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Hypothermia and Cold Injury

Core temperature below 35°C is a life-threatening emergency seen with cold exposure or cold-water immersion.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Hypothermia and Cold Injury?

Hypothermia is defined by a core body temperature below 35°C. It is divided into mild (32-35°C), moderate (28-32°C) and severe (below 28°C). Severity guides clinical decisions and rewarming strategy.

Causes include environmental cold exposure, immersion in cold water, prolonged cold operative theatres, large infusions of cold fluids, and depressed thermoregulation in older adults, alcohol intoxication or major trauma.

Cardiac arrhythmias (notably ventricular fibrillation), coagulopathy and acidosis are leading complications. The principle 'no one is dead until warm and dead' guides resuscitation.

Symptoms

Shivering, pale and cold skin (mild)
Confusion, dysarthria and impaired coordination
Bradycardia, hypotension and bradypnoea
Loss of shivering at temperatures below 32°C
Coma and respiratory depression
Cardiac arrhythmias and asystole

Risk Factors

Outdoor exposure or immersion in cold water
Older age and chronic illness
Alcohol intoxication or substance use
Inadequate clothing or homelessness
Hypothyroidism or adrenal insufficiency
Major trauma and large blood loss

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Suspected hypothermia in cold exposure
  • Altered mental status or unresponsiveness
  • Loss of shivering
  • Cold injury or frostbite of the extremities

Treatment Methods

01
Remove wet clothing and prevent further heat loss
02
Passive external rewarming (warm blankets, dry environment) for mild hypothermia
03
Active external rewarming (forced-air warmers, heating pads)
04
Active internal rewarming with warm intravenous fluids and warm humidified oxygen
05
Extracorporeal rewarming (ECMO/CPB) in severe hypothermia or cardiac arrest
06
Prolonged CPR — do not declare death until the patient is rewarmed

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.