Accidental Hypothermia (Not Arrest)
Objective: Stage hypothermia on the truck, prevent further heat loss, and know when gentle handling and a rewarming destination matter.
Why This Is Hard
They are “just drunk” in a doorway. Core temp is 28 °C and the next rough roll throws them into VF. AHA 2025 and WMS: accidental hypothermia is a staged disease. Handle gently. Rewarm as you can.
- Scene: get them out of wind and wet.
- Cut wet clothes, dry insulation, hat, vapor barrier if you have it.
- Glucose. Hypoglycemia and hypothermia travel together.
Field Rules (Education)
- Mild: shivering, talking — passive rewarming, shelter, calories if they can swallow.
- Moderate/severe: altered, little shivering — gentle handling, insulated packaging, avoid rough movement. Active external rewarming as protocol allows.
- Pulse checks can take longer. If no signs of life, see hypothermic arrest.
- Afterdrop and VF risk: keep them horizontal when you can; do not have a severe patient walk.
Field Pitfalls
- Leaving wet cotton on and adding a sheet.
- Walking a profoundly cold patient to the stretcher.
- Calling them drunk and skipping glucose.
Practice
60-second drill
Partner: wet hiker, GCS 12, shivering stopped. 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.
- NASEMSO National Model EMS Clinical Guidelines (2022) — U.S. EMS model language; protocol still wins
- AHA 2025 Part 10: Special Circumstances — accidental hypothermia staging and gentle handling
- WMS 2019 accidental hypothermia CPG — field staging, gentle handling, and rewarming themes — follow your protocol
Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.
Check Your Understanding
Street decisions from this lesson only. After you check, the key is highlighted. Education practice — not a certification exam.