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Hypothermia

Hypothermia

You may treat minor cold exposure at home with blankets and home care techniques. Call a doctor to ask about danger signs that might warrant immediate transportation to a medical facility.

Any person who is at risk for hypothermia and is suspected to have sustained a cold exposure should be brought to a hospital’s Emergency Department. Look for these danger signs of cold exposure:

  • Intense shivering, stiffness, and numbness in the arms and legs, stumbling and clumsiness, sleepiness, confusion, and amnesia.
  • The adage that "a person is not dead until warm and dead" means that victims may appear dead because of cold exposure, but many of these people have made complete recoveries when rearmed. All such victims in this situation need rapid transport to a hospital so that resuscitation attempts may be made.

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Self-Care at Home

The first priority is to perform a careful check for breathing and a pulse and initiate cardiopulmonary resuscitation (CPR) as necessary.

  • If the person is unconscious, having severe breathing difficulty, or is pulseless, call 911 for an ambulance.
  • Because the victim’s heartbeat may be very weak and slow, the pulse check should ideally be continued for at least 1 minute before beginning CPR. Rough handling of these victims may cause deadly heart rhythms.

The second priority is rewarding.

  • Remove all wet clothes and move the person inside.
  • The victim should be given warm fluids if he or she is able to drink, but do not give the person caffeine or alcohol.
  • Cover the person’s body with blankets and aluminum-coated foils, and place the victim in a sleeping bag. Avoid actively heating the victim with outside sources of heat such as radiators or hot water baths. This may only decrease the amount of shivering and slow the rate of core temperature increase.
  • Strenuous muscle exertion should be avoided.

Some cold exposure, such as cold hands and feet, may be treated with home care techniques

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Follow-up

People who experience accidental hypothermia with body temperatures in the range of 95-89.9°F (35-32.2°C) and are otherwise healthy usually rewarm easily and can be safely sent home. Those whose core temperatures are below 89.9°F (32.2°C) are admitted to the hospital. Underlying medical disorders are investigated and cardiac monitoring performed.

Prevention

Prepare well before embarking on any cold weather activities.

  • Make sure you are conditioned physically with adequate nutrition and rest.
  • Travel with a partner.
  • Wear multiple layers of clothing, loosely fitted. Cover the head, wrists, neck, hands, and feet and try to remain dry.
  • In an emergency, drink cold water rather than ice or snow.
  • Be wary of wind and wet weather because they increase the rate of heat loss.
  • Keep the homes of the elderly heated to at least 70°F (21.1°C), especially the sleeping area.

People with accidental hypothermia in the range of 95-89.9°F (35-32.2°C) and who are otherwise healthy usually rearm easily and can be safely sent home. Those with lower core body temperatures are usually admitted to the hospital.

People with uncomplicated hypothermia do better as a group than do people with hypothermia and another associated disease. In fact, outcome depends more on the underlying disease process than the person’s initial temperature or the rewarding method employed.

Age is not always a risk factor, although elderly people tend to have more associated medical problems. People with mild to moderate hypothermia usually have a complete recovery.

Outlook

People with poor outcomes usually have had cardiac arrest, a very low or no blood pressure, and the need to have breathing assisted with a tube—all before arriving at the hospital.

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