From the Guidelines
For patients with mild hypothermia (temperature >34°C [93.2°F]), passive rewarming is generally adequate and should be initiated immediately. This approach involves preventing additional evaporative heat loss by removing wet garments and insulating the victim from further environmental exposures 1. The goal is to prevent further loss of heat and begin to rewarm the victim. Key interventions include:
- Removing wet clothing and replacing it with dry, warm layers
- Providing insulation to prevent further environmental heat loss
- Using passive rewarming techniques, such as blankets, to cover the head, neck, sides of chest, and groin
- Monitoring vital signs regularly during rewarming to ensure a gradual temperature increase of 0.5-1°C per hour. It is essential to note that active external warming techniques, such as forced air or other efficient surface-warming devices, are typically reserved for patients with moderate hypothermia (30°C to 34°C [86°F to 93.2°F]) or severe hypothermia (<30°C [86°F]) 1. In the case of mild hypothermia, passive rewarming is usually sufficient, and the focus should be on supporting the body's natural heat generation processes.
From the Research
Treatment of Mild Hypothermia
- Mild hypothermia can be treated with supportive care in most clinical settings, and has good patient outcomes 2
- Treatment modalities for mild hypothermia include noninvasive, passive external warming techniques, such as:
- Removal of cold, wet clothing
- Movement to a warm environment
- Active external rewarming techniques, such as insulation with warm blankets, can also be used to treat mild hypothermia 2
Rewarming Methods
- Rapid rewarming by immersion appears to be a safe, effective, and relatively simple method for treating accidental hypothermia victims 3
- Other rewarming methods, such as the use of warmed intravenous fluid infusions, heated humidified oxygen, and body cavity lavage, can also be effective in treating hypothermia 2
- Microwave ovens can be used to safely warm crystalloids, such as normal saline and lactated Ringer's solution, for infusion into hypothermic patients 4
Specific Considerations
- Selective brain cooling, or local brain hypothermia, has been proposed as an alternative treatment strategy for stroke, and can be achieved through local infusion of ice-cold lactated Ringer's solution 5
- Therapeutic peritoneal lavage with warm saline solution can be used as an option for rewarming critical hypothermic trauma patients 6