What to Do If Someone Has Hypothermia

What to Do If Someone Has Hypothermia

When someone is suffering from hypothermia, every second counts. This condition isn’t just about being a little cold—it’s a potentially life-threatening emergency that requires immediate and careful action. Hypothermia happens when the body loses heat faster than it can produce it, causing the core body temperature to drop to dangerous levels. This drop interferes with the normal functioning of the heart, nervous system, and other vital organs. If untreated, it can lead to complete failure of the heart and respiratory system and eventually to death.

Whether you’re hiking in the mountains, spending time outdoors in winter, or even in a poorly heated home, hypothermia can strike quickly and silently. And the scariest part? The person suffering from it often doesn’t realize just how much danger they’re in.

In this article, we’re going to walk through exactly what you should do if you suspect someone has hypothermia. You’ll learn how to identify the signs, what immediate steps to take, and how to safely help the person recover without making things worse. We’ll also talk about the long-term effects, how to prevent hypothermia in the first place, and even dispel some dangerous myths floating around.

By the end of this guide, you won’t just be informed—you’ll be prepared. Whether you’re an outdoor enthusiast, a parent, a caregiver, or someone who lives in colder climates, this is information that could one day help you save a life.

So, let’s dive into the cold truth about hypothermia and how you can be ready to respond.

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Understanding Hypothermia

What Is Hypothermia?

Hypothermia occurs when the body’s core temperature falls below 95°F (35°C). Your body works best within a very narrow temperature range—around 98.6°F (37°C). When that balance is thrown off, your organs and systems start to slow down. That’s why hypothermia isn’t just uncomfortable—it’s downright dangerous.

The body loses heat through radiation, evaporation, conduction, and convection. Under normal conditions, the body replaces this lost heat by generating more, primarily through metabolism and muscle activity. But in cold environments, or when a person is exposed to wind, rain, or wet clothing, heat loss can outpace heat production.

As core temperature drops:

• The body starts shivering to generate heat.

• Blood vessels constrict to retain warmth.

• Mental function begins to decline.

• Eventually, shivering stops—this is a very bad sign.

There are three stages of hypothermia:

1. Mild (90–95°F) – Shivering, confusion, fast breathing.

2. Moderate (82–90°F) – Drowsiness, slow heartbeat, slurred speech.

3. Severe (below 82°F) – No shivering, unconsciousness, weak pulse.

The scary part is that people with hypothermia may not even realize what’s happening due to impaired mental function. That’s why early recognition and immediate action are so important.

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Causes of Hypothermia

Hypothermia doesn’t only happen during blizzards or in snowy mountain passes—it can strike in surprisingly common situations. Most cases are caused by exposure to cold environments, but how that exposure happens varies widely.

Common causes include:

• Prolonged exposure to cold weather: Especially without proper clothing.

• Wet clothing or immersion in cold water: Water conducts heat away from the body 25 times faster than air.

• Wind chill: Wind removes heat from the body faster than still air.

• Alcohol and drug use: These substances can impair judgment and reduce the body’s ability to retain heat.

• Poor heating in homes: Especially in older or low-income housing.

• Medical conditions: Certain conditions like diabetes, hypothyroidism, and malnutrition increase risk.

Sometimes, people develop hypothermia indoors—especially the elderly—if the heating isn’t adequate. Hypothermia isn’t just an “outdoors” issue. Urban exposure can be just as deadly as wilderness exposure if not recognized in time.

Understanding the causes helps you avoid risky situations and prepare for them better. Prevention is key—but if exposure happens, knowing what led to it can guide your response.

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Who Is at Risk?

While anyone can develop hypothermia under the right conditions, some groups are significantly more vulnerable due to age, health, or social circumstances.

High-risk individuals include:

• Infants and young children: They lose heat more quickly than adults and may not be able to communicate discomfort.

• Older adults: They often have reduced metabolic rates, impaired thermoregulation, and may live alone in cold conditions.

• People with chronic illnesses: Conditions like diabetes, Parkinson’s disease, or hypothyroidism can increase risk.

• Individuals under the influence of alcohol or drugs: Impaired judgment and sensation can prevent someone from recognizing the danger.

• The homeless or those living in poorly insulated homes: Constant exposure and lack of adequate clothing or shelter increase risk dramatically.

• Outdoor workers and enthusiasts: Hikers, climbers, hunters, and workers exposed to the elements must take precautions.

Recognizing who’s most at risk allows us to target prevention efforts and keep vulnerable individuals safe. It also reminds us not to dismiss symptoms in people who “shouldn’t” be cold—they just might be in real danger.

