Hypothermia occurs when the body loses heat faster than it can produce it, causing the core temperature to fall to a dangerous level. It is a medical emergency. Although it is often associated with winter weather, hypothermia can also develop in cool rain, cold water exposure, wet clothing, prolonged outdoor immobility, or poorly heated indoor settings. Older adults, infants, and people with impaired mobility or substance use are particularly vulnerable. ^[1][3][4]

Early symptoms may include intense shivering, confusion, slurred speech, poor coordination, drowsiness, and cold pale skin. As hypothermia worsens, shivering may stop, which is a dangerous sign rather than an improvement. Severe hypothermia can lead to slowed breathing, low heart rate, loss of consciousness, and cardiac arrest. A person with altered awareness in a cold environment should be assumed to be at risk until proven otherwise. ^[1][2][5]

Cold-water immersion is especially dangerous because heat loss in water occurs much faster than in air. Even temperatures that do not seem extreme can be hazardous if a person is wet, exhausted, intoxicated, inadequately clothed, or unable to seek shelter. Hypothermia can also accompany trauma, sepsis, endocrine disease, or certain medications. ^[1][3][4]

First aid begins with moving the person to a warmer environment if possible, removing wet clothing, insulating the body with dry blankets or coats, and focusing on gentle rewarming. Direct intense heat to the arms and legs is generally avoided because rapid peripheral warming can worsen circulatory instability. If the person is conscious and able to swallow safely, warm beverages may help. Alcohol should not be given. Emergency services should be contacted promptly. ^[2][4][5]

Rough handling should be avoided in severe hypothermia because the heart may be irritable. If the person is unresponsive and not breathing normally, emergency instructions for resuscitation should be followed. In hospital, treatment may include active external rewarming, warmed intravenous fluids, airway support, monitoring of heart rhythm, and management of associated injuries or illness. ^[2][5]

Prevention is often overlooked but extremely important. Layered dry clothing, weather-appropriate planning, avoiding prolonged wet exposure, checking on vulnerable older adults, and respecting the risk of cold water can all reduce harm. Because judgment may become impaired during hypothermia, people do not always recognize how sick they are becoming. ^[1][4]

FAQ

What are the first signs of hypothermia?

Shivering, confusion, clumsiness, slurred speech, and unusual drowsiness are common early signs. ^[1][2]

Is hypothermia only a winter problem?

No. It can occur in cool rain, cold water, wet clothing, or poorly heated environments as well. ^[1][4]

What should be done first?

Move the person to a warmer place, remove wet clothing, begin gentle rewarming, and seek emergency help. ^[2][4][5]

Is it good when shivering stops?

No. In the context of hypothermia, stopping shivering can be a sign that the condition is becoming more severe. ^[1][2]

When is hypothermia an emergency?

It is always potentially serious, and urgent care is especially important when confusion, drowsiness, slowed breathing, or unconsciousness is present. ^[1][5]