From the Guidelines
If your oral temperature is low, indicating hypothermia, move to a warm environment, remove saturated clothing, and use blankets to passively rewarm, and consider active rewarming if resources are available, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When dealing with hypothermia, it is essential to prioritize warming the body's core first. The guidelines suggest protecting the person from further heat loss by insulation from the ground, covering of head and neck, and shielding from heat loss by wind using a plastic or foil layer in addition to a dry insulating layer 1. Some key considerations for rewarming include:
- Following the manufacturer’s instructions for any rewarming devices used
- Placing insulation between the heat source and skin
- Frequently monitoring for burns and pressure injury 1 In cases where the person with hypothermia has a decreased level of responsiveness, it is crucial to activate the emergency response system while rewarming the person by any available method 1. For patients experiencing mild hypothermia who are alert and can safely consume oral food or fluids, providing high-calorie foods or drinks is recommended 1. It is also important to note that body-to-body rewarming is not beneficial for active rewarming over other active rewarming techniques such as chemical heat packs or forced air systems 1.
From the Research
Hypothermia Treatment
If the oral temperature is low, indicating hypothermia, the following steps can be taken:
- Use a hypothermia wrap and a chemical heat blanket to rewarm the patient in the field, as seen in a case report where a patient with apparent moderate hypothermia was successfully rewarmed using these methods 2
- Apply insulation to the patient and allow them to shiver for a period of time before attempting to stand or walk, as this may help prevent increased afterdrop with deleterious results 2
- Consider using modern devices that utilize feedback loops to maintain a steady body temperature and prevent overcooling, as these have advantages in ease of application, patient safety, and control of decooling 3
Temperature Measurement
It's essential to note that normal body temperature can vary significantly between individuals, with some people having a mean oral temperature considerably lower than 37.0°C (98.6°F) 4
- Oral temperature can range from 35.2°C (95.4°F) to 37.4°C (99.3°F), with a mean temperature of 36.1°C (97.0°F) across all participants in one study 4
- Using a standardized "normal" temperature can lead to errors in detecting fever or hypothermia in individuals with a low normal temperature 4
- Continuous long-term temperature monitoring and pattern analysis can aid in revealing unique fever responses and potentially be used as a novel diagnostic tool 5
Rewarming Methods
Different methods can be used to rewarm a hypothermic patient, including:
- Chemical heat blankets, which can be used in conjunction with a hypothermia wrap to rewarm a patient in the field 2
- Modern devices that utilize feedback loops to maintain a steady body temperature and prevent overcooling 3
- Traditional means of cooling, such as ice packs or cold compresses, although these may have disadvantages in terms of ease of application and patient safety 3