Considerations

Persons most likely to experience hypothermia include those who are:

• Very old or very young
• Chronically ill, especially who have heart or blood flow problems
• Malnourished
• Overly tired
• Under the influence of alcohol or drugs

Causes

Hypothermia occurs when more heat is lost than the body can generate. It is usually caused by extended exposure to the cold.

Common causes include:

• Being outside without enough protective clothing in winter
• Falling overboard from a boat into cold water
• Wearing wet clothing in windy or cold weather
• Heavy exertion, not drinking enough fluids, or not eating enough in cold weather

Symptoms

As people develop hypothermia, they slowly lose the ability to think and move. In fact, they may even be unaware that they need emergency treatment. Someone with hypothermia also is likely to have frostbite.

The symptoms include:

• Drowsiness
• Weakness and loss of coordination
• Pale and cold skin
• Confusion
• Uncontrollable shivering (although at extremely low body temperatures, shivering may stop)
• Slowed breathing or heart rate

Lethargy, cardiac arrest, shock, and coma can set in without prompt treatment. Hypothermia can be fatal.

First Aid

1. If any symptoms of hypothermia are present, especially confusion or changes in mental status, immediately call 911.
2. If the person is unconscious, check airway, breathing, and circulation. If necessary, begin rescue breathing or CPR. If the victim is breathing fewer than 6 breaths per minute, begin rescue breathing.
3. Take the person inside to room temperature and cover him or her with warm blankets. If going indoors is not possible, get the person out of the wind and use a blanket to provide insulation from the cold ground. Cover the person's head and neck to help retain body heat.
4. Once inside, remove any wet or constricting clothes and replace them with dry clothing.
5. Warm the person. If necessary, use your own body heat to aid the warming. Apply warm compresses to the neck, chest wall, and groin. If the person is alert and can easily swallow, give warm, sweetened, nonalcoholic fluids to aid the warming.
6. Stay with the person until medical help arrives.

DO NOT

• Do NOT assume that someone found lying motionless in the cold is already dead.
• Do NOT use direct heat (such as hot water, a heating pad, or a heat lamp) to warm the person.
• Do NOT give the person alcohol!

When to Contact a Medical Professional

Call 911 anytime you suspect someone has hypothermia. Give first aid while awaiting emergency assistance.

Prevention

Before you spend time outside in the cold, do NOT drink alcohol or smoke. Drink plenty of fluids and get adequate food and rest.

Wear proper clothing in cold temperatures to protect your body. These include:

• Mittens (not gloves)
• Wind-proof, water-resistant, many-layered clothing
• Two pairs of socks (avoid cotton)
• Scarf and hat that cover the ears (to avoid major heat loss through the top of your head)

Avoid:

• Extremely cold temperature, especially with high winds
• Wet clothes
• Poor circulation, which is more likely from age, tight clothing or boots, cramped positions, fatigue, certain medications, smoking, and alcohol

If you have diabetes or circulatory problems, see your doctor regularly and maintain good health habits in order to reduce the risk of blood vessel complications that may put you at risk for hypothermia.

Alternative Names

Low body temperature; Cold exposure

References

Danzl DF. Accidental hypothermia. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. St. Louis, MO: Mosby; 2009:chap 138.

Bessen HA. Hypothermia. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 192.

Update Date: 1/14/2012

Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.