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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