Clinical features

The clinical feature of hypothermia include:

• grey complexion, with pallor and cyanosis
• skin is cold to touch, both where exposed and where usually warm, for example the abdomen and axilla
• puffy face and hoarse voice
• confusion, drowsiness and stupor, with poor judgement
• increased muscle tone, with rigidity at 32 degrees C
• shivering, until below 30 degrees C
• weakness
• hypokinesia
• ataxia, occasionally tremor
• tachycardia, followed by bradycardia at lower temperatures
• characteristic changes on the ECG e.g. J-waves, prolonged QT and T wave inversion may be found
• hypertension, with hypotension at lower temperatures
• hyperventilation, followed by shallow respiration, with hypoventilation causing hypoxia at lower temperatures

Reference

1. Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society clinical practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2019 update. Wilderness Environ Med. 2019 Dec;30(4 Suppl):S47-69.