Hypothermia is often defined as any body temperature below 35.0 °C (95.0 °F). With this method it is divided into degrees of severity based on the core temperature.
Another classification system, the Swiss staging system, divides hypothermia based on the presenting symptoms which is preferred when it is not possible to determine an accurate core temperature.
Other cold-related injuries that can be present either alone or in combination with hypothermia include:
Signs and symptoms vary depending on the degree of hypothermia, and may be divided by the three stages of severity. People with hypothermia may appear pale and feel cold to touch.
Infants with hypothermia may feel cold when touched, with bright red skin and an unusual lack of energy.
Behavioural changes such as impaired judgement, impaired sense of time and place, unusual aggression and numbness can be observed in individuals with hypothermia; they can also deny their condition and refuse any help. A hypothermic person can be euphoric and hallucinating.
Cold stress refers to a near-normal body temperature with low skin temperature; signs include shivering. Cold stress is caused by cold exposure and it can lead to hypothermia and frostbite if not treated.
Symptoms of mild hypothermia may be vague, with sympathetic nervous system excitation (shivering, high blood pressure, fast heart rate, fast respiratory rate, and contraction of blood vessels). These are all physiological responses to preserve heat. Increased urine production due to cold, mental confusion, and liver dysfunction may also be present. Hyperglycemia may be present, as glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity to insulin may be blunted. Sympathetic activation also releases glucose from the liver. In many cases, however, especially in people with alcoholic intoxication, hypoglycemia appears to be a more common cause. Hypoglycemia is also found in many people with hypothermia, as hypothermia may be a result of hypoglycemia.
As hypothermia progresses, symptoms include: mental status changes such as amnesia, confusion, slurred speech, decreased reflexes, and loss of fine motor skills.
There is often cold, inflamed skin, hallucinations, lack of reflexes, fixed dilated pupils, low blood pressure, pulmonary edema, and shivering is often absent. Pulse and respiration rates decrease significantly, but fast heart rates (ventricular tachycardia, atrial fibrillation) can also occur. Atrial fibrillation is not typically a concern in and of itself.
Twenty to fifty percent of hypothermia deaths are associated with paradoxical undressing. This typically occurs during moderate and severe hypothermia, as the person becomes disoriented, confused, and combative. They may begin discarding their clothing, which, in turn, increases the rate of heat loss.
Rescuers who are trained in mountain survival techniques are taught to expect this; however, people who die from hypothermia in urban environments who are found in an undressed state are sometimes incorrectly assumed to have been subjected to sexual assault.
An apparent self-protective behaviour, known as "terminal burrowing", or "hide-and-die syndrome", occurs in the final stages of hypothermia. Those affected will enter small, enclosed spaces, such as underneath beds or behind wardrobes. It is often associated with paradoxical undressing. Researchers in Germany claim this is "obviously an autonomous process of the brain stem, which is triggered in the final state of hypothermia and produces a primitive and burrowing-like behavior of protection, as seen in hibernating mammals". This happens mostly in cases where temperature drops slowly.
Hypothermia usually occurs from exposure to low temperatures, and is frequently complicated by alcohol consumption. Any condition that decreases heat production, increases heat loss, or impairs thermoregulation, however, may contribute. Thus, hypothermia risk factors include: substance use disorders (including alcohol use disorder), homelessness, any condition that affects judgment (such as hypoglycemia), the extremes of age, poor clothing, chronic medical conditions (such as hypothyroidism and sepsis), and living in a cold environment. Hypothermia occurs frequently in major trauma, and is also observed in severe cases of anorexia nervosa. Hypothermia is also associated with worse outcomes in people with sepsis— while most people with sepsis develop fevers (elevated body temperature), some develop hypothermia.
In urban areas, hypothermia frequently occurs with chronic cold exposure, such as in cases of homelessness, as well as with immersion accidents involving drugs, alcohol or mental illness. While studies have shown that people experiencing homelessness are at risk of premature death from hypothermia, the true incidence of hypothermia-related deaths in this population is difficult to determine. In more rural environments, the incidence of hypothermia is higher among people with significant comorbidities and less ability to move independently. With rising interest in wilderness exploration, and outdoor and water sports, the incidence of hypothermia secondary to accidental exposure may become more frequent in the general population.
