How Do You Provide First Aid for Hypothermia?

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Assessing Hypothermia Severity Mild hypothermia (core temperature 32-35°C / 90-95°F) shows violent shivering, confusion, and lack of coordination. Moderate hypothermia (28-32°C / 82-90°F) shows reduced shivering, severe confusion, slurred speech, and lethargy. Severe hypothermia (below 28°C / 82°F) shows loss of consciousness, barely detectable pulse and breathing, and apparent death.
The phrase “no one is dead until they’re warm and dead” applies to hypothermia victims. People have recovered after being in cardiac arrest in cold water for over an hour. Never give up on rewarming a severely hypothermic victim, and never perform CPR if the person is already receiving rescue—movement can trigger fatal cardiac arrhythmia.
Gentle Rewarming Technique For mild hypothermia, move the person to shelter and allow active rewarming. Remove wet clothing and provide warm drinks and high-calorie food. Gradually increase body warmth through movement and activity. For moderate to severe hypothermia, avoid active rewarming—instead provide passive external rewarming with blankets and shelter.
Handle the person gently to avoid triggering cardiac arrest. Do not rub skin or apply direct heat. Warm the core before extremities—apply warmth to the torso, not the arms and legs, which can cause afterdrop when peripheral blood vessels dilate. If possible, use extracorporeal rewarming (medical treatment) for severe cases, but absent that, provide insulation and shelter.
Monitoring and Complications Watch for afterdrop: paradoxical undressing (the person removes clothing despite cold), and stumbling. Afterdrop occurs when peripheral blood vessels dilate and send cold blood back to the core, causing core temperature to drop further. Prevent this by avoiding rough handling and rapid rewarming.
Monitor for cardiac arrhythmias—a severely hypothermic heart may be irritable and susceptible to fatal arrhythmia from rough handling. Keep the person still and calm. If the person goes into cardiac arrest, begin CPR and continue it during evacuation—defibrillation may not be effective in severe hypothermia and should wait until the person is warmer. Evacuation is essential for severe cases.