Presentation
If hypoglycemia is present, 25-50 mg of glucose as a D50 solution should be given. [clinicaladvisor.com]
Trench foot : Lower extremities with prolonged exposure to wet and cold conditions develop tissue damage, often presenting as paresthesias, pain, or numbness. [cdemcurriculum.com]
The clinical presentation of hypothermia includes a spectrum of symptoms and is grouped into the following three categories: mild, moderate, and severe. Management depends on the degree of hypothermia present. [ncbi.nlm.nih.gov]
Entire Body System
- Hypothermia
GI: Ileus is a common finding in hypothermia and in moderate-to-severe hypothermia is almost universal. [clinicaladvisor.com]
Hypothermia results when body heat loss exceeds body heat production. [msdmanuals.com]
This module will discuss only hypothermia caused by the unintentional exposure to cold temperatures (primary hypothermia), not that caused by other disease processes (secondary hypothermia) or therapeutic hypothermia. [cdemcurriculum.com]
Perioperative hypothermia: Hypothermia may be deliberate (see below), or accidental. [patient.info]
- Unconsciousness
On arrival at the university hospital, she was unconscious and had dilated pupils. She was tachycardic with a body temperature of 33.5°C. She was transferred to the intensive care unit and TH was maintained with invasive cooling. [ncbi.nlm.nih.gov]
Don't try to give fluids to an unconscious person. Continued If the hypothermic person is unconscious, or has no pulse or signs of breathing, call for emergency help right away. [webmd.com]
(F) is: Exhaustion or Unconsciousness Expected Time of Survival is: 32.5 Under 15 min. [wasserstart.hu]
- Weakness
SUMMARY: A 59-year-old female presented to the emergency department with altered mental status, generalized weakness, chills, and fatigue and was diagnosed with a urinary tract infection. [ncbi.nlm.nih.gov]
The early symptoms of heat cramps include: Muscle cramps and pains that most often occur in the legs or abdomen Very heavy sweating Fatigue Thirst Later symptoms of heat exhaustion include: Headache Dizziness, lightheadedness Weakness Nausea and vomiting [nlm.nih.gov]
The primary symptoms are shivering, dizziness, confusion, weakness, increased heart rate and faster breathing. As hyperthermia progresses, it can cause very shallow breathing, sleepiness, slurred speech, clumsiness and loss of consciousness. [foxnews.com]
- Fatigue
[…] definition noun Whether it was the beginnings of altitude sickness, hypothermia, or simply fatigue I have no idea. the condition of having an abnormally low body temperature, typically one that is dangerously low. translation of 'hypothermia' अल्पताप, [helloenglish.com]
History Humans have known for millennia that exposure to the cold could result in death and that fatigue or exhaustion make it worse. [verywellhealth.com]
SUMMARY: A 59-year-old female presented to the emergency department with altered mental status, generalized weakness, chills, and fatigue and was diagnosed with a urinary tract infection. [ncbi.nlm.nih.gov]
Hypothermia symptoms include: intense shivering, fatigue, stumbling or poor coordination, slurred speech, and irrationality. To Treat Hypothermia Shelter the victim from the wind and weather. [dnr.alaska.gov]
Some warning signs to look out for include: Hypothermia : nausea, fatigue, dizziness, irritability, euphoria or shivering. Heat stroke : sudden and severe fatigue, nausea, dizziness, light-headedness. [fitforwork.org]
- Surgical Procedure
In human beings, hypothermia may be artificially induced to decrease the metabolic need for oxygen during certain surgical procedures and for the control of some kinds of cancer. [britannica.com]
Generalized lowering of the body temperature decreases the metabolism of tissues and thereby the need for oxygen; it is used in various surgical procedures, especially on the heart. [medical-dictionary.thefreedictionary.com]
Severe hypothermia: may require core re-warming methods that may include invasive surgical re-warming techniques - eg, peritoneal lavage, A-V re-warming or cardiopulmonary bypass. [patient.info]
Respiratoric
- Bradypnea
Degree of Hypothermia Degree of Hypothermia Mild (32-35 o C) Moderate (28-32 o C) Severe ( o C) Vital Signs Tachypnea Tachycardia without hemodynamic instability Bradycardia Bradypnea Bradycardia Hypotension Pulselessness Bradypnea/apnea Muscular Shivering [cdemcurriculum.com]