Heat is lost much more quickly in water than in air. Thus, water temperatures that would be quite reasonable as outdoor air temperatures can lead to hypothermia in survivors, although this is not usually the direct clinical cause of death for those who are not rescued. A water temperature of 10 °C (50 °F) can lead to death in as little as one hour, and water temperatures near freezing can cause death in as little as 15 minutes. During the sinking of the Titanic, most people who entered the −2 °C (28 °F) water died in 15–30 minutes.
Heat is primarily generated in muscle tissue, including the heart, and in the liver, while it is lost through the skin (90%) and lungs (10%). Heat production may be increased (to over 1200 W in trained endurance athletes) through muscle contractions (i.e. exercise and shivering). The rate of heat loss is determined, as with any object, by convection, conduction, and radiation. The rates of these can be affected by body mass index, body surface area to volume ratios, clothing and other environmental conditions.
Accurate determination of core temperature often requires a special low temperature thermometer, as most clinical thermometers do not measure accurately below 34.4 °C (93.9 °F). A low temperature thermometer can be placed in the rectum, esophagus or bladder. Esophageal measurements are the most accurate and are recommended once a person is intubated. Other methods of measurement such as in the mouth, under the arm, or using an infrared ear thermometer are often not accurate.
As a hypothermic person's heart rate may be very slow, prolonged feeling for a pulse could be required before detecting. In 2005, the American Heart Association recommended at least 30–45 seconds to verify the absence of a pulse before initiating CPR. Others recommend a 60-second check.
Covering the head is effective, but no more effective than covering any other part of the body. While common folklore says that people lose most of their heat through their heads, heat loss from the head is no more significant than that from other uncovered parts of the body. However, heat loss from the head is significant in infants, whose head is larger relative to the rest of the body than in adults. Several studies have shown that for uncovered infants, lined hats significantly reduce heat loss and thermal stress. Children have a larger surface area per unit mass, and other things being equal should have one more layer of clothing than adults in similar conditions, and the time they spend in cold environments should be limited. However, children are often more active than adults, and may generate more heat. In both adults and children, overexertion causes sweating and thus increases heat loss.
Building a shelter can aid survival where there is danger of death from exposure. Shelters can be constructed out of a variety of materials. Metal can conduct heat away from the occupants and is sometimes best avoided. The shelter should not be too big so body warmth stays near the occupants. Good ventilation is essential especially if a fire will be lit in the shelter. Fires should be put out before the occupants sleep to prevent carbon monoxide poisoning. People caught in very cold, snowy conditions can build an igloo or snow cave to shelter.
Babies should sleep at 16–20 °C (61–68 °F) and housebound people should be checked regularly to make sure the temperature of the home is at least 18 °C (64 °F).
Aggressiveness of treatment is matched to the degree of hypothermia. Treatment ranges from noninvasive, passive external warming to active external rewarming, to active core rewarming. In severe cases resuscitation begins with simultaneous removal from the cold environment and management of the airway, breathing, and circulation. Rapid rewarming is then commenced. Moving the person as little and as gently as possible is recommended as aggressive handling may increase risks of a dysrhythmia.
Rewarming can be done with a number of methods including passive external rewarming, active external rewarming, and active internal rewarming. Passive external rewarming involves the use of a person's own ability to generate heat by providing properly insulated dry clothing and moving to a warm environment. Passive external rewarming is recommended for those with mild hypothermia.
Active external rewarming involves applying warming devices externally, such as a heating blanket. These may function by warmed forced air (Bair Hugger is a commonly used device), chemical reactions, or electricity. In wilderness environments, hypothermia may be helped by placing hot water bottles in both armpits and in the groin. Active external rewarming is recommended for moderate hypothermia. Active core rewarming involves the use of intravenous warmed fluids, irrigation of body cavities with warmed fluids (the chest or abdomen), use of warm humidified inhaled air, or use of extracorporeal rewarming such as via a heart lung machine or extracorporeal membrane oxygenation (ECMO). Extracorporeal rewarming is the fastest method for those with severe hypothermia. When severe hypothermia has led to cardiac arrest, effective extracorporeal warming results in survival with normal mental function about 50% of the time. Chest irrigation is recommended if bypass or ECMO is not possible.
For people who are alert and able to swallow, drinking warm (not hot) sweetened liquids can help raise the temperature. General medical consensus advises against alcohol and caffeinated drinks. As most hypothermic people are moderately dehydrated due to cold-induced diuresis, warmed intravenous fluids to a temperature of 38–45 °C (100–113 °F) are often recommended.
