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]
- Shivering
Violent shivering is the body’s way of generating hear from muscle contraction so don’t suppress shivering, instead have the person be more active. [outdoored.com]
Shivering increases metabolic rate (2-5 times) but only while glycogen stores last and above 30°C. Vasoconstriction fails at temperatures below 24°C Tachycardia is followed by bradycardia, hypotension and fall in cardiac output. [emed.ie]
Moderate 95—93 93—90 Intense shivering, general lack of muscular coordination, slow or stumbling pace, mild confusion, pale skin. Violent shivering, gross lack of muscular coordination, mental sluggishness, amnesia, difficulty speaking. [grainger.com]
Symptoms progress from shivering and lethargy to confusion, coma, and death. Mild hypothermia requires a warm environment and insulating blankets (passive rewarming). [msdmanuals.com]
- Falling
When body temperature falls below 95° F (35° C), physiological processes are slowed, consciousness is impaired, and coma, cardiorespiratory failure, and death may ensue. [britannica.com]
Renal blood flow falls. There may be a large diuresis due to initial vasoconstriction. [emed.ie]
The effects of hypothermia are proportional to the change in temperature, with metabolic rate reduced in proportion to the fall in core body temperature. [patient.info]
A fall in core temperature of only 1°C can slow reaction times and impair judgment leading to poor decisions. [coolantarctica.com]
- 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]
- 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]
Respiratoric
- Respiratory Distress
No studies have examined the impact of hypothermia on outcomes for preterm infants treated with CPAP for respiratory distress syndrome (RDS). [ncbi.nlm.nih.gov]
Miller And Donna Thornton, USA TODAY, "What we know about Alabama dock fire: Four of eight who died were children," 28 Jan. 2020 He was described by doctors as severely and chronically malnourished, dehydrated, suffering from acute respiratory distress [merriam-webster.com]
Severe Hypothermia – the person collapses and is unconscious and shows signs of respiratory distress and/or cardiac arrest probably leading to death. Conservation of heat is the foremost objective for a person in the water. [wasserstart.hu]
In newborns, hypoglycemia can produce irritability, jitters, myoclonic jerks, cyanosis, respiratory distress, apneic episodes, sweating, hypothermia, somnolence, hypotonia, refusal to feed, and seizures or "spells." [en.wikipedia.org]
Gastrointestinal
- Nausea
Patient 3 was a 79-year-old woman who presented with nausea, vomiting, and headache 2 h after consuming honey. Her temperature was 35°C, her blood pressure was 70/40 mm Hg, and her heart rate was 40 beats/min. [ncbi.nlm.nih.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]
मदात्यय, शराब की लत, शराबीपन, मद्यपता, पियक्कड़पन, अधिक मदिरा पीने से Her father died of alcoholism / he had a long history of depression, drug abuse and alcoholism Alopecia खालित्य, गंजापन, केशाभाव, Minor toxic effects, such as stomatitis, malaise, nausea [studysite.org]
Symptoms of Heat Stress If you experience these symptoms during hot weather, you should seek medical help: dizziness, rapid heartbeat, nausea, throbbing headache, lack of perspiration, mental changes and breathing problems How to Avoid Heat Stress Slow [columbiagasma.com]
- Vomiting
Patient 3 was a 79-year-old woman who presented with nausea, vomiting, and headache 2 h after consuming honey. Her temperature was 35°C, her blood pressure was 70/40 mm Hg, and her heart rate was 40 beats/min. [ncbi.nlm.nih.gov]
DO NOT give the person anything by mouth (not even salted drinks) if the person is vomiting or unconscious. Call 911 if: The person loses consciousness at any time. [nlm.nih.gov]
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]
Cyanosis -- Syncope -- Depressed consciousness and coma -- Confusion -- Seizures -- Dizziness and vertigo -- Headache -- Diplopia -- Red and painful eye -- Sore throat -- Hemoptysis -- Dyspnea -- Chest pain -- Abdominal pain -- Jaundice -- Nausea and vomiting [worldcat.org]
- Diarrhea
शराब की लत, शराबीपन, मद्यपता, पियक्कड़पन, अधिक मदिरा पीने से Her father died of alcoholism / he had a long history of depression, drug abuse and alcoholism Alopecia खालित्य, गंजापन, केशाभाव, Minor toxic effects, such as stomatitis, malaise, nausea, diarrhea [studysite.org]
[…] consciousness and coma -- Confusion -- Seizures -- Dizziness and vertigo -- Headache -- Diplopia -- Red and painful eye -- Sore throat -- Hemoptysis -- Dyspnea -- Chest pain -- Abdominal pain -- Jaundice -- Nausea and vomiting -- Gastrointestinal bleeding -- Diarrhea [worldcat.org]
- 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]
- Tachycardia
The initial rhythm was ventricular tachycardia with no detectable pulse. [ncbi.nlm.nih.gov]
Vasoconstriction fails at temperatures below 24°C Tachycardia is followed by bradycardia, hypotension and fall in cardiac output. Arrhythmias are common, may be refractory to treatment. Asystole and VF may occur spontaneously < 25°C. [emed.ie]
- 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]
Skin
- Flushing
Shave the top inner edge with your yard stick so that the whole 1st layer is flush and at the same angle. Step 7: Continue making blocks Around row three the blizzard let up for a moment. [wildearth.org]
Thoracic lavage (flushing the thoracic [chest] region with warm water) with isotonic saline (pre-warmed to about 105.8 F or 41 C) has also been done. [medicinenet.com]
Alcohol and other drugs – alcohol makes people feel cosy because it relaxes the blood vessels, allowing more blood to flow near the skin, providing a flushed appearance and a warm sensation. [betterhealth.vic.gov.au]
- Erythema
Immunohistochemical detection of hemoglobin in frost erythema. Forensic Sci Int. 2006;158:131–4. PubMed Google Scholar 127. Schoning P. Experimental frostbite in Hanford miniature swine. III Sweat gland changes. Int J Exp Pathol. 1990;71:713–6. [doi.org]
Psychiatrical
- Hunger
Additional symptoms of hypothermia may include: Mild: dizziness hunger and nausea difficulty speaking Moderate to severe: shivering may stop slurred speech significant confusion drowsiness apathy or lack of concern weak pulse When a person has severe [medicalnewstoday.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. [merckmanuals.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]
- Irritability
The pulse first slows down and then the heart becomes more irritable as temperature reduces further, often leading to an irregular pulse (atrial fibrillation) at core temperatures below 32 degrees C. Severe. [altitude.org]
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]
Lethargy and clumsiness are followed by confusion, irritability, sometimes hallucinations, and eventually coma. Pupils may become unreactive. Respirations and heartbeat slow and ultimately cease. [merckmanuals.com]
Cardiac monitoring: dysrhythmias, changes of hyperkalaemia; J waves are pathognomonic of hypothermia: Cardiac output falls proportionately to the degree of hypothermia and cardiac irritability begins at about 33°C. [patient.info]
- Dizziness
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]
Gastrointestinal upset, headache, and dizziness are common adverse effects, and prolongation of the rate-corrected electrocardiographic QT interval and malignant arrhythmias have been reported. [ncbi.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]
- Lethargy
Symptoms progress from shivering and lethargy to confusion, coma, and death. Mild hypothermia requires a warm environment and insulating blankets (passive rewarming). [msdmanuals.com]
Common signs include shivering, slurred speech, an abnormally slow rate of breathing, cold and pale skin, fatigue, lethargy and apathy. A depressed level of consciousness is the most common feature of hypothermia. [patient.info]
In the present case, an 80-year-old woman who had been diagnosed with Parkinson's disease 3 years earlier (Hoehn and Yahr stage III) was admitted with a few days history of lethargy and bradykinesia. [ncbi.nlm.nih.gov]
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]