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Recognizing the Signs and Symptoms

Early Symptoms

Identifying hypothermia in its early stages can be the difference between a quick recovery and a life-threatening emergency. The tricky part is, early symptoms can often be subtle or mistaken for something else.

Here’s what to watch for in the beginning:

• Shivering: The body’s natural response to generate heat. Continuous shivering is a sign the body is still trying to compensate.

• Cold, pale, or bluish skin: This happens as blood vessels constrict to keep warmth in the core.

• Fatigue or drowsiness: A subtle sign that body systems are slowing down.

• Slurred speech or mumbling: Hypothermia affects brain function very quickly.

• Poor coordination: You might notice fumbling hands or difficulty walking straight.

• Irritability or confusion: As the brain cools, decision-making and mood are affected.

What’s terrifying is that the person may deny anything is wrong. They might claim to feel “fine” or “just a little cold,” even as their condition worsens.

If you notice these signs in yourself or someone else during cold conditions, act immediately. Early action can prevent the condition from progressing to more dangerous stages.

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Immediate First Aid Measures

Assessing the Situation Safely

Before jumping in to help someone who might be hypothermic, you need to first ensure the scene is safe—for you and the victim. Why? Because in many cold-weather emergencies, the environment poses serious risks: slippery ice, cold water, or freezing temperatures. Rushing in without thinking could make you the second victim.

Start by observing the surroundings. If the person is in icy water or a snowstorm, you’ll need to carefully plan your approach. Avoid direct exposure to the same elements, especially if you’re unprepared or underdressed. If the person is in water, do not go in unless you are trained in water rescue—use a rope, stick, or flotation device to pull them out.

Once you reach the individual, try to assess their level of consciousness. Talk to them. Do they respond? Are they coherent? Are they shivering or still? This tells you a lot about the stage of hypothermia they might be in.

It’s also important to determine how long they’ve been exposed to the cold and whether they are wet. Wet clothing accelerates heat loss significantly. You should also check for injuries, as trauma can worsen hypothermia and complicate treatment.

Keep your calm. Panicking will only delay help. Gather this information quickly but thoroughly—it’s valuable when communicating with emergency responders. Prioritizing your safety allows you to help more effectively and avoid becoming part of the emergency.

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Calling Emergency Services

Once you recognize that someone may be suffering from hypothermia, your next move should be to call emergency services immediately. Don’t assume that you can “warm them up at home” or wait to see if they improve. Time is critical. Hypothermia can advance quickly from mild to severe, and complications like cardiac arrest or unconsciousness can strike suddenly.

When calling 911 (or your local emergency number), be clear and concise:

• Explain that the person may have hypothermia.

• Describe their symptoms (shivering, confusion, cold skin, etc.).

• Share their age, current condition, and any known medical history.

• Mention environmental details—are they wet, was it windy, how long were they exposed?

This info helps dispatchers send the right kind of help—paramedics trained to handle cold-weather emergencies.

While waiting for emergency responders:

• Stay on the line unless told otherwise.

• Follow any instructions they give you, especially regarding CPR or rewarming steps.

• Do not assume everything is okay if the person seems awake—hypothermia affects judgment, and the condition can rapidly deteriorate.

Prompt medical intervention can save their life. Never hesitate or delay contacting professionals. Even if you’re unsure about the severity, it’s better to be safe and get help on the way.

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Moving the Person to Safety

Once emergency services are on the way, or if you’re in a remote location without immediate access to help, your next priority is to move the hypothermic person to a warmer and safer environment.

But here’s the key: do it gently and carefully. When someone is hypothermic, their body is in a fragile state. Sudden movements can trigger cardiac arrhythmias—or even cardiac arrest—because the heart is extremely sensitive to jarring when cold.

Here are steps to follow:

1. Move them out of the cold: If possible, get them indoors or into a sheltered space like a car, tent, or even behind a windbreak. Protection from wind and wetness is vital.

2. Lay them flat: Unless they’re actively choking or vomiting, keep them lying flat to avoid dizziness or further strain on the heart.

3. Handle like glass: Avoid rough handling. Don’t jostle, rub their skin, or move their limbs too much. Support their neck and back if needed.

4. Remove wet clothing: Wet garments steal body heat quickly. Gently take off wet clothes and replace with dry layers or blankets if available.

If you can’t move them far, do your best to shield them from the elements. Use blankets, sleeping bags, extra clothing, or even body heat from another person if needed. Insulation is everything.

Getting out of the cold doesn’t fix hypothermia instantly—but it stops it from getting worse, which is half the battle in early treatment.