Degree of Hypothermia Degree of Hypothermia Mild (32-35oC) Moderate (28-32oC) Severe (<28oC) Vital Signs Tachypnea Tachycardia without hemodynamic instability Bradycardia Bradypnea Bradycardia Hypotension Pulselessness Bradypnea/apnea Muscular Shivering [saem.org]
They may become hypotensive with bradycardia and bradypnea. Shivering typically ceases between 30 to 32 C and paradoxical undressing may be observed. [ncbi.nlm.nih.gov]
- Dyspnea
She presented to the emergency department with a 1-month history of progressive dyspnea associated with general weakness. She also showed hypothermia, decreased mental status, and general edema. [ncbi.nlm.nih.gov]
Adult resuscitation -- Fever in the adult patient -- Weakness -- Cyanosis -- Syncope -- Depressed consciousness and coma -- Confusion -- Seizures -- Dizziness and vertigo -- Headache -- Diplopia -- Red and painful eye -- Sore throat -- Hemoptysis -- Dyspnea [worldcat.org]
- Sore Throat
Shock -- Brain resuscitation -- Adult resuscitation -- Fever in the adult patient -- Weakness -- Cyanosis -- Syncope -- Depressed consciousness and coma -- Confusion -- Seizures -- Dizziness and vertigo -- Headache -- Diplopia -- Red and painful eye -- Sore [worldcat.org]
Gastrointestinal
- Choking
If they are semi-conscious or unconscious: Prompt evacuation must be organised (activate your PLB) It is not safe to give them food or drink because they may choke They need to be moved carefully (carried horizontally to shelter) and not be allowed to [mountainsafety.org.nz]
A person with significantly altered mental state should not be allowed to eat or drink because of the potential for choking or vomiting. [backpacker.com]
Cardiovascular
- Weak Pulse
The following are the most common symptoms of hypothermia: Confusion Sleepiness Fumbling hands Shivering and exhaustion Slow, slurred speech, or shallow breathing Weak pulse and/or low blood pressure Drowsiness A change in behavior or appearance during [hopkinsmedicine.org]
According to Mayo Clinic, The Symptoms of Hypothermia Include: shivering slurred speech or mumbling slow, shallow breathing weak pulse clumsiness or lack of coordination drowsiness or very low energy confusion or memory loss loss of consciousness bright [statefarm.com]
- Slow Pulse
Because of the physiologic slowing, pulse, respiration, and blood pressure are depressed; in some cases the victim of hypothermia appears to be dead, although revival may still be possible with appropriate treatment. [britannica.com]
- Irregular Heart Rhythm
This extreme heat can cause skin damage, an irregular heart rhythm, or even cardiac arrest. If a person with severe hypothermia who is unconscious seems to not have a pulse or not be breathing, perform CPR. CPR should continue during rewarming. [scouting.org]
Often, even if no pulse can be felt and no heartbeat can be heard, the heart may be beating. Also, a severely hypothermic person must be handled gently, because a sudden jolt may cause an irregular heart rhythm (arrhythmia) that could be fatal. [msdmanuals.com]
The heart rhythm may become irregular. At temperatures below 82.4 F (28 C), reflexes are lost and cardiac output continues to fall. The risk of dangerously irregular heart rhythms increases, and brain activity is seriously slowed. [emedicinehealth.com]
Skin
- Sweating
Keep active when it's cold, but not to the point where you are sweating. If you exercise outdoors during the winter and you sweat after exercising, make sure you dry off and put on warm clothes immediately afterwards. [web.archive.org]
Prevent your clothing from getting wet either from sweat or from rain or snow. Wet clothing will rob you of heat 25 times faster than dry clothing. [outdoored.com]
Sweating leads to wet clothing, which increases the possibility of becoming chilled. Dressing in layers that are easy to put on or take off will help you to avoid becoming chilled, or becoming too warm and sweating heavily in your clothes. [scouting.org]
If you are someone who sweats a lot with activity, your foot and polypropylene liner sock may be totally soaked before the body shuts down sweating. Having this liquid water next to the skin is going to lead to increased heat loss. [princeton.edu]
Take layers off if you begin to sweat and put them back on when you cool down. Stay well fueled. Snack on high carbohydrate foods and drink lots of water. Water helps your body turn calories into heat. Watch for signs of hypothermia. [dnr.alaska.gov]
