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Hypothermia

Hypothermia is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • A core temperature of <35°C (95°F)
  • May take several hours to days to develop
  • Patients with cold-water immersion may appear dead but can sometimes still be resuscitated.
  • System(s) affected: all body systems
  • Synonym(s): accidental hypothermia

Epidemiology

  • Predominant age: very young and the elderly
  • Predominant sex: male > female

Geriatric Considerations
More common in elderly due to lower metabolic rate, impaired ability to maintain normal body temperature, and impaired ability to detect temperature changes

Prevalence
Estimates vary widely; typically a secondary issue

Etiology and Pathophysiology

  • Overwhelming environmental cold stress
  • Decreased heat production
  • Increased heat loss
  • Impaired thermoregulation

Risk Factors

  • Alcohol consumption
  • Bronchopneumonia
  • Cardiovascular disease
  • Cold-water immersion
  • Dermal dysfunction (burns, erythrodermas)
  • Drug intoxication
  • Endocrinopathies (myxedema, severe hypoglycemia)
  • Excessive fluid loss
  • Hepatic failure
  • Hypothalamic and central nervous system (CNS) dysfunction
  • Malnutrition
  • Mental illness; Alzheimer disease
  • Prolonged cardiac arrest
  • Prolonged environmental exposure
  • Renal failure
  • Sepsis
  • Trauma (especially head)
  • Uremia

General Prevention

  • Appropriate clothing, with particular attention to head, feet, and hands
  • For outdoor activities, carry survival bags with rescue foil blanket for use if stranded or injured.
  • Avoid alcohol.
  • Alertness to early symptoms and initiating preventive steps (e.g., drinking warm fluids)
  • Identify medications that may predispose to hypothermia (e.g., neuroleptics, sedatives, hypnotics, tranquilizers).

Commonly Associated Conditions

  • Addison disease
  • CNS dysfunction
  • Congestive heart failure
  • Diabetes
  • Hypopituitarism
  • Hypothyroidism
  • Ketoacidosis
  • Pulmonary infection
  • Sepsis
  • Uremia

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Citation

Stephens, Mark B., et al., editors. "Hypothermia." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816651/all/Hypothermia.
Hypothermia. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816651/all/Hypothermia. Accessed April 21, 2019.
Hypothermia. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816651/all/Hypothermia
Hypothermia [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 21]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816651/all/Hypothermia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hypothermia ID - 816651 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816651/all/Hypothermia PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -