Wilderness Medicine Updates Ep. 31: Hypothermia Basics
Mar 12, 2026
Clear breakdown of how the body responds as core temperature drops and why measuring true core temperature is hard in the field. Walkthrough of the Modified Swiss staging system from cold stress to hypothermic cardiac arrest. Practical field care steps for each stage, safe handling to avoid afterdrop, and how defibrillation and drug rules change with deep hypothermia.
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Address Moderate Hypothermia With External Heat And Gentle Handling
- Stage 2 moderate hypothermia: prioritize external active rewarming, check for hypoglycemia, secure IV access, warm IV fluids, and minimize movement to avoid afterdrop.
- Use heat packs near core, consider warm bodies in the burrito wrap, and expedite evacuation.
Afterdrop Can Worsen Core Temperature During Movement
- Afterdrop occurs when warmed core blood is circulated to cold extremities, returning colder blood to the core and worsening hypothermia.
- Increasing cardiac output via exertion or premature movement can trigger dangerous core cooling and arrest.
Manage Severe Hypothermia With Gentle Support And Rapid Evacuation
- Stage 3 severe hypothermia: handle extremely gently, provide airway/ventilation support, active external rewarming, warm IV fluids, and transport urgently to advanced care.
- Check pulse/breathing up to 60 seconds before declaring absent signs.
