Hypothermia (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- What is hypothermia?
- What causes hypothermia?
- What are the risk factors for hypothermia?
- What are the signs and symptoms of hypothermia?
- How is hypothermia diagnosed?
- How is hypothermia treated?
- When should I call the doctor for hypothermia?
- Can hypothermia be prevented?
- Hypothermia At A Glance
- Find a local Doctor in your town
What causes hypothermia?
Hypothermia most often occurs because of prolonged exposure to cold weather. Inadequate clothing for conditions may not provide enough insulation for the body to prevent heat loss. Immersion in water hastens hypothermia, and just a few minutes in cold water may be fatal.
What are the risk factors for hypothermia?
There are numerous factors that increase the risk of hypothermia:
- Age: The very young and very old may be less able to generate
heat. The elderly with underlying medical conditions such as
hypothyroidism
or Parkinson's
disease that limit the ability of the body to regulate temperature are less
able to generate heat. Infants
don't generate heat as efficiently, and with their relatively large head size
compared to the body, they are at risk for increased heat loss by radiation.
- Mental status: Impaired judgment and mental function can lead to cold
exposure. Patients with Alzheimer's disease are prone to wander and become exposed to the elements.
- Substance abuse: Alcohol and
drug abuse increase the risk of hypothermia
in two ways. First, impaired judgment can lead to
cold exposure. Additionally, alcohol and similar drugs can dilate blood vessels near the skin
(vasodilation) and decrease the efficiency of the shivering mechanism, both of
which decrease the body's ability to compensate for cold exposure.
- Medical conditions: Underlying medical conditions can also lead to accidental hypothermia.
- Patients with hormonal abnormalities (thyroid, adrenal,
pituitary), and those
with peripheral neuropathy (due to
diabetes or other conditions)
or may be less able to feel the cold and generate a shivering response.
- Patients with spinal
cord injuries, similarly, may not be able to adequately shiver.
- Patients who have suffered
strokes or
brain tumors may have impaired thermal regulation centers in the
brain.
- Overwhelming infection and sepsis may both present with a lowered temperature instead of fever. People with diabetes who have very low blood sugar can appear unconscious and very cold.
- Patients with hormonal abnormalities (thyroid, adrenal,
pituitary), and those
with peripheral neuropathy (due to
diabetes or other conditions)
or may be less able to feel the cold and generate a shivering response.
- Medications: Some medications can increase the risk of hypothermia by limiting the shivering mechanism including some psychiatric medications.
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