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Hypothermia, Emergency Medicine

Jordan Moskoff Reviewed 06/2017



  • Body temperature <35°C

  • Risk factors:

    • Poor temperature regulation:

      • Very young

      • Advanced age

      • Comorbid condition

      • Intoxication

  • Pathophysiology:

    • Loss of heat:

      • Radiation: Most rapid, 50% of heat ...


Signs and Symptoms

  • Mild (35–32.2°C/95–90°F):

    • Initial excitation phase to combat cold:

      • HTN

      • Shivering

      • Tachycardia

      • Early tachycardia followed by bradycardia

      • Tachypnea

      • Vasoconstriction

    • Over time with ons...



  • Patient is not dead until “Warm and Dead”:

    • CPR recommended during transport:

  • Prolonged palpation/auscultation for cardiac activity: 30–45 sec

    • Apparent cardiovascular collapse may be...



Admission Criteria

  • Moderate to severe hypothermia (<32°C)

  • Young, healthy patients with no comorbid illness who have mild accidental hypothermia (>32°C) that responds well to w...

Pearls and Pitfalls

  • Defibrillation is rarely successful at temperatures <28–30°C:

    • Defibrillate 1–3 times and then again post rewarming.

  • Atrial fibrillation usually converts spontaneously.

  • Faster rewar...

Additional Reading

  • Brown  D, Brugger  H, Boyd J, et al. Accidental hypothermia. N Engl JMed.  2012;367:1930–1938.

  • Corneli  HM. Accidental hypothermia. Pediatr Emerg Care.  2012;28(5):475–480.

  • ...



  • 778.3 Other hypothermia of newborn

  • 780.65 Hypothermia not associated with low environmental temperature

  • 991.6 Hypothermia


  • P80.9 Hypothermia of newborn, unspecified

  • R68.0 Hypothermia, not as...

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