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Rewarming the Body Safely

Passive Rewarming Techniques

When you first start rewarming someone with hypothermia, the safest method—especially if they are still conscious and responsive—is passive rewarming. This involves allowing the person’s own body to generate heat while you help trap and retain it. It’s gentle, safe, and effective for mild to moderate cases.

Here’s how to do passive rewarming right:

• Dry the person off: Wet clothing draws heat from the body fast. Replace it with warm, dry clothing or cover them with blankets.

• Insulate properly: Use multiple layers, focusing especially on the chest, neck, head, and groin. Avoid wrapping only the arms and legs—that can actually push cold blood from the limbs into the core.

• Use body heat: If you’re in a survival situation or lack supplies, use your own body heat. Get into a sleeping bag or under blankets with the person, skin-to-skin, to share warmth.

• Keep the person still: Movement can worsen the condition. Let them rest quietly and remain in a lying position.

• Offer warm fluids: If they are fully alert and able to swallow, small sips of warm (not hot) sugary drinks can help. Avoid caffeine and alcohol.

Remember, passive rewarming is a slow and steady process. Rushing it can backfire. Keep the person warm and monitor them closely for signs of improvement—or worsening. If they stop shivering or become less responsive, it could indicate a deeper level of hypothermia that needs urgent care.

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Active External Rewarming

In moderate cases of hypothermia—or if passive rewarming isn’t working fast enough—you might need to help the body warm up more directly. This is called active external rewarming. But be cautious—this method can be risky if done incorrectly.

Some safe ways to apply active external heat:

• Warm blankets or towels: Use items heated in a dryer or in a warm environment, not scalding hot, and apply them to core areas like the chest, neck, and groin.

• Heating pads or hot water bottles: Wrap them in towels to avoid burns and apply only to the chest, back, or groin. Never put heat on the arms or legs—that can cause cold blood to rush back to the heart and cause shock.

• Electric blankets: If available and safe to use, electric blankets can be very effective—but monitor the person closely to avoid overheating.

Important rules:

• Avoid direct skin contact with heat sources—hypothermic skin can be numb, and burns can happen without the person feeling it.

• Never immerse in hot water—this can cause dangerous shifts in blood pressure and lead to cardiac arrest.

• Don’t rewarm limbs first—always start with the torso.

Use active rewarming only if the person is conscious, responsive, and their vitals are stable. If they’re unconscious or in severe hypothermia, emergency professionals should handle it.

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Monitoring the Person’s Condition

Checking Breathing and Pulse

In hypothermic individuals, vital signs can be deceptive. As the body cools, both breathing and heart rate slow significantly. Sometimes, they can be so faint that you may not detect them easily—and that’s why careful assessment is critical.

Here’s how to check:

• Breathing: Look, listen, and feel. Place your cheek close to their mouth and nose while watching the chest. Look for slow, shallow breaths.

• Pulse: Use the carotid artery (on the neck) rather than the wrist. Check for at least 30 to 45 seconds before deciding it’s absent—pulse can be dangerously slow.

If breathing is extremely shallow or you’re not sure whether the person is breathing at all, begin rescue breathing only if you’re trained and it’s safe to do so. Remember, rough handling can cause the heart to go into fibrillation, especially when core body temp is below 86°F (30°C).

Stay calm and focused. Hypothermic patients may appear dead—but they might not be. There’s a saying among rescue professionals: “They’re not dead until they’re warm and dead.” This means you continue life-saving efforts until they’ve been rewarmed and reassessed by medical professionals.

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Managing Unconsciousness

If the person becomes unresponsive or unconscious, you need to treat them as a medical emergency. But again—handle them extremely gently. Don’t shake them to wake them up. Rapid movements or jerking can disrupt their fragile cardiovascular state.

Steps to follow:

1. Call emergency services immediately or make sure someone else has.

2. Check for breathing and pulse carefully.

3. Begin CPR only if there’s no breathing or pulse.

4. Keep the person warm: Focus on the chest and head. Don’t try to warm arms or legs first.

5. Don’t assume they’re gone: People in deep hypothermia can appear dead—blue lips, no movement, barely detectable pulse—but still be revivable.

Maintain a calm and reassuring presence. Even if they’re unconscious, people sometimes retain partial hearing. Avoid saying negative things or giving up—help is coming, and your role is to preserve them until it arrives.

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Performing CPR if Necessary

Performing CPR on a hypothermic person requires a very specific approach. The heart is extremely fragile when cold. But if there’s no detectable breathing or pulse after checking for 45 seconds, and help hasn’t yet arrived, start CPR.

Here’s how:

• Begin chest compressions: Use the standard method—push hard and fast in the center of the chest at about 100–120 compressions per minute.

• Be gentle but consistent: Bones are more brittle when cold, and the heart is more susceptible to arrhythmias. Compress carefully.

