Treatment of Hypothermia with 94.3°F Underarm Temperature
A temperature of 94.3°F (34.6°C) indicates mild hypothermia that requires immediate passive rewarming plus active external warming methods to prevent further complications and reduce mortality risk. 1
Assessment and Classification
Your underarm temperature of 94.3°F (34.6°C) falls into the mild hypothermia category (32-35°C). However, it's important to note that axillary (underarm) temperatures typically read 0.5-1°C lower than core temperature, so your actual core temperature may be slightly higher but still within the mild hypothermia range 1.
Severity classification based on core temperature:
- Cold stress: 35-37°C (95-98.6°F)
- Mild hypothermia: 32-35°C (89.6-95°F)
- Moderate hypothermia: 28-32°C (82.4-89.6°F)
- Severe/profound hypothermia: <28°C (<82.4°F)
Treatment Approach for Mild Hypothermia
Immediate Interventions:
- Move to a warm environment
- Remove any wet clothing
- Apply passive warming with dry blankets, especially covering the head and neck 1
- Increase ambient room temperature
Active External Warming:
- Apply warm blankets
- Use forced-air warming systems (e.g., Bair Hugger)
- Apply heat packs to groin, axillae, and neck (avoid direct contact with skin)
- Consider radiant heaters 1, 2
Fluid Management:
- Administer warm IV fluids (if available and needed)
- Warm fluids to 40-42°C before administration 1
Monitoring During Treatment
- Monitor core temperature continuously if possible
- Target rewarming rate: 0.25-0.5°C per hour
- Continue warming until reaching 36°C
- Stop active warming after reaching 37°C to prevent rebound hyperthermia 1
- Monitor for:
- Cardiac rhythm abnormalities
- Blood pressure changes
- Electrolyte disturbances
- Signs of coagulopathy
Special Considerations
- Shivering is a natural response that generates heat but increases oxygen consumption. In mild hypothermia, shivering should be allowed as it helps with rewarming 1
- A 1°C drop in temperature is associated with a 10% drop in coagulation function, so monitor for bleeding tendencies 1
- Handle the patient gently to prevent arrhythmias, particularly if temperature is below 32°C 1
When to Escalate Care
Seek emergency medical attention if:
- Temperature continues to drop despite warming measures
- Mental status deteriorates
- Cardiac arrhythmias develop
- Respiratory distress occurs
Prevention of Future Episodes
- Identify and address underlying causes (exposure, metabolic disorders, medications)
- Proper clothing and shelter in cold environments
- Adequate nutrition and hydration
- Avoid alcohol in cold environments as it causes vasodilation and increased heat loss
The American Heart Association and European Society of Intensive Care Medicine emphasize that early recognition and prompt treatment of hypothermia significantly improve outcomes and reduce complications 1. Even mild hypothermia requires attention as it can progress to more severe forms if left untreated.