What To Do:

Evaluate the patient. Is this severe hypothermia or mild/moderate hypothermia?

The chart below shows quick, in the field ("real life"), determination of the severity of hypothermia.

Determining severity will help you decide on appropriate treatments:

Note: If a thermometer is available, you can attempt to measure core body temperature, but remember exposure of skin to the air may cause significant heat loss. Temperatures below 90 degrees (F) are present in severely hypothermic patients. It may not be prudent to try to take temperature in the field.

You have determined MILD / MODERATE hypothermia exists in your patient:

• Your patient will be able to rewarm their own body, with your assistance.
• Gently move the victim to warm shelter.
• Check breathing and heartbeat. In cases of hypothermia you should check very closely for as long as two minutes. Start CPR if necessary.
• If victim is wet, remove victim's clothing with a minimum of movement, cut them away if necessary.
• If the victim is able to reposition themselves you may lay them face up, otherwise lay victim, on their side, in a recovery position with a blanket or other insulation beneath them.
• Wrap victim in warm blankets, sleeping bag or other warm covering. Silver survival blankets are light for packs, but add reflective warmth and block wind.
• Evacuate for medical attention and follow-up care. Evaluate the urgency of evacuation and methods used for evacuation, depending upon patients medical history and age or combination of these. Some patients may be able to walk and assist in evacuating themselves.

• Your patient will NOT be able to rewarm their own body, there is also the possibility of afterdrop or cardiac complications.
• Evacuation and any movement of the victim must be done very carefully! Jostles or bumps can cause severe cardiac complications.
• Check breathing and heartbeat. Check very closely for as long as two minutes. Lay the victim on their side, incase they aspirate. If CPR is necessary, move to face up position.
• Gently move the victim to warm shelter.
• If victim is wet, remove victim's clothing with a minimum of movement, cut them away if necessary.
• Wrap victim in warm blankets, sleeping bag or other warm covering. Silver survival blankets are light for packs, but add reflective warmth and block wind.
• Evacuate for medical attention as soon as possible, full medical backup will be needed.

If there will be a long delay before victim arrives at a medical facility use the following rewarming techniques.

• Apply heating pads or hot water bottles (wrapped in a towel to prevent burns) to the head, neck (carotid), pits, and groin.
• Do not apply heat to arms and legs or give them a hot bath. This forces blood out through the cold extremities and back to the heart, lungs and brain, which will further drop the core temperature. This can cause "after drop" which can be fatal.
• Do not massage or rub the victim, rough handling may cause cardiac arrest.
• Apply warmth by direct body to body contact. Have someone remove their own clothes and lay next to victim skin to skin. Wrap both in blankets.
• If person is alert enough you can give them hot drinks. If they are unconscious or stuporous do not give them anything to drink. Never give alcoholic beverages.

Read more about the search and rescue incident illustrated by these photos.