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Hypothermia

Hypothermia is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Normal body temperature is around 98.6 F (37 C). Hypothermia (hi-poe-THUR-me-uh) occurs as your body temperature falls below 95 F (35 C).

When your body temperature drops, your heart, nervous system and other organs can’t work normally. Left untreated, hypothermia can lead to complete failure of your heart and respiratory system and eventually to death.

Hypothermia is often caused by exposure to cold weather or immersion in cold water. Primary treatments for hypothermia are methods to warm the body back to a normal temperature.

Symptoms

Shivering is likely the first thing you’ll notice as the temperature starts to drop because it’s your body’s automatic defense against cold temperature — an attempt to warm itself.

Signs and symptoms of hypothermia include:Shivering Slurred speech or mumbling Slow, shallow breathing Weak pulse Clumsiness or lack of coordination Drowsiness or very low energy Confusion or memory loss Loss of consciousness Bright red, cold skin (in infants)

Someone with hypothermia usually isn’t aware of his or her condition because the symptoms often begin gradually. Also, the confused thinking associated with hypothermia prevents self-awareness. The confused thinking can also lead to risk-taking behavior.

Causes

Hypothermia occurs when your body loses heat faster than it produces it. The most common causes of hypothermia are exposure to cold-weather conditions or cold water. But prolonged exposure to any environment colder than your body can lead to hypothermia if you aren’t dressed appropriately or can’t control the conditions.

Specific conditions leading to hypothermia include:Wearing clothes that aren't warm enough for weather conditions Staying out in the cold too long Being unable to get out of wet clothes or move to a warm, dry location Falling into the water, as in a boating accident Living in a house that's too cold, either from poor heating or too much air conditioning

How your body loses heat

The mechanisms of heat loss from your body include the following:Radiated heat. Most heat loss is due to heat radiated from unprotected surfaces of your body. Direct contact. If you're in direct contact with something very cold, such as cold water or the cold ground, heat is conducted away from your body. Because water is very good at transferring heat from your body, body heat is lost much faster in cold water than in cold air. Similarly, heat loss from your body is much faster if your clothes are wet, as when you're caught out in the rain. Wind. Wind removes body heat by carrying away the thin layer of warm air at the surface of your skin. A wind chill factor is important in causing heat loss.

Risk factors

Risk factors for hypothermia include:Exhaustion. Your tolerance for cold diminishes when you are fatigued. Older age. The body's ability to regulate temperature and to sense cold may lessen with age. And some older adults may not be able to communicate when they are cold or to move to a warm location if they do feel cold. Very young age. Children lose heat faster than adults do. Children may also ignore the cold because they're having too much fun to think about it. And they may not have the judgment to dress properly in cold weather or to get out of the cold when they should.

Prevention
Staying warm in cold weather

Before you or your children step out into cold air, remember the advice that follows with the simple acronym COLD — cover, overexertion, layers, dry:Cover. Wear a hat or other protective covering to prevent body heat from escaping from your head, face and neck. Cover your hands with mittens instead of gloves. Overexertion. Avoid activities that would cause you to sweat a lot. The combination of wet clothing and cold weather can cause you to lose body heat more quickly. Layers. Wear loosefitting, layered, lightweight clothing. Outer clothing made of tightly woven, water-repellent material is best for wind protection. Wool, silk or polypropylene inner layers hold body heat better than cotton does. Dry. Stay as dry as possible. Get out of wet clothing as soon as possible. Be especially careful to keep your hands and feet dry, as it's easy for snow to get into mittens and boots.

Keeping children safe from the cold

To help prevent hypothermia when children are outside in the winter:Dress infants and young children in one more layer than an adult would wear in the same conditions. Bring children indoors if they start shivering — that's the first sign that hypothermia is starting. Have children come inside frequently to warm themselves when they're playing outside. Don't let babies sleep in a cold room. Mental problems. People with a mental illness, dementia or other conditions that interfere with judgment may not dress appropriately for the weather or understand the risk of cold weather. People with dementia may wander from home or get lost easily, making them more likely to be stranded outside in cold or wet weather. Alcohol and drug use. Alcohol may make your body feel warm inside, but it causes your blood vessels to expand, resulting in more rapid heat loss from the surface of your skin. The body's natural shivering response is diminished in people who've been drinking alcohol. In addition, the use of alcohol or recreational drugs can affect your judgment about the need to get inside or wear warm clothes in cold-weather conditions. If a person is intoxicated and passes out in cold weather, he or she is likely to develop hypothermia. Certain medical conditions. Some health disorders affect your body's ability to regulate body temperature. Examples include an underactive thyroid (hypothyroidism), poor nutrition or anorexia nervosa, diabetes, stroke, severe arthritis, Parkinson's disease, trauma, and spinal cord injuries. Medications. Some drugs can change the body's ability to regulate its temperature. Examples include certain antidepressants, antipsychotics, narcotic pain medications and sedatives.