Hypothermia 

Assessment

Pediatric Pearls: Signs & Symptoms: Differential: 
□ Use approved reference document for medication dosing, electrical therapy, and equipment sizes. 

□ Hypothermia appears quickly in children		□ Cold, clammy 
□ Shivering 
□ Mental status changes 
□ Extremity pain or sensory abnormality 
□ Bradycardia 
□ Hypotension or shock		□ Metabolic disorder (hypoglycemia, hypothyroidism) 
□ Toxins 
□ Environmental exposure 
□ Shock 
□ Sepsis 

Clinical Management Options

EMT-B
• Oxygen, target SpO2 92 – 96% 
• Temperature less than 95 F (< 35 C): Remove wet clothing, blankets as needed 
• Handle very gently if < 88 F (< 30 C) 
• BGL assessment 
• Use heat packs  
Paramedic
• Increase temperature of transport compartment 
• Vascular access 
• Warm IV Isotonic Crystalloid if available 
Consult Online Medical Control as Needed

Pearls

  • Extremes of age are more susceptible (young and old) 
  • < 34 C (93.2 F), shivering may diminish at < 31 C (87.8 F) shivering may stop. 
  • With temperature less than 30 C (88 F) ventricular fibrillation is common cause of death. Handle patients gently to reduce the risk. Transport immediately for re-warming. 
  • If the temperature is unable to be measured, treat the patient based on the suspected temperature. 
  • Hypothermia may produce severe physiologic bradycardia. Do not treat unless profound hypotension unresponsive to fluids. 
  • Hypothermia: 
    • Mild: 89.6 – 95 F (32 – 35 C) 
    • Moderate: 82.4 – 89.6 F (28 – 32 C) 
    • Severe: < 82.4 F (< 28 C) 
  • During warming, cold blood may re-enter central circulation causing a subsequent decrease in body temperature.