• Add rescue breaths if trained: 2 breaths for every 30 compressions.

• Continue until help arrives or until the person starts breathing on their own.

Note: In very cold environments, CPR might need to be prolonged—sometimes for hours—until medical teams can successfully rewarm the person. There are real-life cases of people surviving after extended periods of CPR during hypothermia.

Never assume death in the cold. If you’re trained in CPR and you suspect the person still has a chance, your efforts could absolutely make the difference.

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Preventing Further Heat Loss

Insulating the Person

One of the most effective ways to stop hypothermia from getting worse is to insulate the individual from cold air, wind, and wet surfaces. Insulation helps preserve whatever body heat is left and supports slow rewarming.

Here’s how to insulate someone properly:

• Use layers: Start with dry clothes close to the skin, then build layers using blankets, jackets, sleeping bags, or even newspapers or dry leaves if that’s all you have.

• Cover the entire body: Especially focus on the chest, neck, and groin—these areas have major blood vessels near the surface.

• Don’t forget the head: A significant amount of heat escapes through the head. Use hats, scarves, or any soft cloth to cover it.

• Create a barrier underneath: Don’t let the person lie directly on the cold ground. Use sleeping pads, dry coats, or even backpacks as insulation beneath them.

Avoid wrapping the arms and legs too tightly or aggressively. Blood circulation in those limbs could push cold blood into the core, worsening the situation.

Insulation isn’t a “fix” on its own—it won’t reverse severe hypothermia—but it stops the clock, giving the person a better chance while waiting for rewarming and rescue.

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Using Warm, Dry Clothing

Clothing plays a huge role in hypothermia prevention and treatment. The right layers and materials can trap heat effectively, while the wrong ones can actually accelerate heat loss.

What to do:

• Remove wet clothing immediately: Wet fabric draws heat from the body 25 times faster than air. Even damp clothes are dangerous.

• Replace with dry, insulating materials: Wool and synthetic fibers are best. Avoid cotton—it loses its insulating value when wet.

• Layer correctly: Start with a moisture-wicking base layer, then insulating layers (fleece, wool), and finally a waterproof and windproof outer layer.

• Cover extremities: Use socks, gloves, hats, and scarves. If you don’t have these, wrap hands and feet in dry fabric or even plastic bags in a pinch.

• Check frequently: As the person warms, make sure they don’t start sweating, which can cool them again if layers become damp.

Warm, dry clothing not only helps retain body heat but also reduces further heat loss. Combined with insulation and shelter, it forms the backbone of any effective hypothermia first-aid approach.

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What Not to Do in a Hypothermia Emergency

Avoiding Rapid Rewarming

It’s natural to want to warm someone up as fast as possible when they’re suffering from hypothermia—but that instinct can actually be deadly. Rapid rewarming, especially of the arms and legs, can cause a phenomenon called “afterdrop.”

Afterdrop occurs when cold blood from the extremities returns to the core too quickly. This sudden influx of cold can cause the heart temperature to drop even further, potentially leading to cardiac arrest. That’s why gradual rewarming—focusing on the torso—is essential.

Avoid the following:

• Hot baths or showers: This can shock the body and cause unconsciousness or death.

• Heat packs on limbs: Only apply heat to the chest, neck, or groin.

• Overloading with heat sources: Excessive heat can burn or overstimulate a cold-sensitive system.

In emergency situations, your goal isn’t to make them “feel warm fast,” but to stabilize their condition slowly and safely. Let professionals handle aggressive rewarming.

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Don’t Give Alcohol or Caffeine

This is a common and dangerous myth—alcohol and caffeine do not help with cold. In fact, they make things worse.

• Alcohol: While it creates a warm sensation, it actually dilates blood vessels, pulling heat away from the core and increasing heat loss. It also impairs judgment and can mask hypothermia symptoms.

• Caffeine: Found in coffee, tea, and energy drinks, caffeine is a stimulant that can increase the heart rate and interfere with the body’s heat regulation.

Instead, offer warm (not hot), non-caffeinated, non-alcoholic beverages like warm water, broth, or diluted fruit juice—only if the person is conscious and able to swallow.

Never force fluids, and never use alcohol to “warm someone up.” It’s one of the fastest ways to worsen hypothermia.

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Avoid Massage or Vigorous Movement

Another well-meaning mistake is trying to massage or rub someone who’s cold to “get the blood flowing.” In hypothermia cases, that’s extremely dangerous.

Here’s why:

• Rubbing limbs can force cold, stagnant blood from the arms and legs into the core, dropping internal temperature further.

