Hypothermia

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

To view the entire topic, please or .

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

Description

  • Accidental hypothermia is the result of an unanticipated environmental exposure to cold temperatures. It is manifested as 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

Incidence
From 1999–2011, the Centers for Disease Control and Prevention reported 16,911 deaths due to hypothermia.

Prevalence
Estimates vary widely; typically a secondary issue

Etiology and Pathophysiology

Core temperature is typically tightly maintained between 36.5°C and 37.5°C. Accidental hypothermia is most often the result of overwhelming environmental cold stress. Other contributing factors include:

  • Decreased heat production (e.g., hypopituitarism; hypothyroidism; adrenal insufficiency)
  • Increased heat loss (e.g., immersion—this is the most commonly encountered form of hypothermia in emergency situations—or burns)
  • Impaired thermoregulation (e.g., stroke, central nervous system [CNS] tumors)

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 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

-- To view the remaining sections of this topic, please or --

Basics

Description

  • Accidental hypothermia is the result of an unanticipated environmental exposure to cold temperatures. It is manifested as 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

Incidence
From 1999–2011, the Centers for Disease Control and Prevention reported 16,911 deaths due to hypothermia.

Prevalence
Estimates vary widely; typically a secondary issue

Etiology and Pathophysiology

Core temperature is typically tightly maintained between 36.5°C and 37.5°C. Accidental hypothermia is most often the result of overwhelming environmental cold stress. Other contributing factors include:

  • Decreased heat production (e.g., hypopituitarism; hypothyroidism; adrenal insufficiency)
  • Increased heat loss (e.g., immersion—this is the most commonly encountered form of hypothermia in emergency situations—or burns)
  • Impaired thermoregulation (e.g., stroke, central nervous system [CNS] tumors)

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 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

There's more to see -- the rest of this entry is available only to subscribers.