It is usually recommended not to declare a person dead until their body is warmed to a near normal body temperature of greater than 32 °C (90 °F), since extreme hypothermia can suppress heart and brain function. This is summarized in the common saying "You're not dead until you're warm and dead." Exceptions include if there are obvious fatal injuries or the chest is frozen so that it cannot be compressed. If a person was buried in an avalanche for more than 35 minutes and is found with a mouth packed full of snow without a pulse, stopping early may also be reasonable. This is also the case if a person's blood potassium is greater than 12 mmol/L.
Those who are stiff with pupils that do not move may survive if treated aggressively. Survival with good function also occasionally occurs even after the need for hours of CPR. Children who have near-drowning accidents in water near 0 °C (32 °F) can occasionally be revived, even over an hour after losing consciousness. The cold water lowers the metabolism, allowing the brain to withstand a much longer period of hypoxia. While survival is possible, mortality from severe or profound hypothermia remains high despite optimal treatment. Studies estimate mortality at between 38% and 75%.
In those who have hypothermia due to another underlying health problem, when death occurs it is frequently from that underlying health problem.
Between 1995 and 2004 in the United States, an average of 1,560 cold-related emergency department visits occurred per year and in the years 1999 to 2004, an average of 647 people died per year due to hypothermia. Of deaths reported between 1999 and 2002 in the US, 49% of those affected were 65 years or older and two-thirds were male. Most deaths were not work related (63%) and 23% of affected people were at home. Hypothermia was most common during the autumn and winter months of October through March. In the United Kingdom, an estimated 300 deaths per year are due to hypothermia, whereas the annual incidence of hypothermia-related deaths in Canada is 8,000.
Hypothermia has played a major role in the success or failure of many military campaigns, from Hannibal's loss of nearly half his men in the Second Punic War (218 B.C.) to the near destruction of Napoleon's armies in Russia in 1812. Men wandered around confused by hypothermia, some lost consciousness and died, others shivered, later developed torpor, and tended to sleep. Others too weak to walk fell on their knees; some stayed that way for some time resisting death. The pulse of some was weak and hard to detect; others groaned; yet others had eyes open and wild with quiet delirium. Deaths from hypothermia in Russian regions continued through the first and second world wars, especially on the Eastern Front in battles such as the Battle of Moscow and the Battle of Stalingrad where German soldiers were not provided with winter clothing.
Civilian examples of deaths caused by hypothermia occurred during the sinkings of the RMS Titanic and RMS Lusitania, and more recently of the MS Estonia.
In 2024, at least six babies in Gaza died of hypothermia under the harsh rain and cold, which they had to endure in flimsy camps due to the bombing of their homes and forced displacement inflicted upon them by the IDF. Three of the babies died in the coastal zone of Al-Mawasi, which their families had been forced to evacuate to, given its designation as a "safe zone".
Various degrees of hypothermia may be deliberately induced in medicine for purposes of treatment of brain injury, or lowering metabolism so that total brain ischemia can be tolerated for a short time. Deep hypothermic circulatory arrest is a medical technique in which the brain is cooled as low as 10 °C, which allows the heart to be stopped and blood pressure to be lowered to zero, for the treatment of aneurysms and other circulatory problems that do not tolerate arterial pressure or blood flow. The time limit for this technique, as also for accidental arrest in ice water (which internal temperatures may drop to as low as 15 °C), is about one hour.
Hypothermia can happen in most mammals in cold weather and can be fatal. Baby mammals such as kittens are unable to regulate their body temperatures and have a risk of hypothermia if they are not kept warm by their mothers.
