Hypothermia

Diagnosis

The diagnosis of hypothermia usually is clear based on a person's symptoms. The conditions in which the person with hypothermia became ill or was found also often make the diagnosis clear. Blood tests can help confirm hypothermia and its severity.

A diagnosis may not be clear, however, if the symptoms are mild. For example, hypothermia may not be considered when an older person who is indoors has symptoms of confusion, lack of coordination and speech problems.

Treatment

Seek immediate medical attention for anyone who appears to have hypothermia. Until medical help is available, follow these first-aid guidelines for hypothermia.

First-aid tips

• Be gentle. When helping someone with hypothermia, handle them gently. Only move the person as much as is necessary. Don't massage or rub the person. Vigorous or jarring movements may trigger cardiac arrest.
• Move the person out of the cold. Move the person to a warm, dry location if possible. If moving is not possible, shield the person from the cold and wind as much as possible. The person should be kept in a flat position if possible.
• Remove wet clothing. If the person is wearing wet clothing, remove it. Cut away clothing if necessary to avoid too much movement.
• Cover the person with blankets. Use layers of dry blankets or coats to warm the person. Cover the person's head, leaving only the face exposed.
• Insulate the person's body from the cold ground. If you're outside, lay the person flat on a blanket or other warm surface.
• Monitor breathing. A person with severe hypothermia may appear unconscious, with no clear signs of a pulse or breathing. If the person's breathing has stopped or appears dangerously low or shallow, begin CPR right away if you're trained.
• Supply warm beverages. If the affected person is alert and able to swallow, give the person a warm, sweet, nonalcoholic, noncaffeinated drink. Warm drinks can help warm the body.

• Use warm, dry compresses. Use first-aid warm compresses, which are plastic fluid-filled bags that warm up when squeezed. Other options include a makeshift compress of warm water in a plastic bottle or a dryer-warmed towel.

Apply the compresses only to the neck, chest wall or groin. Don't apply them to the arms or legs. Heat applied to the arms and legs forces cold blood back toward the heart, lungs and brain, causing the core body temperature to drop. This can be fatal.

• Don't apply direct heat. Don't use hot water, a heating pad or a heating lamp to warm the person. The extreme heat can damage the skin. It also can trigger irregular heartbeats that cause the heart to stop.

Medical treatment

Depending on the severity of hypothermia, emergency medical care for hypothermia may include one of the following interventions to raise the body temperature:

• Passive rewarming. For mild hypothermia, covering the person with heated blankets and offering them warm fluids to drink may be enough.
• Blood rewarming. Blood may be drawn, warmed and recirculated in the body. A common method of warming blood is the use of a hemodialysis machine, which is usually used to filter blood in people with poor kidney function. Heart bypass machines also may need to be used.
• Warm intravenous fluids. A warmed solution of salt water may be put into a vein to help warm the blood.
• Airway rewarming. The use of humidified oxygen, given through a mask or nasal tube, can warm the airways and help raise the temperature of the body.
• Irrigation. A warm saltwater solution may be used to warm certain areas of the body, such as the area around the lungs or the abdominal cavity. The warm liquid is delivered to the affected area through small tubes called catheters.