The Swiss Society for Mountain Medicine developed a staging system for patients with hypothermia. The stage can help guide subsequent management.
Parameters:
(1) mental status
(2) core body temperature
(3) shivering as response to cold
(4) breathing
|
Mental Status
|
Core Body Temperature
|
Shivering?
|
Breathing?
|
Stage
|
|
alert
|
> 35°C (> 95°F)
|
yes
|
yes
|
0
|
|
alert
|
32 - 35°C (89.6 - 95°F)
|
yes
|
yes
|
I
|
|
drowsy
|
28 - 31.9°C (82.4 - 89.5°F)
|
no
|
yes
|
II
|
|
unconscious
|
24 - 27.9°C (75.2 - 82.3°F)
|
no
|
yes
|
III
|
|
unconscious
|
< 24°C (< 75.2°F)
|
no
|
no
|
IV
|
Field management for Stages I and II:
(1) administer hot, sweet drinks
(2) change clothing if practicable
(3) transport to nearest hospital with intensive care unit
Field management for Stages III:
(1) intubate and ventilate with warm, humidified oxygen
(2) transport to hospital with cardiopulmonary bypass capabilities
Field management for Stages IV:
(1) CPR
(2) intubate
(3) if ventricular fibrillation apply DC shocks
(4) transport to hospital with cardiopulmonary bypass capabilities
