# Hypothermia

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: No dose - emergency referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - emergency referral pathway, no medicine given in primary care
- Hypothermia - disease-level clinical article (hypothermia-clinical.txt)

## Treatment metadata

- No drug therapy in primary care (Emergency Referral)

## Complete treatment card

```text
HYPOTHERMIA
Sources: No dose - emergency referral pathway, no medicine given in primary care
Review status: REVIEWED against No dose - emergency referral pathway, no medicine given in primary
               care, Hypothermia - disease-level clinical article (hypothermia-
               clinical.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - A history of substantial recent cold exposure typically precedes the presentation
    - Hunger, nausea and fatigue mark the earliest, mild stage of cold exposure  [fatigue · nausea]
    - Progressive confusion with impaired memory and judgment as the core temperature falls
      [confusion]
  SIGNS - what you find (6)
    - Increased muscle tone, blood pressure, pulse and respiration occur as the body tries to
      generate heat in mild cases
    - Once core temperature drops to 30-32 C, shivering stops and paradoxical undressing may appear
    - Dilated, sluggish pupils with reduced reflexes appear as CNS depression develops in the
      moderate stage  [drowsiness · lethargy]
    - Hypotension, a slow pulse and slowed breathing appear as hypothermia progresses to the
      moderate range  [bradycardia · hypotension · hypothermia]
    - Atrial fibrillation is the dysrhythmia most often seen as hypothermia deepens  [arrhythmia ·
      hypothermia]
    - In severe cases the patient becomes unresponsive as blood pressure, heart rate and cardiac
      output keep falling  [loss of consciousness]
  TESTS (8)
    - Esophageal probing in the lower third of the esophagus is the most accurate temperature
      method, but only once an advanced airway is placed
    - Oral and standard tympanic infrared thermometers can only rule hypothermia out, since most
      can't read below 35 C
    - Baseline work-up includes a finger-stick glucose, complete blood count and basic metabolic
      panel
    - Coagulation testing is unreliable unless the sample is warmed back to 37 C first
    - Fibrinogen is checked to exclude disseminated intravascular coagulation
    - An ECG is obtained in every hypothermic patient given how common conduction problems and
      dysrhythmias are
    - PR, QRS and QT intervals lengthen on the ECG, and an Osborn J wave may appear
    - Head CT is used when mental status is worse than the measured degree of hypothermia would
      explain
  IF NOT THIS - what else fits (3)
    - Sepsis, hypothyroidism, adrenal insufficiency and hypoglycemia should be considered when the
      picture outpaces the measured temperature drop
    - Carbon monoxide exposure, undernutrition, intoxication, or an overdose of drugs can also
      produce or worsen a low core temperature
    - Beta-blockers, clonidine, antipsychotics, sedative-hypnotics, alcohol and anaesthetic drugs
      can blunt the body's response to cold
  Source  StatPearls "Hypothermia" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (EMERGENCY REFERRAL)   [1st line]
   Adult    Remove wet clothing, insulate with dry blankets, provide warm sweetened drinks if fully
            conscious, and arrange urgent emergency transport - Immediate emergency transfer
   Peds     Immediate emergency pediatric transport
   Source   No dose - emergency referral pathway, no medicine given in primary care
   Why      Severe hypothermia risks lethal cardiac arrhythmias during rewarming, requiring
            inpatient monitoring.
   Caution  Do NOT actively rewarm with direct heat like hot water bottles on skin (risks burns and
            shock).
            Handle the patient gently to avoid precipitating ventricular fibrillation.
            Check for signs of frostbite.
            RED FLAG - Handle patient gently and avoid rough movement, which can precipitate fatal
            dysrhythmias in moderate/severe hypothermia.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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