Hypothermia, also known as hypotheralmia, is a condition where the body's internal temperature drops below normal, typically defined as 95°F or 35°C. It is caused by prolonged exposure to cold temperatures and can be life-threatening if not properly treated. The document discusses the history, epidemiology, classification, symptoms, pathophysiology, risk factors, treatment, and prevention of hypothermia. Key points include that hypothermia can occur even above freezing temperatures, symptoms range from shivering to loss of consciousness depending on severity, and treatment involves slowly rewarming the body while avoiding rough movements.

1. Hypothermi
a
- The silent killer in the
Cold
Presented By:
Ganesh Gupta

2. Introduction
• Derived from Greek word: υποθερμία which means Hypo: less
and thermia: temperature
• A condition in which the internal body temperature falls below
37oC (95 F)
• Prolonged exposure to cool or freezing temperatures
• It DOES NOT need to be below freezing temperatures
• Shivering and mental confusion is the most common symptom.
• Water, wind & cold combination is especially dangerous 2

3. History
Martime / War litérature
Hannibal expérience in 218 B.C
Battle of Stalingrad in World War II
Civilian Loss of life due to sinking of
RMS Titanic (1912) and
RMS Lusitania (1917)
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4. Hannibal Against Rome
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5. Epidemiology
• Defined as temperature <35O C (<95O F)
• 900 die each year in US from hypothermia
• ½ of those are 65+ years old
• Individuals at age extremes and those with Acute
Mountain Sickness (AMS) are at greatest risk
• Not confined to any country or region.
• Most common in Alaska, North America and
Europe, Quebec Province of Canada and Siberia
Region.
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6. Température Classification:
Normal 36.5–37.5 °C (97.7–
99.5 °F)
Hypothermia <35.0 °C (95.0 °F)
Fever >37.5–38.3 °C (99.5–
100.9 °F)
Hyperthermia >37.5–38.3 °C (99.5–
100.9 °F)
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7. Hypothermia Classification:
Hypothermia: <35.0 °C
Based on Severity, it is futher classified:
Mild : 32-35°C
Moderate : 28-32°C
Severe : < 28°C
Injuries that can either be present alone or in combination
with hypothermia include:
Chilblains ,Frostbite ,Frostnip ,Trench foot 7

8. Mild Hypothermia (> 32 °C)
• Increase metabolic rate
• Maximum shivering thermogenesis
• Amnesia / dysarthria / ataxia
• Hyperglycemia / Loss of coordination
• Tachycardic, tachypneic
• Normal BP
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9. Moderate Hypothermia (28– 32 °C)
• Stupor
• Violent shivering
• Low Bradycardic and Blood Pressure
• Pupils gets dilated (< 30°C)
• Body skins turns pale or white
• Lips, ears, fingers and toes may become blue.
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10. Severe Hypothermia (<28 °C )
• Coma
• Difficulty in speaking / sluggish thinking /amnesia
start
• Inability to use hands / Stumbling
• Cellular metabolic processes shut down.
• No corneal or oculocephalic reflexes
• Apnea /Asystole
• Low Pulse rate but fast Heart Rate
• Flat EEG (19°C)
Beyond 28 °C, the brain activity stop and the
person is dead. 95% true in all cases. 10

11. Paradoxical Undressing
• 20 – 50% of hypothermia deaths
• Occurs during moderate to severe hypothermia
• Person becomes disoriented, confused, and combative
• They begin discarding their clothing, which, in turn,
increases the rate of heat loss
Terminal Burrowing
• Hypothermia is also known as Hide – die Syndrome.
• The process is similar to Hibernation
• Indoors: enter small enclosed spaces such as wardrobes,
cupboards and closets
• Outdoors: piles of leaves, crevices between rocks or 11
fallen trees.

12. Pathophysiology
Radiation
Conduction
Convection
Respiration
Evaporation

13. Who are at the Risk Factors for
Hypothermia?
• Age : Young / Old age is at higher risk.
• Mental status : Impaired Judgment.
• Substance Abuse: Alcohol and drug abuse
• Mental Conditions: Spinal cord Injuries, strokes or brain
tumors.
• Medications: Some medicines limit the shivering action.
e.g. psychiatric medications 13

14. How is Hypothermia Treated
• Initiate First Aid & stop further heat loss.
• Hot water should not be used
• Avoid rough movements and activities because it may
cause ventricular fibrillation
• Hydrate with warm liquids, and treat any injuries
Mild Hypothermia :Use fast rewarming methods
Severe Hypothermia: Use slow rewarming methods
• Handle victim gently during CPR, intubation, BVM 14

15. Hypothermia: Known No’s
• No rush &o rough handling
• No body to body re-warming - rescuer risk
• No giving up until they are warm and dead
• No immediate rewarming
• Individuals with a detectable heart beat, no matter how
slow, should not receive CPR or rescue breathing
• If the victim is breathing, oxygen administration at a
generous flow rate prior to transport may reduce the risk
of fibrillation.
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16. Conclusion
• Hypothermia is rare but treatable
• Requires good planning and good judgment.
• Wear appropriate clothing for the weather.
• Prepare for the worst when enjoying an outdoor activity if
cold weather is a possibility.
• Communities ensuring safe housing for poor and elderly
people.
• Shut-ins should have routine social service or family
contacts.
• Prevention is still the best and ….
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17. If planning out for Winter Holiday ??
Play Carefully…
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