Hypothermia is a condition wherein the person’s core body temperature falls below 35º C (95 º F). Its effects to the body vary depending on the degree to which the temperature falls and the rate or rapidity of the development of hypothermia. Most of the time, mild and moderate hypothermia can usually be reversed. But a temperature of less than 30 º C – severe hypothermia – is often, though not always, fatal.

Symptoms. Most common symptoms of severe hypothermia are related to the central nervous system. Apathy, disorientation, irrational behavior, impaired consciousness, and weakness may occur. Of course, there is shivering, cold, pale, dry skin, and slowing or weakening of pulse. Eventually, the person develops slow and shallow breathing. Due to the effect of cold on the heart muscle and its alteration on the electrical conductivity, the heart develops arrhythmia (irregular rate and rhythm of beating). This is the most common cause of death in hypothermia. In extreme cases, the heart may stop.

Causes. Persons who are particularly vulnerable to hypothermia are the homeless, infants, elderly people and those who are thin and frail. It can be caused by prolonged exposure to cold outdoors since moving air has much greater cooling effect than still air. Hypothermia can also occur from immersion in cold water or in cases of drowning. When the body is immersed in cold water, the body cools 30 times faster than in dry air, causing the body temperature to fall rapidly. Thus, some casualties of drowning did not actually die of drowning, but by hypothermia.

The risk for hypothermia increases with chronic illness, lack of activity and fatigue. Alcohol and drug use can aggravate existing hypothermic conditions.

Treatment. Most hypothermic patients will respond well to common sense treatment, such as putting them in warm bed and covering them with heating blankets. Treatment aims should focus on preventing the person from losing more body heat, rewarming the person slowly and to obtain medical aid if necessary.

• Promptly replace any wet clothing with warm, dry garments.

• Put the person in bed and ensure that he is very well covered. Cover the head for additional warmth. If he is young, fit and able to take a bath unaided, he can be rewarmed by bathing with a warm but not too hot water – about 40 º C (104 º F).

Caution! Do not allow an elderly person to have a warm bath even if he or she is able to do so. Elderly persons should be slowly and carefully warmed because sudden rewarming can cause blood to divert suddenly from the heart and brain to the body surfaces, triggering arrthymia. For the same reason, do not place any heat sources such as fires or hot water bottles near the person.

• To help rewarm him, give him warm drinks, or soup, or high energy foods such as chocolate.

Caution! Do not give him alcohol because these will worsen the hypothermia by dilating superficial blood vessels, allowing more heat to escape from the skin.

• Stay with the person until color and warm return to his skin. Monitor the temperature, breathing, pulse, and level of response. Continue resuscitative efforts until the body temperature is above 35 º C.

• Call the doctor when in doubt about the person’s condition. But if hypothermia occurs in elderly and infants, always seek medical aid.

Unlike other fatal conditions, hypothermia is one of the few instances in which pulseless patients can be resuscitated beyond the usual 10 minutes of efforts.