- Blister
[…] itching and swelling Keep blisters and ulcers clean and covered Recommendations for Employers Employers should take the following steps to protect workers from cold stress: Schedule maintenance and repair jobs in cold areas for warmer months. [web.archive.org]
If frostbite is allowed to progress, skin can blister or turn black from deeper tissue necrosis. So what can you do to prevent hypothermia and frostbite this winter? Dress appropriately for the weather. [foxnews.com]
[…] features Acute frostbite can occur in isolation or as a complication of hypothermia Areas most frequently affected: face (nose, cheeks, chin), ears, fingers, and toes Cold and paresthesia of affected region Pale (white or grayish-yellow), blue-red, or blistered [amboss.com]
Trench foot : Skin may appear red and swollen at first, progressing to blisters and bullae and finally hemorrhage in the skin and deeper tissues. [cdemcurriculum.com]
The cold feeling disappears and is replaced with numbness, and blisters might form. At this point, it's very easy to cause other damage besides the actual freezing. [medbroadcast.com]
Neurologic
- Confusion
Some degree of confusion or lowered level of consciousness is common with mild hypothermia. Early signs include weakness, confusion and ataxia. (Neurologic changes are sometimes referred to as the "umbles": fumbles, mumbles, stumbles, and crumbles.) [clinicaladvisor.com]
If you seem confused or sluggish, someone should take you to a hospital. Doctors may have to do special warming treatments. [msdmanuals.com]
- Slurred Speech
Rapid warming may cause heart arrhythmias How to Prevent Hypothermia Be aware of the warning signs of cold-related illness, such as uncontrollable shivering, sleepiness, confusion, changes in skin color, slurred speech and loss of consciousness. [health.mo.gov]
Hypothermia symptoms include: intense shivering, fatigue, stumbling or poor coordination, slurred speech, and irrationality. To Treat Hypothermia Shelter the victim from the wind and weather. [dnr.alaska.gov]
Extreme fatigue, slurred speech, and memory loss require urgent medical attention. [share.upmc.com]
As hyperthermia progresses, it can cause very shallow breathing, sleepiness, slurred speech, clumsiness and loss of consciousness. [foxnews.com]
- Encephalopathy
PATIENTS: Two hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic encephalopathy. An actively cooled group of 136 newborns were compared with a control group of 78 newborns. [ncbi.nlm.nih.gov]
- Seizure
TCA poisoning can cause hypotension, seizures, and cardiac conduction disturbances, which can lead to life-threatening arrhythmia. [ncbi.nlm.nih.gov]
Maternal causes of fetal distress include comorbidities, medications, recreational drugs, infections, metabolic abnormalities, toxins, hypothermia, and seizures. [dictionary.cambridge.org]
Eligible patients had convulsive status epilepticus, defined as 5 minutes or more of continuous clinical seizure activity or more than two seizures without a return to baseline in the interval; had been admitted less than 8 hours after the onset of seizures [nejm.org]
If the person shows signs of shock ( bluish lips and fingernails and decreased alertness ), starts having seizures, or loses consciousness, call 911 and give first aid as needed. [nlm.nih.gov]
- Amnesia
Amnesia याददाश्त खो जाना/विस्मरण, स्मृति लोप, याददाश्त खो जाना, भूलने की बीमारी, शब्दस्मृतिलोप, Due to head injury he suffered from amnesia / Because she was suffering from amnesia, the police could not get the young girl to identify herself. / He was [studysite.org]
As hypothermia progresses to the more dangerous end of the moderate spectrum, the person may have difficulty speaking and amnesia may start. [safetyandhealthmagazine.com]
[…] opioids OD) Phenothiazines (impaired shivering) Neurological CVA Paraplegia Parkinson's disease Endocrine Hypoglycaemia and diabetes Hypothyroidism Hypoadrenalism Severity 35-32°C Mild Increased basal metabolic rate, Maximum shivering thermogenesis Amnesia [emed.ie]
Mild hypothermia causes symptoms like shivering, weakness, and confusion; if core temperature reaches 91 degrees, amnesia might set in. At 82 degrees, a person may lose consciousness. [newser.com]
