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Lesson

Accidental Hypothermia (Not Arrest)

10 min Medical Skip to quiz

Objective: Stage accidental hypothermia, stop further heat loss, and handle a profoundly cold patient gently. Check glucose. Do not walk them to the stretcher.

Why this matters

A person in a doorway can be labeled drunk when the core temperature is 28 °C. A rough move can put them into ventricular fibrillation. First, get them out of the wind and off wet clothes. Check glucose. Do not walk a profoundly cold patient to the stretcher.

Key points
  • First, move them out of the wind and off wet ground.
  • Cut off wet clothes. Add dry insulation, a hat, and a vapor barrier if you have one.
  • Check glucose. Low glucose and hypothermia often travel together.

Clinical sequence

  1. Move them out of the wind and off wet ground.
  2. Cut off wet clothes. Insulate them, including the head, and add a vapor barrier if you have one.
  3. Check glucose and treat it if it is low.
  4. Handle them gently and keep them flat. Do not walk a profoundly cold patient to the stretcher.

Teaching points

  • Mild. They are shivering and talking. Use shelter and dry insulation. Give calories if they can swallow.
  • Moderate or severe. They are altered, and shivering has faded. Handle them gently and package them in insulation. Add active external rewarming only if your protocol allows it.
  • Pulse check. A pulse check may need more time. If there are no signs of life, use the hypothermic arrest lesson and follow your protocol.
  • Afterdrop. Afterdrop is more cooling of the core as cold blood returns from the limbs. Keep them flat when you can. Do not have a severely cold patient walk.

Common errors

  • Do not leave wet cotton on and cover it with only a sheet.
  • Do not walk a profoundly cold patient to the stretcher.
  • Do not call them drunk and skip the glucose check.

Practice

One-minute check

A wet hiker has a GCS of 12, and shivering has stopped. Name the first three packaging moves.

Related: Hypothermic arrest.

Sources & Further Study

Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.

Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.

Check Your Understanding

Questions drawn only from this lesson. After you check, the key is highlighted. Education practice — not a certification exam.

1. Wet clothes on a cold altered patient:
2. Shivering has stopped and they are confused:
3. Rough movement in severe hypothermia:
4. “Just drunk” in a doorway:
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