Accidental Hypothermia

  • Carrie Harvey
  • Ivan Nathaniel CoEmail author


Accidental hypothermia, defined as a core temperature <35 °C secondary to unanticipated cold exposure, is prevalent in all geographic regions and carries significant morbidity and mortality. The adage that “a person is not dead until warm and dead” remains true and aggressive resuscitation is therefore indicated in nearly every patient who presents with accidental hypothermia. Unfortunately, no strong evidence-based guidelines exist as the literature surrounding optimal management consists almost exclusively of case reports. Still, the amount of information on the topic allows the provider to develop a rationale treatment plan specific to the patient’s presentation and available resources. This chapter will review the existing evidence surrounding the accurate diagnosis of accidental hypothermia, basics of rewarming strategies, appropriate selection of rewarming modality, and controversial aspects of management.


Environmental hypothermia Osborne wave Passive rewarming Active external rewarming Active internal rewarming Body cavity lavage Continuous arteriovenous rewarming Continuous venovenous rewarming Extracorporeal membrane oxygenation Cardiopulmonary bypass 



Degrees Celsius


Advanced Cardiac Life Support


American Heart Association


Continuous arteriovenous rewarming


Cardiopulmonary bypass


Cardiopulmonary resuscitation


Continuous venovenous hemodiafiltration


Continuous venovenous rewarming


Chest X-ray




Emergency medicine services




Packed red blood cells


Venoarterial extracorporeal membrane oxygenation


Ventricular fibrillation


Ventricular tachycardia


Venovenous extracorporeal membrane oxygenation


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Emergency MedicineMichigan MedicineAnn ArborUSA
  2. 2.Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary and Critical CareMichigan MedicineAnn ArborUSA

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