Stages of hypothermia Signs and Symptoms Mild, 32–35°C (90–95°F) Excitement Confusion, amnesia, dysarthria, and impaired judgement Ataxia, apathy Tachycardia, tachypnea Cold diuresis Moderate, 28–32°C (82–90°F) Exhaustion Worsening CNS depression: lethargy [amboss.com]
Workup
EEG
- Burst Suppression
In both groups, if the results showed ongoing seizures, repeated propofol boluses were administered, followed by a maintenance intravenous infusion to obtain and maintain a burst-suppression EEG pattern for 24 hours. [nejm.org]
Treatment
Treatment includes ibuprofen as an anti-inflammatory agent, tetanus toxoid, elevation of the affected area, and narcotic analgesia. [cdemcurriculum.com]
A brief treatment of hibernation follows. For full treatment, see dormancy.… [britannica.com]
We aimed to determine whether hypothermia treatment could remain effective within 12 h after birth. [ncbi.nlm.nih.gov]
Hypothermia Treatment When the signs of hypothermia are detected, it is critical to begin treatment immediately—even in mild cases. [grainger.com]
A high index of suspicion is needed in such cases to ensure appropriate treatment is initiated early. B. [clinicaladvisor.com]
Prognosis
Prognosis The prognosis depends on the severity and nature of the cause. Most people tolerate mild hypothermia, which is not associated with significant morbidity or mortality. Overall mortality then increases with the degree of hypothermia. [patient.info]
Prognosis of Hypothermia How is Hypothermia Treated? Hypothermia References What is Hypothermia Hypothermia will occur when the bodies natural defences against it (such as shivering and heat retention in body core) fail. [healthengine.com.au]
Prognosis and Patient Counseling. Estimates for the mortality rate of treated hypothermia are wide and range from 12% to 73% depending on the population studied. [clinicaladvisor.com]
The initial prognosis under the standard protocol was 2017 BMJ Publishing Group Ltd. [ncbi.nlm.nih.gov]
Etiology
etiology suspected Arterial blood gas (acidosis can provide prognostic information). [clinicaladvisor.com]
Etiology Decreased heat production Several etiologies related to endocrine derangements may cause decreased heat production. These include hypopituitarism, hypoadrenalism, and hypothyroidism. [emedicine.com]
References:[4][7] Hypothermia and frostbite Summary Etiology Pathophysiology Hypothermia Frostbite [amboss.com]
Epidemiology
Electronic address: [email protected]. 2 National and Kapodistrian University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, Athens, Greece; European University Cyprus, Department of Health Science & Department [ncbi.nlm.nih.gov]
Contact Information Bureau of Environmental Epidemiology Missouri Department of Health and Senior Services PO Box 570 Jefferson City, MO 65102 Telephone: 573-751-6102 or (toll-free) 866-628-9891 Fax: 573-526-6946 Email: [email protected] [health.mo.gov]
Epidemiology US frequency Accurately estimating the incidence of hypothermia is impossible, as hospital encounters only represent the "tip of the iceberg" in that they reflect the more severe cases. [emedicine.com]
Pathophysiology
The aim of this review is to give an overview of the pathophysiological aspects of hypothermia and to illustrate different aspects relevant to forensic medical casework. [ncbi.nlm.nih.gov]
References:[4][7] Hypothermia and frostbite Summary Etiology Pathophysiology Hypothermia Frostbite [amboss.com]
As it relates to cold water diving, the pathophysiology of immersion and mild to severe hypothermia is reviewed including thermoregulation and effects on organ systems. [archive.rubicon-foundation.org]
Prevention
Appropriate Prophylaxis and Other Measures to Prevent Readmission. Prophylaxis: Most patients with hypothermia do not require any disease specific prophylactic measures. [clinicaladvisor.com]
To prevent neurological damage, therapeutic hypothermia was used, and she was cooled for 24 hours. After therapeutic hypothermia, her Glasgow coma score was 15, fortunately no sequela appeared. [ncbi.nlm.nih.gov]
Hypothermia victims often can't help themselves so it is important for each group member to be aware of prevention and treatment methods. To Prevent Hypothermia Dress in layers. [dnr.alaska.gov]
Wear a hat or other protective covering to prevent body heat from escaping from your head, face and neck. Cover hands with mittens instead of gloves. [patient.info]