Hypothermia Basics
What is the primary mechanism of heat loss in cold, windy environments?
What is Convection
What is a key sign of mild hypothermia?
What is Shivering.
Where do you place heat packs for hypothermia?
What is Axillae, chest, and groin.
Frostnip affects which layers of the tissue?
What is superficial layers only: reversible.
You find a patient in wet clothing, shivering, alert. What stage of hypothermia is this?
What is Mild.
At what core temperature does shivering typically stop?
What is around 31–32°C (moderate hypothermia).
What is the typical mental status change in moderate hypothermia?
What is Confusion or slowed mentation.
What type of rewarming is appropriate for mild hypothermia?
What is Passive rewarming (blankets, removing wet clothes).
What is the FIRST priority in frostbite management?
What is Prevent refreezing.
A patient who is hypothermic with slowed breathing and bradycardia should be managed how?
Handle gently, rewarm, support ABCs, initiate/help with transport (BCEHS).
How long should you check a pulse in a severely hypothermic patient?
What is 30-45 seconds.
What cardiac rhythm is most feared in severe hypothermia?
What is Ventricular Fibrillation.
WHY? Because once in VF, this rhythm is often resistant to standard resuscitation efforts like defibrillation (Often ineffective at temperatures below 30°C) and anti-arrhythmic drugs until the patient is warm
A patient is wet and cold but alert. What is the first priority in preventing worsening hypothermia?
Remove wet clothing and insulate with dry blankets or vapor barriers.
Frostbite tissue often feels:
A. Soft
B. Waxy and firm
C. Warm
D. Soggy
What is B Waxy and firm
A skier with white, waxy fingers and no sensation presents to you. What is the correct field treatment?
Protect, pad between digits, do NOT thaw if risk of refreezing.
Hypothermia from water exposure occurs mainly through which type of heat transfer?
What is Conduction.
A patient has slurred speech, ataxia, and cold skin. What stage of hypothermia is most likely?
What is Moderate hypothermia.
What is the BCEHS/ and EMALB EMR stance on hypothermic cardiac arrest resuscitation?
Prolonged resuscitation; “No one is dead until warm and dead.”
Why should you NOT rub frostbitten tissues?
It causes ice crystals to damage cells.
A patient collapses after being in icy water. They have a faint pulse. What is your first priority?
Airway and gentle handling; remove wet clothing; begin rewarming.
What is “afterdrop”?
What is a continued fall in core temperature after rewarming begins due to cold peripheral blood returning to the core.
Note: This is why we rewarm slowly, typically 0.2-0.5 °C per hour, to prevent complications like free radicals damaging/preventing the healing of tissues and minimizing the severity of afterdrop.
A hypothermic patient is no longer shivering, has paradoxical undressing, and is attempting to burrow into the snow.
What stage of hypothermia does this indicate, and what is the physiological reason these behaviours occur?
Stage: Severe hypothermia.
Reason: Failure of thermoregulation due to central nervous system depression, the brain misinterprets intense vasodilation as overheating (leading to paradoxical undressing), and impaired brain function triggers terminal burrowing or “hide-and-die” behaviour.
Why must you handle severely hypothermic patients gently?
What is Rough handling can trigger VF due to myocardial irritability.
What is the preferred rewarming technique in-hospital for frostbite?
What is a circulating water bath at 37–39°C.
You suspect severe hypothermia and cannot detect a pulse. How long do you assess and what do you do next?
Check for 30–45 seconds — begin CPR and follow hypothermia cardiac arrest protocol.