Hypothermia

Updated Tuesday December 22, 2015 by Cheryl Erickson.

                                                    Hypothermia
                   Hypothermia is a decrease in core body temperature.

Recognition
Overview:
1. Mild Hypothermia - shivering, cold sensation, goose bumps, numb hands. 
2. Moderate Hypothermia - intense shivering, muscle incoordination, slow and labored movements, mild confusion, difficulty speaking, signs of depression, withdrawn. 
3. Severe Hypothermia - shivering stops, exposed skin is bluish and puffy, inability to walk, poor muscle coordination, muscle rigidity, decrease in pulse and respiration rate, unconsciousness.

Stage	Core Temperature in Degrees	Signs and Symptoms
Mild Hypothermia	99-97F	Normal, shivering may begin
	97-95F	Cold sensation, goose bumps, unable to perform complex tasks with hands, shiver can be mild to severe, hands numb
Moderate Hypothermia	95-93F	Intense shivering, muscle in-coordination becomes apparent, movements slow and labored, stumbling pace, mild confusion, may appear alert.
	93-90F	Violent shivering persist, difficulty speaking, sluggish thinking, amnesia starts to appear, gross muscle movements sluggish, unable to use hands, stumbles frequently, signs of depression, withdrawn.
Severe Hypothermia	90-86F	Shivering stops, exposed skin blue or puffy, muscle coordination very poor, inability to walk, confusion, incoherent/irrational behavior, but may be able to maintain posture and appearance of awareness.
	86-82F	Muscle rigidity, semiconscious, stupor, loss of awareness of others, pulse and respiration rate decrease, possible heart fibrillation.
	82-78F	Unconscious, heart beat and respiration erratic, pulse may not be palpable.
	78-75F	Pulmonary edema, cardiac and respiratory failure, death. Death may occur before this temperature is reached.

Management: The basic principles of rewarming victims of hypothermia are to conserve the heat they have, and replace the heat that they have already lost. The best method to determine the extent of core temperature loss is measurement of rectal temperature. Unfortunately, obtaining a rectal temperature reading on a moderately or severely hypothermic patient can be difficult, and may expose the athlete to further cooling. 
 

Overview: 

• Remove athlete from cold environment.
• Remove wet clothing and replace with dry clothing and/or blankets.
• Refer all moderate cases to the emergency room once safe to transport.
• Treat severe hypothermia as a medical emergency! Wrap the athlete in an insulated blanket and see emergency medical care immediately. 

Details: The following describes the management regimes for hypothermia relative to severity. 

• Mild hypothermia - Seek dry shelter; replace wet clothing, insulate whole body and head, avoid sweating, use external warmth (bath, fire) only if core above 95 degrees F, give warm sweet drinks and food.
• Moderate hypothermia - Avoid exercise and external warmth, gently rest, give warm sweet drinks and calories, internal warming via warm moist air, monitor pulse and breathing.
• Severe hypothermia - Medical emergency, give nothing by mouth, wrap in an insulated blanket, avoid rapid rewarming, transfer to hospital immediately