From the Guidelines
To treat hypothermia, first get the person to a warm, dry place and remove any wet clothing, and for moderate to severe hypothermia, active rewarming techniques are necessary while seeking immediate medical attention. The treatment of hypothermia depends on the severity of the condition, with mild hypothermia (body temperature >34°C [93.2°F]) typically requiring passive rewarming, such as wrapping the person in blankets, using skin-to-skin contact, and providing warm, sweet beverages if they're conscious and able to swallow 1.
For moderate to severe hypothermia (body temperature below 34°C [93.2°F]), active rewarming techniques are necessary, including external warming techniques, such as forced air or other efficient surface-warming devices, and internal warming methods, like warm IV fluids, heated oxygen, and in extreme cases, techniques like peritoneal lavage or extracorporeal membrane oxygenation 1.
Some key points to consider when treating hypothermia include:
- Preventing additional evaporative heat loss by removing wet garments and insulating the victim from further environmental exposures 1
- Using passive rewarming for mild hypothermia and active rewarming for moderate to severe hypothermia 1
- Avoiding rubbing or massaging the limbs, which can push cold blood toward the heart and potentially cause cardiac arrest 1
- Using internal warming methods, like warm IV fluids, heated oxygen, and in extreme cases, techniques like peritoneal lavage or extracorporeal membrane oxygenation, for severe hypothermia 1
It's also important to note that hypothermia is a serious condition that can have significant morbidity and mortality if not treated promptly and effectively, and that prevention of hypothermia is crucial, especially in trauma patients 1.
In terms of specific treatment algorithms, a potential strategy for early goal-directed therapy of hypothermia amongst trauma patients is detailed in Fig. 1 of the study by Perlman et al. 1, which includes graded “Levels” of warming strategies based on their evidence of successful application in trauma and ease of implementation.
Overall, the treatment of hypothermia requires a careful and nuanced approach, taking into account the severity of the condition, the patient's overall health, and the availability of resources, and should always prioritize the prevention of further heat loss and the rapid restoration of normal body temperature 1.
From the Research
Treatment Modalities for Hypothermia
The treatment for hypothermia depends on the degree of hypothermia present and can range from noninvasive to active core rewarming techniques. The following are some of the treatment modalities:
- Noninvasive, passive external warming techniques, such as removal of cold, wet clothing and movement to a warm environment 2
- Active external rewarming, such as insulation with warm blankets 2, 3
- Active core rewarming, such as warmed intravenous fluid infusions, heated humidified oxygen, body cavity lavage, and extracorporeal blood warming 2, 3, 4, 5
- Cardiopulmonary bypass for resuscitation of patients with accidental hypothermia and cardiac arrest 4
- Extracorporeal circulation in patients with cardiocirculatory arrest 5
Considerations for Treatment
The choice of rewarming modality should be based on the patient's hemodynamic stability and the resources available 3, 5. It is also important to consider the potential risks of rewarming, such as hypothermia-rewarming injury, which may occur due to improper rewarming processes 6. The prognosis for patients with severe accidental hypothermia is excellent if no hypoxic event precedes hypothermia and no serious underlying disease exists 5.