Hypothermia: Recognition and management

Definition and mechanism

Lightweight	35 to 32 C	The victim is conscious, and their breathing and heart rate are rapid. She has constant chills and her skin is cold.
Moderate	32 to 28 C	The victim is delirious, presents with hallucinations and progressively worsening disturbances of consciousness. His breathing and heart rate slow down. There are no more shivers, but moderate muscle rigidity.
Severe	28 to 24 C	The victim has lost consciousness, the pulse is difficult to perceive, and the heart rate and ventilation are slow. There is significant muscle rigidity and the victim is very sensitive to any movements which can trigger rhythm disturbances or even cardiac arrest.
Severe	< 24 C	The victim is in apparent cardiac arrest.

Contributing factors

At-risk population:

• Children and the elderly
• People from hot countries

Individual factors:

• Illness, fatigue, malnutrition
• Alcohol or drug use
• Intense physical activity (sweating)

Risky situations:

• Prolonged immobility
• Immersion in an aquatic environment
• Severe trauma or burn

Signs of recognition

Initial observation:

• Prolonged exposure to cold/humidity
• Pale, cold and dry skin
• Presence or absence of chills depending on severity ###

Signs of Distress:

• Neurological: disorientation, confusion
• Respiratory: slowing of the rhythm
• Circulatory: pulse barely perceptible
• Possible loss of consciousness or cardiac arrest

Course of action

1. Remove the victim from the cause
2. Avoid any additional heat loss
3. Seek medical advice
4. Implement appropriate warming
5. Monitor vital functions

When providing care to a victim, it is essential to wear protective gloves. To ensure they are always readily available during an intervention, many firefighters use a glove pouch attached to the belt or their jacket, like the DEXTER Pocket.

Warming techniques

Mild hypothermia (with shivering):

• Passive heating
• Protection against wind and humidity
• Wrapping (sheet + blanket)

Moderate/severe/severe hypothermia (without shivering):

• Active warming required
• Minimal and cautious mobilization
• Oxygen administration
• Rapid evacuation