Care and Management of Hypothermia

Hypothermia is a condition where the body temperature falls below the level Hypothermiasufficient to maintain normal bodily functions. In humans, the accepted normal body temperature is 98.6°F (37°C). Although the body can adapt to the constant fluctuations in body temperature as a result of exposure to surrounding environment, very high or very low body temperature can potentially lead to health problems.

Hypothermia occurs when the body temperature falls below 35°C. At this point, many vital body functions can fail and potentially lead to life-threatening complications. Usually, victims do not realize the seriousness of the condition because of its gradual onset.

Disclaimer: the information posted on this page on care and management of hypothermia is for learning purposes only. To learn to recognize and manage victims of hypothermia take a hands on training first aid course through St Mark James here.

What causes hypothermia?

There are a lot of factors that can lead to hypothermia. Some of the common causes of drops in body temperature include:

  • Exposure to extremely cold climate
  • Immersion or submersion in cold water
  • Use of certain drugs such sedatives and alcohol
  • Severe blood loss due to burns or severe trauma
  • Impairment in metabolism
  • Diseases and conditions that result in altered levels of consciousness (ex. stroke)
  • Severe infections
  • Malnutrition

What are the stages of hypothermia?

As mentioned above, the body maintains a constant core temperature that is between 36.5°C to 37.5°C to ensure that vital organs work well. Even a slight drop in body temperature (1°C to 2°C) can progress into hypothermia that proceeds in three stages:

Stage 1 – Core body temperature drops to 35-37°C. The person may experience mild to severe shivering, with hands and feet starting to feel numb due to the constriction of blood vessels. These are normal responses of the body to produce body heat and prevent heat loss. The person may start rapid but shallow breathing.

Stage 2 – Core body temperature further drops to 33-35°C. The person experiences increased shivering that is concentrated in the trunk and upper extremities. This is a reflex response of the body to maintain heat and blood supply in the heart, lungs and brain. Without intervention, shivering continues to become intense often making it difficult for the victim to move or even talk. The person may also have difficulty thinking and concentrating, usually becoming confused or irrational. As the core body temperature continues to fall, vital bodily functions may start to shut down and blood supply to vital organs may soon drop. The blood may pool to the extremities causing temporary ‘warmth’. The fingers and toes may gradually turn bluish due to lack of oxygenated blood.

Stage 3 – The core body temperature drops below 32°C. Shivering may eventually stop with the person having great difficulty to talk and may even have loss of memory. Motor skills may become impaired or totally absent. Prolonged hypothermia can lead to unconsciousness. The skin may gradually become puffy and turn more bluish. If not treated, death can occur within an hour. Severe hypothermia can lead to cardiac arrhythmias or cardiac arrest.

To help determine if a person is progressing from Stage 1 to Stage 2, instruct the casualty to put their little finger and thumb, tip to tip. If they are unable to do this, they may be starting to lose muscle coordination and are most likely in Stage 2.

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