Managing accidental hypothermia: progress but still some way to go

Accidental hypothermia has become much better understood over the last 25 years. Not only is it recognised that it significantly worsens the prognosis if it occurs alongside many medical conditions including major trauma1 2 and elective surgery,3 but it is also well established that severe accidental hypothermia (core temperature <28°C) is eminently survivable if treated correctly, even in the presence of cardiac arrest.4 In practice, hypothermia can be divided into two groups: mild hypothermia (core temperature 32°–35°C, table 1) and everything else. In the presence of trauma, mild hypothermia starts at 36°C,5 reflecting its deleterious effect on outcome. Mild hypothermia is very common so prehospital and hospital staff will have experience managing it. The condition per se is not lethal and there is a lot of latitude regarding general management and to which hospital a patient is taken. By...

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