2012 Nov 15 – Accidental Hypothermia

Douglas J.A. Brown, M.D., Hermann Brugger, M.D., Jeff Boyd, M.B., B.S., and Peter Paal, M.D. N Engl J Med 2012; 367:1930-1938November 15, 2012
Accidental hypothermia (i.e., an involuntary drop in core body temperature to <35°C [95°F]) is a condition associated with significant morbidity and mortality.1-4 Each year, approximately 1500 patients in the United States have hypothermia noted on their death certificate; however, the incidence of primary and secondary hypothermia and the associated morbidity and mortality remain unknown.5

In a single tertiary care center, 14 different rewarming methods were used to treat 84 cases of accidental hypothermia,3 which reflects the uncertainties about treatment and the potential for complications.3 Certain treatment approaches are available only in specialized centers, and clarification is needed regarding the choice between transporting a patient to a specialized center and providing treatment locally. Existing recommendations do not include recent developments in rewarming methods nor do they assist with decisions regarding transportation.6-8
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