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Accidental hypothermia in adults

C Crawford Mechem, MD, FACEP
Section Editor
Daniel F Danzl, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Death from exposure and accidental hypothermia occurs throughout the world and can present significant management problems [1-5]. While typically associated with regions of the world with severe winters, hypothermia is also seen in areas with milder climates, such as the southern United States [6]. Cases of hypothermia occur during the summer months and in hospitalized patients [7]. Even with modern supportive care, the in-hospital mortality of patients with moderate or severe accidental hypothermia approaches 40 percent [8].

The definition, pathophysiology, and management of accidental hypothermia will be discussed here. A table outlining the emergency management of hypothermia in adults is provided (table 1). Drowning, which is often complicated by hypothermia, is discussed separately, as are external injuries from cold and accidental hypothermia in children. (See "Drowning (submersion injuries)" and "Frostbite" and "Hypothermia in children: Clinical manifestations and diagnosis" and "Hypothermia in children: Management".)


Hypothermia is defined as a core temperature below 35°C (95°F). The stage of hypothermia, defined by core temperature, has a large impact on both recognition and treatment. The most commonly used definitions found in the literature are as follows [9,10]:

Mild hypothermia – Core temperature 32 to 35°C (90 to 95°F)

Moderate hypothermia – Core temperature 28 to 32°C (82 to 90°F)

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Literature review current through: Nov 2017. | This topic last updated: Mar 30, 2017.
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