Accidental hypothermia

Last reviewed: 2 Sep 2022
Last updated: 04 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • cold exposure and body temperature <95°F (<35°C)
  • impaired mental state
  • shivering
  • frostbite
More key diagnostic factors

Other diagnostic factors

  • tachypnea, tachycardia, hypertension if mild hypothermia
  • respiratory depression, bradycardia, hypotension if moderate hypothermia
  • coma and apnea if severe hypothermia
  • cold-induced diuresis
Other diagnostic factors

Risk factors

  • general anesthetic use
  • substance abuse
  • impaired mental status
  • hypothyroidism
  • stroke
  • Parkinson disease
  • neuroleptic medication
  • beta-blocker medication
  • sedative hypnotic medication
  • homelessness
  • older age
  • infants and young children
  • gram-negative septicemia
More risk factors

Diagnostic investigations

1st investigations to order

  • core temperature measurement
  • 12-lead ECG
  • CBC
  • serum electrolytes
  • blood glucose
  • ABG
  • coagulation factors
  • chest x-ray
More 1st investigations to order

Treatment algorithm

ACUTE

mild hypothermia: >90°F to 95°F (>32°C to 35°C)

moderate or severe hypothermia: ≤90°F (≤32°C)

moderate or severe hypothermia in cardiac arrest: ≤90°F (≤32°C)

Contributors

Authors

Emmanuel Atta Agaba, MD, FRCSEd, FACS
Emmanuel Atta Agaba

Attending Surgeon

Assistant Professor of Surgery

Montefiore Medical Center at Albert Einstein College of Medicine

Bronx

NY

Disclosures

EAA declares that he has no competing interests.

Rafael Barrera, MD, FACP
Rafael Barrera

Director

Surgical Intensive Care Unit

Long Island Jewish Medical Center

New Hyde Park

NY

Disclosures

RB declares that he has no competing interests.

Acknowledgements

Dr Emmanuel Agaba and Dr Rafael Barrera would like to gratefully acknowledge the assistance of Dr Juan Jose Gilbert.

Disclosures

JJG declares that he has no competing interests.

Peer reviewers

Wail Malaty, MD

Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

Assistant Program Director

MAHEC Rural Family Medicine Residency

Hendersonville

NC

Disclosures

WM declares that he has no competing interests.

James S. Milledge, MBBS

Honorary Professor

Department of Physiology

University College London

London

UK

Disclosures

JSM declares that he has no competing interests.

  • Differentials

    • Sepsis
    • Hypothyroidism
    More Differentials
  • Guidelines

    • European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances
    • 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Adult Basic and Advanced Life Support
    More Guidelines
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