Doctor's Notes on Hypothermia
Hypothermia is defined as a core or internal body temperature (best measured with a rectal thermometer) of less than 95 F or 35 C. Signs and symptoms of hypothermia vary with the decreasing core temperature. Shivering, along with an increase in heart rate, breathing rate, and blood pressure are seen at a core temperature of about 95 F or somewhat below. As temperature decreases toward 89.9 F, heart rate, breathing rate, and blood pressure decrease and the person becomes clumsy, confused, apathetic, and develops slurred speech; below 89.9 F, the shivering and oxygen consumption drops while the person may develop an irregular heartbeat and may become stuporous. At core temperatures below 82.4 F, reflexes are lost, cardiac output falls, the chances of a dangerous heart rhythm increase, brain activity slows, and the patient appears comatose or dead. However, some patients can be revived. Almost all individuals with hypothermia should be evaluated by an emergency medical caregiver (call 911).
The cause of hypothermia is exposure to a cold or frigid environment long enough to not allow the body to sustain a normal core temperature (98 F-100 F). Cold water immersion can drop core temperatures to dangerous levels in minutes (falling through ice in a lake or river). It may take hours for hypothermia to develop in cold dry environments (homeless, elderly in an unheated house).
What Is the Treatment for Hypothermia?
Call 911, and begin first aid:
- Gently handle the patient to avoid cardiac arrest.
- Move patient to a warm and dry location.
- Remove wet clothing.
- Cover the patient with dry blankets.
- If outside, insulate the patient from the cold ground.
- Monitor breathing (may need CPR).
- Apply warm, dry compresses only to the neck, chest wall, and groin -- do not apply the compresses to the extremities as this may cause a drop in core temperature that can be fatal.
- Don't apply direct heat like hot water or a heat lamp to avoid irregular heartbeats.
- Hospital medical treatment (depends on the severity) may include the following:
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Cold Hands and Feet
When parts of your body get too cold, like your hands, feet, and sometimes other parts of the body, especially your ears and nose, they can be injured or react in different ways. Symptoms and signs of cold hands and feet include loss of sensation, numbness, tingling, itching, burning, unusual color of the affected area, and blistering. Types of cold injury include frostbite, frostnip, immersion, pernio, Raynaud's phenomenon, cryoglobulins, and cold urticaria. The best treatment is rapid rewarming in the emergency department. -
Frostbite
Frostbite is a condition caused by skin exposed over a long period of time to cold exposure. Frostbite symptoms include burning, numbness, tingling, itching, and cold sensations in the affected areas. Deep frostbite there may be complete loss of sensation. Treatment of frostbite is best under medical supervision to minimize tissue damage. -
Frostbite vs. Hypothermia Differences in Symptoms and Stages
Frostbite and hypothermia are two real dangers from cold exposure. Aside from cold exposure, risk factors for frostbite and hypothermia is alcohol consumption. Fingers, toes, ears, and nose are the first parts to freeze. Treatment for frost bite and hypothermia includes warming the person.Frostbite occurs when the body is exposed to extremely cold temperatures. For the body to continue functioning under these conditions, blood circulation moves to the internal organs and brain, and away from the skin and extremities, for example, the fingers, hands, toes, and feet. The lack of blood circulation to these body parts causes frostbite. Hypothermia occurs when the body is exposed to extremely cold conditions over a prolonged period, and as a result the body temperature becomes dangerously low (95 F or 35 C).
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.