Medicines for Hypothermia

What it is

Hypothermia is a dangerous condition that occurs when the body loses heat faster than it can produce it, causing the body temperature to drop below the normal level (below about 35°C). It is a medical emergency, because if the body gets too cold, the heart, nervous system, and other organs cannot work properly, which can be life-threatening. Hypothermia is usually caused by being exposed to cold — for example being outside in cold weather without enough protection, falling into cold water, or being in a cold home (particularly a risk for older people). Certain groups are more vulnerable, including older people, babies and young children, people who are unwell, under the influence of alcohol, or have certain conditions, and those who are wet or exhausted. The signs of hypothermia can include: shivering (though shivering may stop as it becomes more severe, which is a bad sign); cold, pale skin; tiredness, confusion, or slurred speech; slow, shallow breathing; a slow or weak pulse; clumsiness or loss of coordination; and, as it worsens, drowsiness, loss of consciousness, and eventually the heart stopping. In babies, signs can include cold skin, being unusually quiet or floppy, and refusing to feed. Because hypothermia is dangerous and can progress, it needs prompt action: getting the person out of the cold, warming them gradually, and seeking medical help — with severe hypothermia being a medical emergency needing urgent help. Gradual, gentle rewarming is important, and certain things (such as rapid heating or rubbing the skin, or giving alcohol) should be avoided. Preventing hypothermia — by keeping warm and dry, dressing appropriately for the cold, keeping homes adequately heated, and taking particular care of vulnerable people — is important, especially in cold weather.

How it is treated

Hypothermia needs prompt action to warm the person gradually and safely, and severe hypothermia is a medical emergency needing urgent help. If someone has hypothermia, the key first-aid steps are to: move them somewhere warm (out of the cold and wind); remove any wet clothing and replace it with warm, dry clothing or blankets, covering the head too; warm them gradually — for example with blankets, warm (not hot) drinks if they are fully alert and able to swallow, and warm the body’s core (the trunk); and keep them dry and as still as possible. It is important to rewarm gently and gradually, and to avoid certain things that can be harmful: do not use direct or intense heat (such as a hot bath, hot water bottle directly on the skin, or heat lamp), do not rub or massage the skin (particularly the limbs), and do not give alcohol — these can be dangerous, for example by causing the cold blood in the limbs to move to the core too quickly. Seek medical help, and call emergency services for severe hypothermia (for example if the person is very cold, confused, drowsy, has stopped shivering, is unconscious, or is a baby or vulnerable person) — this is a medical emergency. If the person becomes unconscious and stops breathing normally, be prepared to give CPR, and continue while help is on the way. In hospital, more advanced rewarming and supportive treatment are provided for severe cases. Prevention is important, especially in cold weather and for vulnerable people: keeping warm and dry, dressing in layers and covering up in the cold, keeping homes adequately heated, staying active to generate heat, eating and drinking warm food and drinks, and checking on older people, babies, and others at risk in cold weather all help prevent hypothermia. The key messages are to recognise hypothermia, warm the person gradually and gently, avoid harmful rapid heating, and seek urgent help for severe cases.