Prehospital treatment of hypothermia.

This article considers several issues regarding cold stress, development of hypothermia, and prehospital care of the hypothermic patient. Advice is given on the use of clinical impressions and functional characteristics to determine the level of hypothermia. Response to cold water immersion is characterized as short-term (cold shock response), midterm (loss of performance), and long-term (development of hypothermia). Circum-rescue collapse is the dramatic worsening condition of the patient just before, during, or after rescue from cold stress. After rescue, the treatment priorities are to arrest the fall in core temperature, establish a steady, safe rewarming rate while maintaining the stability of the cardiorespiratory system, and provide sufficient physiological support.