Seek immediate medical attention for anyone who appears to have hypothermia. Until medical help is available, follow these hypothermia treatment guidelines.
- Be gentle. When you're helping a person with hypothermia, handle him or her gently. Limit movements to only those that are necessary. Don't massage or rub the person. Excessive, vigorous or jarring movements may trigger cardiac arrest.
- Move the person out of the cold. Move the person to a warm, dry location if possible. If you're unable to move the person out of the cold, shield him or her from the cold and wind as much as possible.
- Remove wet clothing. If the person is wearing wet clothing, remove it. Cut away clothing if necessary to avoid excessive movement.
- Cover the person with blankets. Use layers of dry blankets or coats to warm the person. Cover the person's head, leaving only the face exposed.
- Insulate the person's body from the cold ground. If you're outside, lay the person on his or her back on a blanket or other warm surface.
- Monitor breathing. A person with severe hypothermia may appear unconscious, with no apparent signs of a pulse or breathing. If the person's breathing has stopped or appears dangerously low or shallow, begin CPR immediately if you're trained.
- Share body heat. To warm the person's body, remove your clothing and lie next to the person, making skin-to-skin contact. Then cover both of your bodies with blankets.
- Provide warm beverages. If the affected person is alert and able to swallow, provide a warm, sweet, nonalcoholic, noncaffeinated beverage to help warm the body.
Use warm, dry compresses. Use a first-aid warm compress (a plastic fluid-filled bag that warms up when squeezed) or a makeshift compress of warm water in a plastic bottle or a dryer-warmed towel. Apply a compress only to the neck, chest wall or groin.
Don't apply a warm compress to the arms or legs. Heat applied to the arms and legs forces cold blood back toward the heart, lungs and brain, causing the core body temperature to drop. This can be fatal.
- Don't apply direct heat. Don't use hot water, a heating pad or a heating lamp to warm the person. The extreme heat can damage the skin or, even worse, cause irregular heartbeats so severe that they can cause the heart to stop.
Depending on the severity of hypothermia, emergency medical care for hypothermia may include one of the following interventions to raise the body temperature:
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- Blood rewarming. Blood may be drawn, warmed and recirculated in the body. A common method of warming blood is the use of a hemodialysis machine, which is normally used to filter blood in people with poor kidney function. Heart bypass machines also may need to be used.
- Warm intravenous fluids. A warmed intravenous solution of salt water may be injected into a vein to help warm the blood.
- Airway rewarming. The use of humidified oxygen administered with a mask or nasal tube can warm the airways and help raise the temperature of the body.
- Irrigation. A warm saltwater solution may be used to warm certain areas of the body, such as the area around the lungs (pleura) or the abdominal cavity (peritoneal cavity).
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Feb. 9, 2014.
- Hypothermia. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/injuries_poisoning/cold_injury/hypothermia.html. Accessed Feb. 10, 2014.
- Brown DJA. Accidental hypothermia. New England Journal of Medicine. 2012;367:1930.
- Mechem CC, et al. Accidental hypothermia in adults. http://www.uptodate.com/home. Accessed Jan. 6, 2014.
- Auerbach PS. Wilderness Medicine. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.clinicalkey.com. Accessed Feb. 9, 2014.
- Extreme cold: A prevention guide to promote your personal health and safety. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/disasters/winter/guide.asp. Accessed Feb. 10, 2014.
- Hypothermia. National Institute on Aging. http://www.nia.nih.gov/print/health/publication/hypothermia. Accessed Feb. 12, 2014.
- Hypothermia prevention: Survival in cold water. Minnesota Sea Grant. http://www.seagrant.umn.edu/coastal_communities/hypothermia. Accessed Feb. 12, 2014.
- Cold water survival tips. U.S. Army Corps of Engineers. http://www.army.mil/article/51309/cold-water-survival-tips-from-usace-and-uscg/. Accessed Feb. 12, 2014.
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