °C (80 °F) are almost uniformly fatal, though body temperatures as low as 14 °C (57.5 °F) have been known to survive. The opposite condition, where temperature is too high, is hyperthermia. more...

For unknown reasons, people who fall critically unconscious (and arguably die, though there are some who argue that any reversible condition is not, by definition, death) in very cold water can, in rare cases, be resuscitated, even though they would be expected to have died of drowning and/or hypothermia. See Mammalian diving reflex.

Types

There are three types of hypothermia, acute, subacute, and chronic.

• Acute hypothermia is the most dangerous; the body temperature drops very swiftly, often in a matter of seconds or minutes, such as when a victim falls through an ice-covered lake.
• Subacute hypothermia occurs on a scale of hours, most commonly by remaining in a cold environment for an extended period of time.
• Chronic hypothermia is typically caused by an underlying disease.

Symptoms

• Amnesia
• Ataxia
• Cold skin, even in torso
• Confusion, progressing to delirium
• Diuresis
• Dysarthria
• Gray complexion (pallor)
• Hypokinesia
• Increased muscle tone
• Low blood pressure (hypotension)
• Peripheral cyanosis
• Rapid breathing (tachypnea) and heart rate (tachycardia), slowing and weakening as temperature decreases
• Shivering
• Tremor
• Uncontrollable bleeding due to reduced coagulation enzyme activity
• Weakness

Treatment

Treatment for hypothermia involves raising the core body temperature of the victim.

The first aid response to someone experiencing hypothermia, however, must be made with caution.

• Do not rub or massage the casualty
• Do not give alcohol
• Do not treat any frostbite
• Do not allow the body to become vertical

Any of these actions will divert blood from the critical internal organs and will worsen the situation.

What you should do:

• Call the emergency services
• Get the patient to shelter
• If possible, put the patient in a bath with medium-temperature water, with the clothes on
• Place hot water bottles (wrapped in a cotton sock) in the patient's armpits and between their legs
• Give food and warm drinks
• Monitor the patient and be prepared to give Cardio-pulmonary resuscitation.
• Remove wet clothing if and only if a dry change is available

If the hypothermia has become severe, notably if the patient is incoherent or unconscious, re-warming must be done under strictly controlled circumstances in a hospital. Bystanders should only remove the patient from the cold environment, give warm drinks (not too warm because it can lead to temperature shock) and get the patient to advanced medical care as quickly as possible.

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