Severe Hypothermia Management

Clinical Presentation and Diagnosis

The American Heart Association and American College of Cardiology classify a core temperature of 30.0°C (86.0°F) as severe hypothermia, requiring immediate active rewarming interventions 1, 2
Severe hypothermia is defined as a core temperature below 32°C, with this patient's temperature falling into the severe category 1, 2

Remove any wet clothing immediately to prevent further heat loss 2
Move to a warm environment and cover with at least two warm blankets to initiate rewarming 1, 2
Insulate from cold surfaces and cover head/neck to minimize heat loss 1
Apply forced-air warming blankets (e.g., Bair Hugger) as part of Level 2 interventions 1, 2
Administer warmed intravenous fluids to help increase core temperature 1, 2
Provide humidified, warmed oxygen to support respiratory function 1, 2
Monitor core temperature every 5 minutes to assess rewarming progress 3

Target minimum core temperature of 36°C before considering the patient stable 1, 2
Cease rewarming at 37°C, as higher temperatures are associated with poor outcomes 1, 2
Monitor continuously for rewarming complications, including arrhythmias, coagulopathy, and hypotension 1, 4
Handle the patient gently throughout to avoid triggering ventricular fibrillation 1