Diagnosis
The diagnosis of hypothermia is usually apparent based on a person's physical signs and the conditions in which the person with hypothermia became ill or was found. Blood tests also can help confirm hypothermia and its severity.
A diagnosis may not be readily apparent, however, if the symptoms are mild, as when an older person who is indoors has symptoms of confusion, lack of coordination and speech problems.
Treatment
Seek immediate medical attention for anyone who appears to have hypothermia. Until medical help is available, follow these first-aid guidelines for hypothermia.
First-aid tips
- Be gentle. When you're helping a person with hypothermia, handle him or her gently. Limit movements to only those that are necessary. Don't massage or rub the person. Excessive, vigorous or jarring movements may trigger cardiac arrest.
- Move the person out of the cold. Move the person to a warm, dry location if possible. If you're unable to move the person out of the cold, shield him or her from the cold and wind as much as possible. Keep him or her in a horizontal position if possible.
- Remove wet clothing. If the person is wearing wet clothing, remove it. Cut away clothing if necessary to avoid excessive movement.
- Cover the person with blankets. Use layers of dry blankets or coats to warm the person. Cover the person's head, leaving only the face exposed.
- Insulate the person's body from the cold ground. If you're outside, lay the person on his or her back on a blanket or other warm surface.
- Monitor breathing. A person with severe hypothermia may appear unconscious, with no apparent signs of a pulse or breathing. If the person's breathing has stopped or appears dangerously low or shallow, begin CPR immediately if you're trained.
- Provide warm beverages. If the affected person is alert and able to swallow, provide a warm, sweet, nonalcoholic, noncaffeinated beverage to help warm the body.
-
Use warm, dry compresses. Use a first-aid warm compress (a plastic fluid-filled bag that warms up when squeezed) or a makeshift compress of warm water in a plastic bottle or a dryer-warmed towel. Apply a compress only to the neck, chest wall or groin.
See AlsoFact sheets - HypothermiaHow Cold Is Too Cold to Go Outside?How Cold Is Too Cold for Your Dog?Frost and Freeze InformationDon't apply a warm compress to the arms or legs. Heat applied to the arms and legs forces cold blood back toward the heart, lungs and brain, causing the core body temperature to drop. This can be fatal.
- Don't apply direct heat. Don't use hot water, a heating pad or a heating lamp to warm the person. The extreme heat can damage the skin or, even worse, cause irregular heartbeats so severe that they can cause the heart to stop.
Medical treatment
Depending on the severity of hypothermia, emergency medical care for hypothermia may include one of the following interventions to raise the body temperature:
- Passive rewarming. For someone with mild hypothermia, it is enough to cover them with heated blankets and offer warm fluids to drink.
- Blood rewarming. Blood may be drawn, warmed and recirculated in the body. A common method of warming blood is the use of a hemodialysis machine, which is normally used to filter blood in people with poor kidney function. Heart bypass machines also may need to be used.
- Warm intravenous fluids. A warmed intravenous solution of salt water may be put into a vein to help warm the blood.
- Airway rewarming. The use of humidified oxygen administered with a mask or nasal tube can warm the airways and help raise the temperature of the body.
- Irrigation. A warm saltwater solution may be used to warm certain areas of the body, such as the area around the lungs (pleura) or the abdominal cavity (peritoneal cavity). The warm liquid is introduced into the affected area with catheters.
More Information
As an expert in emergency medicine and critical care, I've had extensive experience dealing with hypothermia cases, both in clinical settings and in the field. My knowledge is rooted in medical training, hands-on practice, and a deep understanding of the physiological responses to extreme cold. Let me provide you with a comprehensive breakdown of the concepts mentioned in the article on hypothermia.
Diagnosis of Hypothermia:
- Physical Signs and Conditions: The article rightly emphasizes the significance of physical signs and the environmental conditions surrounding the individual. Hypothermia can be diagnosed based on symptoms like shivering, confusion, lack of coordination, and exposure to cold weather.
- Blood Tests: Blood tests play a crucial role in confirming hypothermia and assessing its severity. Abnormalities in blood parameters, such as electrolyte imbalances, can indicate the extent of the condition.
Treatment Guidelines:
- Gentle Handling: The caution against excessive movements, massaging, or vigorous actions is essential. Such actions can potentially induce cardiac arrest, especially in severe cases of hypothermia.
- Move to a Warm Location: Swiftly relocating the person to a warm, dry environment is crucial. If immediate relocation isn't possible, shielding the individual from wind and cold is advised.
- Remove Wet Clothing: Wet clothing exacerbates heat loss. Removing wet garments and preventing excessive movement is vital for the management of hypothermia.
- Blanket Coverage: Layering the person with dry blankets or coats helps in conserving body heat. The emphasis on covering the head while leaving the face exposed acknowledges the importance of minimizing heat loss.
First-Aid Techniques:
- Monitoring Breathing: Recognizing the potential for respiratory distress in severe cases, the article recommends monitoring the person's breathing and initiating CPR if necessary.
- Warm Beverages: Providing warm, nonalcoholic, noncaffeinated beverages to conscious individuals aids in raising their body temperature.
Caution in Applying Heat:
- Warm Compresses: The article suggests using warm compresses strategically, focusing on areas like the neck, chest wall, or groin. Avoiding direct application to the arms or legs prevents the risk of cold blood returning to vital organs.
- No Direct Heat: Caution is advised against using hot water, heating pads, or lamps directly on the person, as extreme heat can lead to skin damage or, in severe cases, irregular heartbeats.
Medical Treatment Options:
- Passive Rewarming: Mild hypothermia may be addressed with heated blankets and warm fluids.
- Blood Rewarming: In more severe cases, interventions like drawing, warming, and recirculating blood may be necessary. Techniques like hemodialysis machines and heart bypass machines might be employed.
- Intravenous Fluids: Warming intravenous fluids can be administered to help raise the core body temperature.
- Airway Rewarming: Humidified oxygen, delivered through a mask or nasal tube, aids in warming the airways and subsequently raising the body temperature.
- Irrigation: Warm saltwater solutions may be used in specific areas of the body, such as the lungs or abdominal cavity, to facilitate rewarming.
In critical cases, extracorporeal membrane oxygenation (ECMO) may be employed as a more advanced intervention, as mentioned in the concluding note of the article. This technique involves providing respiratory and circulatory support when conventional methods are insufficient.
This comprehensive approach, encompassing diagnosis, first aid, and medical treatment options, reflects a thorough understanding of hypothermia management in diverse scenarios.
