Treatment of Accidental Hypothermia with Impaired Consciousness (Core Temperature 28–32 °C)
Moderate and severe accidental hypothermia presenting with impaired or absent consciousness but preserved vital signs represents a clinically urgent scenario. Structured, active intervention is required to restore safe core temperature.
Clinical Scenario
Moderate hypothermia (HT II): core temperature 28–32 °C, impaired consciousness, vital signs present.
Severe hypothermia (HT III): core temperature below 28 °C, unconscious, vital signs present.
Treatment Approach
Active rewarming is necessary for both moderate and severe accidental hypothermia. The approach centres on external rewarming techniques, supported by measures to prevent further heat loss. The complete sequence of interventions and their specific application is set out in the full protocol.
Clinical Goal
Restoration of normothermia — core temperature returning to approximately 37 °C.
References
DOI: 10.3390/ijerph19010501
- Hypothermia II (moderate) — Impaired consciousness; may or may not be shivering — <32–28 °C
- Hypothermia III (severe) — Unconscious; vital signs present — <28 °C
- In patients with moderate or severe (HT II or HT III), active rewarming is necessary.
- Usually, active external rewarming is effective.
- Active rewarming including forced-air surface rewarming, heating pads, e.g. Arctic Sun®, warmed IV fluids (40 °C).
- In patients with spontaneous circulation, and a core temperature of 33–36 °C the goal of rewarming should be normothermia with a core temperature about 37 °C.
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