Primary or Secondary Problem?

It is important (but difficult) to try to decide whether hypothermia is the primary problem or secondary to another pathology. If they are simply cold because they have been lying in a cold environment following a cardiac arrest from another cause it is doubtful aggressive treatment of hypothermia is going to make much difference.

‘You are dead if you’re cold because you’re dead’.

Getting as much information as possible about the circumstances is essential.

Furthermore, it is important to bear in mind that while hypothermic arrest is survivable, being frozen is not. If the body is frozen (for example the chest is so stiff that cardiopulmonary resuscitation (CPR) cannot be carried out or there is ice in the pharynx) resuscitation attempts are futile [10]. Unsurvivable injuries should always stop resuscitation attempts. A potassium > 12 mmol/L makes survival extremely unlikely.