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- Instruct patients with cognitive impairment and their caregivers about ways to avoid hypothermia.
- Institute preventive measures against hypothermia in elderly persons and those with systemic diseases.
- Protect patients during intraoperative and postoperative periods or in the setting of acute resuscitative efforts.
- Inform patients and outdoor enthusiasts about prevention, recognition, and emergency management of hypothermia.
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Instruct patients with cognitive impairment and their caregivers about ways to avoid hypothermia.  |
- Inform patients who abuse drugs or alcohol that intoxication increases the risk of hypothermia by altering their:
- Normal homeostatic thermoregulatory mechanisms
- Perception of hypothermia
- Cognitive ability to make rational decisions
- Provide patients and caregivers with a list of drugs that may predispose to hypothermia, such as:
- Sedatives
- Hypnotics
- Vasodilators
- Narcotic analgesics
- Muscle relaxants
- Cannabinoids (e.g., marijuana)
- Non-steroidal anti-inflammatory drugs
- Teach patients and caregivers the basic principles of preventing hypothermia:
- Limit time of exposure
- Remove wet clothing
- Maintain warm ambient environmental temperature at the place of residence with effective ventilation to avoid carbon monoxide toxicity
- Shield exposed body surfaces
- Provide effective insulation by:
- Maintaining an immobile layer of warm air next to the body (including the head and hands)
- Wearing several layers of dry clothing
- Teach vulnerable patients and their caregivers about the symptoms of hypothermia and the importance of immediate intervention (see Diagnosis).
| Background | Back to top
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Institute preventive measures against hypothermia in elderly persons and those with systemic diseases. |
- Recognize that certain medical conditions, such as hypothyroidism, malnutrition, diabetes mellitus, adrenal insufficiency, and advanced age, also predispose the patient to hypothermia; therefore, initiate appropriate therapy.
- Provide patients and care providers with a list of drugs that may predispose the patient to hypothermia, such as:
- Sedatives
- Anesthetics
- Hypnotics
- Vasodilators
- Narcotic analgesics
- Teach patients and caregivers the basic principles of preventing hypothermia:
- Limit time of exposure and remove wet clothing
- At the patient's residence, maintain:
- A warm ambient environmental temperature
- Effective ventilation to avoid carbon monoxide toxicity
- Shield exposed body surfaces
- Provide effective insulation by:
- Maintaining an immobile layer of warm air next to the body (including the head and hands)
- Wearing several layers of dry clothing
- Instruct vulnerable patients and their caregivers about the symptoms of hypothermia and the importance of immediate intervention (see Diagnosis).
- Refer poorer patients in colder climates to local social services for assistance in obtaining adequately heated housing.
| Background | Back to top
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Protect patients during intraoperative and postoperative periods or in the setting of acute resuscitative efforts.  |
- Protect patients from prolonged and extensive exposure to cold, wet environments:
- Antimicrobal/antiseptic presurgical preparation
- Infusion of fluids that are cold or room temperature
- Be aware that those patients at greatest risk are:
- Infants
- Elderly
- Burned
- Undergoing major abdominal or prolonged surgical procedures
- Provide at-risk patients with sources of heat, such as:
- Convection/forced-air warmers
- Warmed intravenous fluids
- Covers for exposed areas of the body
- Warm inhaled gases
| Background | Back to top
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Inform patients and outdoor enthusiasts about prevention, recognition, and emergency management of hypothermia. |
- Advise outdoor enthusiasts (hunters, skiers, hikers, scuba divers, wind surfers, mountain climbers, runners, etc.) to dress appropriately for the activity:
- Limit the time of exposure to harsh environment
- Remove wet clothing
- Wear hats and jackets during rest periods to help maintain body temperature
- Carry extra warm, dry clothing
- Recommend measures to stay dry:
- Limit perspiration by reducing the layers of clothing during periods of increased muscle and metabolic activity
- Wear undergarments and socks that wick moisture away from the body
- Avoid cotton clothing because it retains moisture
- Remove wet clothes
- Recommend that food and water be carried for hydration and metabolic repletion
- Teach patients and outdoor enthusiasts to recognize:
- That the onset of hypothermia occurs faster in water-related outdoor activities
- The initial and advanced symptoms of hypothermia
| Background | Back to top
| | | FAQs |
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| Albert Cheung, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Dmitri Guvakov, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Stuart Weiss, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Wenjun Zhou Martini, PhD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for continuing medical education grand rounds and lectures given. |
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
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PIER is copyrighted (c) 2010 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Hypothermia