• It can also trigger arrhythmias—sudden, irregular heartbeats that can be fatal in cold victims.

• And if the person is unconscious or semi-conscious, they may have internal injuries or frostbite, which can be made worse by massage.

Instead:

• Handle the person gently and minimally.

• Focus on warmth and insulation, not stimulation.

• Let rewarming occur passively or under medical supervision.

Your goal is to preserve life and prevent worsening, not “wake them up” or “get them moving.” This is one time where less really is more.

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Professional Medical Treatment

Hospital Care for Hypothermia

When someone with hypothermia reaches the hospital, the approach is far more advanced than anything you can do in the field. Medical teams have tools and techniques specifically designed to raise core body temperature safely.

Hospital procedures include:

• Internal rewarming: Through warmed IV fluids, humidified oxygen, or peritoneal lavage (warm fluid into the abdominal cavity).

• External warming systems: These include warm air blankets and heat pads designed for controlled rewarming.

• ECMO (Extracorporeal Membrane Oxygenation): In severe cases, a heart-lung machine is used to warm and oxygenate the blood directly.

Monitoring continues throughout:

• Core temperature is closely tracked.

• Electrolytes, glucose, and blood chemistry are monitored for imbalance.

• Organ function is observed, especially heart and kidney performance.

Most importantly, resuscitation is continued for as long as needed. People have survived core temperatures below 60°F (16°C) thanks to aggressive hospital care.

So if you’re able to get someone with hypothermia to a hospital alive—even barely—they stand a real chance of survival.

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Rewarming Methods Used by Doctors

In a hospital setting, medical professionals use various techniques based on how severe the hypothermia is:

1. Mild Hypothermia (90–95°F / 32–35°C)

   • Passive warming (blankets, warm room).

   • Warm oral fluids.

   • Continuous monitoring.

2. Moderate Hypothermia (82–90°F / 28–32°C)

   • Active external rewarming (heating pads, warm IV fluids).

   • Heated, humidified oxygen.

   • Electrocardiogram (ECG) monitoring.

3. Severe Hypothermia (Below 82°F / 28°C)

   • Internal rewarming (peritoneal lavage, thoracic lavage, extracorporeal blood warming like ECMO).

   • Intubation if breathing is severely compromised.

   • CPR with extended resuscitation time.

Doctors also treat complications such as frostbite, infections, or organ failure. Recovery from severe hypothermia may take days or even weeks, depending on the extent of exposure and complications.

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Long-Term Effects and Recovery

Even after someone survives hypothermia, the journey isn’t over. Recovery can be physical, mental, and emotional.

Physical effects may include:

• Frostbite or tissue damage.

• Kidney damage or liver dysfunction.

• Muscle weakness or fatigue.

Neurological effects:

• Memory loss.

• Impaired cognition or “mental fog.”

• Depression or PTSD from the traumatic experience.

Rehabilitation may involve physical therapy, mental health support, and regular follow-ups to assess internal damage.

However, many people recover fully, especially with early intervention. The body can bounce back from extreme cold—but it needs time, care, and medical guidance.

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Conclusion

Hypothermia is no joke—it’s silent, sneaky, and potentially deadly. But armed with the right knowledge, you can be the difference between life and death for someone caught in the cold. The key lies in recognition, quick thinking, and gentle care. Don’t try to rush rewarming, and never rely on myths like alcohol or rubbing. Be calm, stay safe, and know your limits.

Whether you’re an outdoor adventurer, a concerned neighbor, or just someone who wants to be prepared, these steps equip you to respond with confidence. And remember: when in doubt, always seek professional medical help.

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FAQs

Can you get hypothermia in mild weather?

Yes. Even temperatures in the 50s°F (10–15°C) can cause hypothermia, especially if you’re wet, exposed to wind, or fatigued.

How long does it take to develop hypothermia?

It depends on conditions. In icy water, hypothermia can develop in under 10 minutes. On land, it could take hours—but risk increases quickly if you’re wet or wind-exposed.

What should I do if I’m alone and start feeling hypothermic?

Find shelter, remove wet clothing, wrap yourself in anything dry and insulating, and try to warm your core. Avoid sleeping. Call for help if possible.

Is it possible to recover fully from severe hypothermia?

Yes, many people do—especially with fast, proper medical care. However, severe cases can cause long-term damage, so early treatment is critical.

What clothing materials are best for cold-weather survival?

Wool, fleece, and synthetic materials like polyester are ideal. Avoid cotton—it absorbs moisture and loses insulation when wet.

DISCLAIMER: This article is for informational purposes only and not a substitute for professional medical advice. Always seek immediate help from qualified healthcare providers in case of hypothermia or any emergency.

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