Part 10.4: Hypothermia

Unintentional hypothermia is a serious and preventable health problem. Severe hypothermia (body temperature <30°C [86°F]) is associated with marked depression of critical body functions that may make the victim appear clinically dead during the initial assessment. But in some cases hypothermia may exert a protective effect on the brain and organs in cardiac arrest.1,2 Intact neurologic recovery may be possible after hypothermic cardiac arrest, although those with nonasphyxial arrest have a better prognosis than those with asphyxial-associated hypothermic arrest.3–5 With this in mind, lifesaving procedures should not be withheld on the basis of clinical presentation.4 Victims should be transported as soon as possible to a center where monitored rewarming is possible. When the victim is extremely cold but has maintained a perfusing rhythm, the rescuer should focus on interventions that prevent further heat loss and begin to rewarm the victim. These include the following: For patients with moderate to severe hypothermia, therapy is determined by the presence or absence of a perfusing rhythm. We provide an overview of therapy here and give more details below. Management of the patient with moderate to severe hypothermia is as follows: