Acute Hypothermia

What is acute hypothermia?

Acute hypothermia (HI-poe-ther-mee-uh) is when your core (inside) body temperature goes too low. The word acute is used to define a problem that starts suddenly, worsens quickly, and lasts a short time. Acute hypothermia can occur in any season or area of the world. Acute hypothermia slows down your body's functions, which damages your body organs. Acute hypothermia can lead to life-threatening shock if it is not treated right away.

What are the severity levels of acute hypothermia?

• Mild: This is when your body temperature is 93.2 to 95 degrees Fahrenheit (34 to 35 degrees Celsius).
  
  
• Moderate: This is when your body temperature is 86 to 93.2 degrees Fahrenheit (30 to 34 degrees Celsius).
  
  
• Severe: This is when your body temperature is less than 86 degrees Fahrenheit (30 degrees Celsius). The word severe means very bad.

What causes acute hypothermia?

Any of the following can cause acute hypothermia:

• Heat lost from your body to the air, water, and things around you: Your body can lose heat very fast when you are in a place where the temperature is cold, or outside in cold or wet weather. You can also get too cold if you get wet, or you are in cold water. This may happen if you are bathing, swimming, fall into water, or fall through ice. This causes the heat to be lost from your body very fast. When this happens, your body is not able to replace the heat it needs to function.
  
  
• Medical conditions that cause you to make less body heat, or to lose body heat faster: The following are conditions that decrease your ability to keep your body temperature at a normal level:
  
  
  • Burns and other injuries.
    
    
  • Blood or blood vessel problems, such as sickle cell anemia or poor blood flow.
    
    
  • Certain drugs or medicines, such as alcohol, medicines for sleep, or general anesthesia. This is medicine that keeps you asleep during surgery.
    
    
  • Infections, such as colds.
    
    
  • Mental health problems, such as psychosis.
    
    
  • Strokes and spinal cord injuries.
    
    
  • Thyroid and other endocrine problems, such as hypopituitarism.

What conditions may increase my risk for having acute hypothermia?

• Decreased muscle tissue: Body heat is made in your muscles. Being ill or inactive can make your muscles smaller. Smaller muscles do not make as much heat as larger muscles.
  
  
• Hypothyroidism and other endocrine conditions: These conditions may decrease your body temperature, or make it stay lower all of the time.
  
  
• Inactivity: Body heat increases when you are active. People who are not active, or are ill or need to stay in bed make less body heat.
  
  
• Low body fat: Body fat acts to protect your body from the cold. Newborn babies, especially those born premature (before their due date), may have small amounts of body fat. Babies and young children may have less stored fat, and lose body heat faster than older children or adults.
  
  
• Malnutrition: Your body uses energy from the foods you eat to make body heat. You also store fat from the foods you eat to use as a reserve supply of energy. Malnutrition may happen when you have not been eating enough, have been sick, or do not take in enough nutrition from your food.
  
  
• Not responding to getting cold: Your body may not be able to act the way it should when you get cold. Normally when you are cold, you get goose bumps and you may shiver. These are things your body does on its own to reduce heat loss and make heat in your muscles.

What else can increase my risk of having acute hypothermia?

• Alcohol and certain medications: Drinking alcohol or using certain medicines can decrease your awareness of being cold. Alcohol is found in adult drinks such as beer, wine and vodka. Medicines that increase your risk include those used to treat anxiety (worry), depression, and trouble sleeping.
  
  
• As you age, you become less aware of feeling too cold: Older people may not know that they are getting too cold, and may not do anything to increase their body temperature. They may keep their home too cool, or not wear enough clothing to stay warm.
  
  
• Brain or spinal cord damage, and certain mental health problems may decrease your ability to feel cold: These disorders include strokes and spinal cord injury.

How can I tell caregivers about my acute hypothermia?

Tell caregivers about what you were doing when you got cold, and how long ago that was. Tell them about what you or others tried to get you warm. Tell them about any medical problems you have and what medicines you take. Tell them if you feel sleepy, or feel like you cannot think clearly. Tell caregivers if you have stiff joints or sore muscles. Tell caregivers if you drink alcohol or use street (illegal) drugs.

What signs and symptoms may be related to my acute hypothermia?

• With mild hypothermia you may have any of the following:
  
  
  • Confusion, memory loss, poor judgment and trouble thinking.
    
    
  • Face swelling.
    
    
  • Fast breathing and heart rate, and you may need to pass urine.
    
    
  • Shivering, and clumsy movements.
    
    
  • Skin that is red or pale (white), and cold to touch.
    
    
  • Slow or slurred speech.
    
    
  • Tiredness, loss of interest, easily angered.
  
  
• With moderate hypothermia, you may have any of the following:
  
  
  • Movements that are stiff or jerky.
    
    
  • Pupils (round black center) of the eyes are larger than normal.
    
    
  • Slow, shallow breathing.
    
    
  • You may look sleepy, or it may be hard to wake you up.
    
    
  • You may stop shivering.
  
  
• With severe hypothermia, a person may look like they are dead:
  
  
  • Faint heartbeat, or no heartbeat at all.
    
    
  • No breathing.
    
    
  • Not moving or speaking.
    
    
  • Pupils of the eyes do not change size.
    
    
  • Skin that feels cold, and is blue in color.
    
    
  • Stiff arms and legs.

How may my acute hypothermia be treated?

• If you have signs and symptoms of mild hypothermia:
  
  
  • Move to a warm, dry place.
    
    
  • Remove all wet clothing, and dry your body.
    
    
  • Put on layers of dry clothing, or cover up with blankets. Put on a hat.
    
    
  • Go to a hospital.
  
  
• If you have signs and symptoms of moderate hypothermia:
  
  
  • Call 911, or get to a hospital emergency room.
    
    
  • Do the same as for mild hypothermia.
    
    
  • Put hot water bottles or heating pads on your chest, back and stomach areas. Keep the heating pad turned on the low setting. Place a towel or cloth on your skin under the hot water bottle or heating pad.

What should I do if I find someone who has hypothermia?

• Call 911, or get the person to a hospital emergency room.
  
  
• Move the person to a warm, dry place.
  
  
• Remove his wet clothing, and dry his skin.
  
  
• Dress him in layers of dry clothing, or cover him up with blankets. Put a hat on his head.
  
  
• Put hot water bottles or heating pads on the person's chest, back and stomach areas. Keep the heating pad turned on the low setting. Place a towel or cloth on his skin under the hot water bottle or heating pad.
  
  
• If the person stops breathing, start doing cardiopulmonary resuscitation (CPR). This is when you do chest compressions and give rescue breaths to the person. Ask your caregiver for more information about how to do CPR.

What may be done in the hospital to someone who has hypothermia?

• Medicines:
  
  
  • Glucose: Glucose is a form of sugar. It gives energy to your body, which helps make body heat.
    
    
  • Thiamine: Malnourished people, including people who drink a lot of alcohol, may need thiamine (vitamin B1). This vitamin is needed for your body to make energy and body heat.
  
  
• Treatments and procedures:
  
  
  • A nasogastric (NG) tube may be placed to keep the stomach empty. The stomach and intestines (bowels) may stop working with hypothermia. Fluids that are left in his stomach may be vomited (thrown up) or go into his lungs.
    
    
  • A urinary catheter may be placed to keep track of the amount of urine being passed.
    
    
  • If it is needed, caregivers will do CPR. This may include chest compressions and rescue breathing, as well as giving medicines and using a defibrillator (AED) to shock the heart.
    
    
  • Warm intravenous (IV) fluids may be given. This is fluid that is given through a tube placed in a vein. Large tubes may be placed in veins that will remove the person's blood a little at a time, and replace the blood after it has been warmed.
    
    
  • Warm, moist air may be given for the person to breathe. Warm fluids may be given into chest or abdominal spaces or organs.

What can I do to prevent acute hypothermia?

• Avoid being out in bad weather. Avoid getting wet in cold weather and stay out of the wind on cold days. Avoid getting left out in snow storms. Know if ice is safe to be on during winter months. Be prepared just in case you are stranded in your car during the winter. Be prepared for sudden weather changes when doing outdoor activities. Have food and water, blankets, and cold weather clothes ready in case you need them.
  
  
• Be prepared for cold water. Have accident and rescue equipment available, such as life jackets and rescue rings. Having these available will help get the person out of the cold water faster. Wear a wetsuit or drysuit for cold water activities.
  
  
• Do not drink alcohol. Drinking alcohol, while making you feel warmer at first, acts to lower your body's temperature. If you drink alcohol, you may not be aware of how cold you are. If you have been out in the cold, drink warm liquids and eat warm food.
  
  
• Dress warmly both indoors and outdoors. Dress in layers with clothes that will hold in your body heat. Wool and silk are warmer than cotton or polyester. Always wear a hat or warm head scarf when you are outside in cold weather. Get inside fast if you start to get cold.

What should I expect with time or treatment?

If you have mild hypothermia, you may be seen in the hospital emergency department, and then sent home. If you have moderate or severe hypothermia, you will need to stay in the hospital so that caregivers can watch and treat you. Your recovery from hypothermia depends on your age, size, how much fat and muscle you have, and if you have other medical problems. Some people have no injuries from being hypothermic. Others may have pneumonia, kidney failure, or lose fingers or toes to frostbite. When your body gets so cold that your heart cannot work right, brain damage may happen. Not having a heartbeat before reaching the hospital or developing shock are conditions with higher rates of death.

When should I call my caregiver?

Call your caregiver if:

• The tops of your toes are warm, tender, and swollen.
  
  
• You have signs and symptoms of mild hypothermia.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You have signs and symptoms of moderate or severe hypothermia, or find someone else who does.
  
  
• You have sudden, severe chest pain and trouble breathing.
  
  
• You are very hungry and dizzy, or you faint.
  
  
• You have a high body temperature.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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