Hüpotermias

Hüpotermias is a medical condition in which the body's core temperature falls below the normal range, typically below 35°C (95°F). It is a medical emergency that requires prompt assessment and treatment to reduce organ dysfunction and death.

Causes include prolonged cold exposure, immersion in cold water, inadequate clothing or shelter, wind, and wet conditions. Elderly and infants, malnutrition, thyroid disorders, sepsis, intoxication, and certain medications can impair heat production or regulation.

Clinical signs progress with decreasing core temperature. Early shivering is common; as temperature falls, shivering may stop. Other signs include confusion, slowed speech, clumsiness, drowsiness, impaired judgment, bradycardia, hypotension, and, in severe cases, loss of consciousness. Afterdrop, a fall in core temperature during rewarming due to return of cold peripheral blood, may occur.

Diagnosis relies on measuring core temperature with esophageal, rectal, or bladder probes, along with history and examination. Cardiac monitoring and labs may reveal electrolyte abnormalities, acidosis, or organ dysfunction.

Management priorities are preventing further heat loss, gradual rewarming, and treating complications. In the field, remove wet clothing, insulate, and move to a warm environment. Mild cases may be managed with passive warming; moderate to severe cases require active warming and hospital-based core rewarming with warmed IV fluids, humidified oxygen, and monitoring for arrhythmias. Treat hypoglycemia and electrolyte disturbances.

Prognosis depends on temperature, exposure duration, and comorbidities. Prevention focuses on proper clothing, shelter, safe activity in cold weather, and avoiding intoxication that impairs judgment and thermoregulation.