Hypothermia – Diagnosis and Treatment
Diagnosis
Healthcare providers look for symptoms such as shivering, confusion, and trouble speaking to identify hypothermia.
They check a person’s core body temperature as an important part of the process. Providers diagnose hypothermia when this temperature drops below 35โฏยฐC (95โฏยฐF).
They also consider how the person was exposed to cold or if there was a recent drop in temperature.
Providers may use blood tests and checks of vital signs like breathing and heart rate to confirm the diagnosis and see how severe it is.
Sometimes, older adults or young children show signs that are hard to notice, which can delay care.
Common indicators of hypothermia include:
- Shivering and cold, pale skin
- Slowed breathing or weak pulse
- Confusion or unusual tiredness
- Poor coordination and trouble speaking
Treatment
Quick Response Steps
When someone shows signs of hypothermia, act quickly and carefully. The priority is to keep the person safe, warm, and still. Move the person to a dry, sheltered place away from cold conditions if possible.
Avoid shaking, rubbing, or any rough handling to prevent sudden heart problems. If their clothes are wet, gently take them off without causing too much movement.
Use dry coats, blankets, or towels to cover the person. Wrap their head but leave the face visible. Lay the person on a warm surface, such as a blanket or sleeping bag, to prevent heat loss from the ground.
Never put them into a hot bath or use heated pads. Direct heat can cause skin burns and worsen their condition.
Check their breathing regularly. If the person stops breathing or does not respond and you cannot find a pulse, begin cardiopulmonary resuscitation (CPR) if you are trained.
If they are alert, give them a warm, sweet, non-alcoholic drink in slow sips. Do not give caffeine or alcohol, as these can worsen the condition.
A quick overview of key actions:
| Step | Action |
|---|---|
| Move to safety | Get to a warm, dry place |
| Remove wet items | Replace with dry clothing |
| Add insulation | Cover with blankets/coats, head included, face exposed |
| Prevent ground heat loss | Use a blanket or similar material under the person |
| Warm drinks | Offer if conscious and safe to swallow |
| Check breathing | Start CPR if no response and trained to do so |
| Avoid direct heat | No hot water, pads, or lamps; avoid rapid/extreme temperature |
You may use warm, dry compresses, but only place them on the chest, neck, or groin.
Do not apply heat to arms or legs, as this could send cold blood to the core and make the situation worse.
Hospital-Based Care
Medical professionals use several methods to restore body temperature safely. For less severe cases, they often use passive rewarming. They wrap the person in warm blankets and give heated fluids by mouth.
For moderate to severe hypothermia, medical teams use active rewarming. They give warmed intravenous fluids to help the core temperature rise more quickly and support blood pressure.
Doctors may perform blood warming by removing some blood, warming it, and returning it to the body. In very serious situations, they use devices like heart-lung bypass or hemodialysis machines to warm the blood and help with circulation.
Sometimes, medical staff provide warm, moist air through a mask or breathing tube. This warms the airways and slowly raises internal body heat.
Medical teams watch closely for afterdrop, which happens when cold blood from the arms and legs moves back toward the body center during warming. They rewarm the person at a controlled rate to prevent this.
They may use warm saltwater solutions to irrigate areas around the lungs or in the abdominal cavity through catheters. This method helps gently increase body temperature from the inside.
Fluid resuscitation with warmed fluids helps prevent dehydration and supports blood flow. If they suspect infection, they may start antibiotics, since hypothermia can weaken the immune system.
The treatment plan depends on the severity of hypothermia and any other medical problems. Each step aims to restore normal body temperature while avoiding sudden changes or extra harm.
