The severely hypothermic patient must be handled and moved extremely carefully as the hypothermic myocardium is predisposed to ventricular fibrillation (VF) on patient handling.

The management of hypothermia requires:

  • Initial evaluation and support of the airway, breathing, and circulation
  • Prevention of further heat loss
  • Initiation of rewarming appropriate to the degree of hypothermia
  • Treatment of complications

Selecting the right treatment

The appropriate intervention depends on:

  • Severity of the hypothermia
  • Available resources
  • Clinical state of the patient

As severity of hypothermia increases, treatment needs to become more aggressive.

Other considerations

Other medical factors that should be considered and treated concurrently include:

  • Alcohol intoxication
  • Central nervous system
  • Disease
  • Trauma
  • Infection

Next steps

The following measures should be taken:

  • Wet or cold clothes must be removed
  • The patient must be placed on a cardiac monitor
  • Intravenous access should be established
  • Active rewarming measures should be initiated


The general treatment of any coagulopathies is by rewarming, not by administration of clotting factors.

Rewarming strategies can be active or passive, and invasive or non-invasive.