Hypothermia first aid

Overview

Hypothermia is a dangerous drop in body temperature below 35°C (95°F). It happens when your body loses heat faster than it can produce it, making it hard for your organs to work properly. First aid focuses on gently warming the person and preventing further heat loss.

Hypothermia is less common in general but can happen to anyone exposed to cold, wet, or windy conditions without proper protection. It is more frequent in outdoor activities, accidents in cold water, and in people with limited ability to keep warm.

Anyone can get hypothermia, but it is especially dangerous for older adults, infants, people with certain medical conditions (like diabetes or thyroid problems), and those who are homeless or have substance use issues.

Symptoms

Common symptoms

• Shivering (though shivering may stop as hypothermia worsens)
• Cold, pale, or blue-tinged skin
• Clumsiness or lack of coordination
• Slurred speech or mumbling
• Confusion or drowsiness
• Slow, shallow breathing and a weak pulse

Symptoms in children

• Cold, red skin with low energy
• Fussiness or unusual quietness
• Refusing to eat or drink
• Breathing difficulties

Symptoms in older adults

• Confusion or memory loss that seems worse than usual
• Tiredness and weakness
• Shivering may be absent even with low body temperature
• Slow movements and difficulty speaking

Causes

Main causes

• Prolonged exposure to cold weather, especially with wind or rain
• Falling into cold water or being in wet clothing
• Inadequate clothing for the cold
• Exhaustion or dehydration in cold conditions

Risk factors

• Very young or older age
• Certain medical conditions like diabetes, thyroid issues, or heart problems
• Alcohol or drug use (which can make you feel warm even when you're losing heat)
• Homelessness or living in a poorly heated home
• Being underweight or not eating enough

When to see a doctor

See a doctor urgently if:

• If you suspect someone has hypothermia, call your local emergency number immediately — it's a medical emergency.
• Even after first aid, any person with hypothermia should be seen by a healthcare provider.

Book a routine appointment if:

• If you frequently feel cold or have low body temperature for no clear reason, talk to your doctor.
• If you have a condition that affects temperature regulation (like diabetes or thyroid disease) and experience mild cold symptoms.

Diagnosis

A healthcare provider will diagnose hypothermia based on your symptoms and by measuring your body temperature with a special low-reading thermometer. They will also check your heart, breathing, and mental state.

Tests that may be done

• Temperature measurement (rectal, esophageal, or bladder thermometer for accuracy)
• Electrocardiogram (ECG) to check heart rhythms
• Blood tests to check organ function and blood gases
• Sometimes a chest X-ray if there are breathing concerns

What to expect at your appointment

If you go to the emergency room with hypothermia, the team will gently warm you using blankets, warm fluids, and sometimes special warming devices. They will monitor your vital signs closely. You may need to stay in the hospital for observation even after your temperature returns to normal.

Treatment

Treatment for hypothermia focuses on safely raising your body temperature back to normal. Mild cases can often be managed at home with first aid, but moderate to severe cases require emergency medical care. Never use direct heat like hot water or heating pads as it can cause burns or dangerous heart rhythms.

Self-care at home

• Move the person to a warm, dry place out of the wind and cold.
• Remove wet clothing gently and replace with dry, warm layers. Cover their head, neck, and hands.
• Wrap them in blankets, sleeping bags, or coats. Include a warm (not hot) water bottle if available — but wrap it in cloth.
• Give warm, sweet, non-alcoholic drinks if they are conscious and able to swallow. Do not give alcohol or caffeine.
• Keep them still and lying down to reduce heat loss. Monitor their breathing and pulse.

Medical treatments

In a hospital, doctors use active rewarming methods such as warm intravenous fluids, heated humidified oxygen, and sometimes warm lavage (washing out the bladder, stomach, or chest with warm fluid). Severe cases may require special machines like a heart-lung bypass to warm the blood directly. All treatments are aimed at gentle, controlled rewarming.

When is surgery considered?

Surgery is not typically needed for hypothermia itself. However, if hypothermia leads to complications like frostbite requiring amputation, surgery may be considered later.

Living with this condition

After recovering from hypothermia, most people return to normal activities. There are no long-term restrictions specifically for hypothermia, but it's important to prevent future episodes by staying warm and dry.

Lifestyle tips

• Dress warmly in layers when going out in cold weather, including a hat, gloves, and waterproof outer layer.
• Keep your home heated to at least 18°C (65°F), especially if you are older or have health conditions.
• Avoid alcohol and drugs in cold conditions as they impair judgment and increase heat loss.
• Stay active and eat enough food to help your body generate heat.

Diet and exercise

A well-balanced diet supports your body's ability to regulate temperature. Staying hydrated (with warm drinks) is important. Moderate exercise helps maintain circulation, but avoid strenuous activity in extreme cold without proper preparation.

Mental health and emotional wellbeing

A hypothermia episode can be frightening. Some people may feel anxious about going out in cold weather afterwards. It's okay to talk to a doctor or counselor if you have lingering worries.

Prevention

Yes, in most cases you can prevent hypothermia by being prepared for cold weather. Dress appropriately, stay dry, avoid being outside for long periods in freezing temperatures, and keep your home warm.

Vaccines

There is no vaccine for hypothermia.

Screening programmes

No routine screening is needed. However, if you are at high risk (elderly, homeless, or with chronic illness), regular checks of your home temperature and awareness of weather warnings can help.

Complications

If left untreated

• Irregular heartbeats (arrhythmias) that can lead to cardiac arrest
• Frostbite, especially in fingers, toes, nose, and ears
• Blood clotting problems
• Kidney failure
• Brain damage or death in severe, prolonged cases

Long-term outlook

With prompt first aid and medical care, the outlook for hypothermia is very good. Even many people with severe hypothermia can recover fully when treated in time. Taking quick action saves lives.

Find support

Local organisations

• Your local emergency services · All regions

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