Wilderness Medical Society 2019 Clinical Practice Guidelines
Active external rewarming preferred for mild hypothermia
Field discharge acceptable with full recovery and mitigated risk factors
2024 AHA and American Red Cross First Aid Guidelines
Insulation and gentle handling in field
Warmed oral fluids for conscious patient
AHA 2025 Resuscitation Guidelines (Part 10)
Defibrillation attempt reasonable in hypothermic VF
Withhold ACLS drugs until core temperature > 30°C in moderate/severe
Patient Discharge Instructions
copy discharge instructions
What happened to you
Your body temperature dropped below normal — this is called hypothermia
Mild hypothermia (32 to 35°C) means your body lost too much heat
You were treated with rewarming and your temperature is now normal
Your body's shivering helped warm you back up
This is normal and is your body's natural heat-producing response
How to take care of yourself at home
Stay warm and dry
Keep your home adequately heated
Dress in layers when going outside — always cover head, hands, and feet
Eat and drink well
Have warm meals and beverages
Avoid alcohol — it makes your body lose heat faster
Rest and recover
Mild hypothermia typically resolves fully within 1 to 4 hours of rewarming without lasting effects
You may feel tired for 24 to 48 hours
Frostbite care if present
Do not rub affected areas
Keep warm and dry
Return to ED if blistering, blackening, or severe pain develops
Medications
Take all prescribed medications as directed
If your doctor changed any of your medications due to hypothermia risk, follow those instructions
Do not stop antipsychotics or other prescribed medications without speaking to your prescribing doctor
Return to the emergency department immediately if
You feel very cold again, shivering returns, or you cannot get warm
May indicate recurrence of hypothermia
Confusion, drowsiness, or slurred speech develops
Neurological symptom that requires urgent evaluation
Chest pain, palpitations, or irregular heartbeat
Cardiac complication
Skin turns blue, gray, or develops numbness or blistering
Signs of frostbite or poor circulation
You are unable to care for yourself or are not safe at home
Follow-up appointment
See your family doctor within 48 to 72 hours
Temperature and general health check
Review of medications if drug-induced hypothermia was a concern
If tests suggested a thyroid or adrenal problem, your doctor will arrange further blood tests
References
Guidelines and key sources
Wilderness Medical Society 2019 Clinical Practice Guidelines
Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society Clinical Practice Guidelines for the Out-of-Hospital Evaluation and Treatment of Accidental Hypothermia: 2019 Update. Wilderness Environmental Medicine. 2019
Active external rewarming preferred for mild hypothermia
Swiss Staging System for clinical severity classification
2024 American Heart Association and American Red Cross First Aid Guidelines
Hewett Brumberg EK, Douma MJ, Alibertis K, et al. 2024 AHA and American Red Cross Guidelines for First Aid. Circulation. 2024
Insulation, gentle handling, warmed oral fluids for conscious patient
AHA 2025 CPR and ECC Guidelines Part 10: Special Circumstances
Cao D, Arens AM, Chow SL, et al. Part 10: Adult and Pediatric Special Circumstances. Circulation. 2025
Defibrillation reasonable in hypothermic VF
Withhold ACLS drugs until core temperature > 30°C
Landmark studies and reviews
Brown DJ, Brugger H, Boyd J, Paal P. Accidental Hypothermia. NEJM. 2012
Comprehensive review of pathophysiology, staging, and management
Zonnenberg C, Bueno-de-Mesquita JM, Ramlal D, Blom JD. Hypothermia Due to Antipsychotic Medication: A Systematic Review. Frontiers in Psychiatry. 2017
Antipsychotic-induced hypothermia mechanism and risk stratification
Clozapine and olanzapine highest risk agents
Dietrichs ES, Tveita T, Smith G. Hypothermia and Cardiac Electrophysiology: A Systematic Review. Cardiovascular Research. 2019
Osborn wave mechanism and clinical significance
QT prolongation and arrhythmia risk
Okumura H, Okada N, Hamanaka K, et al. Electrocardiographic Patterns of Accidental Hypothermia. Am J Emerg Med. 2025
Osborn waves present in 53% of hypothermic patients
ECG patterns correlate with core temperature
Classification and staging
ICD-10 codes for hypothermia
T68.XXXA — Hypothermia, initial encounter
E03.5 — Myxedema coma
E27.2 — Addisonian crisis
T43.59XA — Adverse effect of antipsychotics
SNOMED CT concepts
386696006 — Accidental hypothermia
82942005 — Mild hypothermia
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.