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Fears, J. Wayne (February 14, 2011). The Pocket Outdoor Survival Guide: The Ultimate Guide for Short-Term Survival. Simon and Schuster. ISBN 978-1-62636-680-0. 978-1-62636-680-0
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1870. ISBN 978-0-323-05472-0. 978-0-323-05472-0
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1870. ISBN 978-0-323-05472-0. 978-0-323-05472-0
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Robertson, David (2012). Primer on the autonomic nervous system (3rd ed.). Amsterdam: Elsevier/AP. p. 288. ISBN 9780123865250. Archived from the original on September 8, 2017. 9780123865250
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Bracker, Mark (2012). The 5-Minute Sports Medicine Consult (2 ed.). Lippincott Williams & Wilkins. p. 320. ISBN 9781451148121. Archived from the original on September 8, 2017. 9781451148121
"2-latek z Polski rekordzistą. Przeżył wychłodzenie poniżej 12 st. C." Dziennik Naukowy (in Polish). December 5, 2014. Retrieved December 17, 2022. https://dzienniknaukowy.pl/zdrowie/2-latek-z-polski-rekordzista-przezyl-wychlodzenie-ponizej-12-st-c
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1870. ISBN 978-0-323-05472-0. 978-0-323-05472-0
Axelrod YK, Diringer MN (May 2008). "Temperature management in acute neurologic disorders". Neurologic Clinics. 26 (2): 585–603, xi. doi:10.1016/j.ncl.2008.02.005. PMID 18514828. /wiki/Doi_(identifier)
Laupland KB (July 2009). "Fever in the critically ill medical patient". Critical Care Medicine. 37 (7 Suppl): S273-8. doi:10.1097/CCM.0b013e3181aa6117. PMID 19535958. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Marx J (2006). Rosen's emergency medicine: concepts and clinical practice. Mosby/Elsevier. p. 2239. ISBN 978-0-323-02845-5. 978-0-323-02845-5
Marx J (2006). Rosen's emergency medicine: concepts and clinical practice. Mosby/Elsevier. p. 2239. ISBN 978-0-323-02845-5. 978-0-323-02845-5
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
"CDC - NIOSH Workplace Safety and Health Topic - Cold Stress - Cold Related Illnesses". www.cdc.gov. June 6, 2018. Retrieved August 1, 2018. https://www.cdc.gov/niosh/topics/coldstress/coldrelatedillnesses.html
"Cold Stress". Center for Disease Control and Prevention. Archived from the original on August 11, 2012. https://www.cdc.gov/niosh/topics/coldstress/
Marx 2010 p.1862
"Cold Stress". Center for Disease Control and Prevention. Archived from the original on August 11, 2012. https://www.cdc.gov/niosh/topics/coldstress/
Karakitsos D, Karabinis A (September 2008). "Hypothermia therapy after traumatic brain injury in children". The New England Journal of Medicine. 359 (11): 1179–80. doi:10.1056/NEJMc081418. PMID 18788094. /wiki/Doi_(identifier)
Laupland KB (July 2009). "Fever in the critically ill medical patient". Critical Care Medicine. 37 (7 Suppl): S273-8. doi:10.1097/CCM.0b013e3181aa6117. PMID 19535958. /wiki/Doi_(identifier)
"Hypothermia". WebMD. Archived from the original on January 16, 2014. https://web.archive.org/web/20140116080023/http://www.webmd.com/a-to-z-guides/what-is-hypothermia
Hanania NA, Zimmerman JL (1999). "Accidental hypothermia". Critical Care Clinics. 15 (2): 235–49. doi:10.1016/s0749-0704(05)70052-x. PMID 10331126. /wiki/Doi_(identifier)
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
Marx 2010 p.1869
Altus P, Hickman JW (May 1981). "Accidental hypothermia: hypoglycemia or hyperglycemia". Western Journal of Medicine. 134 (5): 455–6. PMC 1272797. PMID 7257359. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1272797
Altus P, Hickman JW (May 1981). "Accidental hypothermia: hypoglycemia or hyperglycemia". Western Journal of Medicine. 134 (5): 455–6. PMC 1272797. PMID 7257359. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1272797
eMedicine Specialties > Emergency Medicine > Environmental >Hypothermia Archived 2016-03-05 at the Wayback Machine Author: Jamie Alison Edelstein, MD. Coauthors: James Li, MD; Mark A Silverberg, MD; Wyatt Decker, MD. Updated: October 29, 2009 http://emedicine.medscape.com/article/770542-overview
Petrone P, Asensio JA, Marini CP (October 2014). "Management of accidental hypothermia and cold injury". Current Problems in Surgery. 51 (10): 417–31. doi:10.1067/j.cpsurg.2014.07.004. PMID 25242454. /wiki/Doi_(identifier)
Marx 2010 p.1869
Petrone P, Asensio JA, Marini CP (October 2014). "Management of accidental hypothermia and cold injury". Current Problems in Surgery. 51 (10): 417–31. doi:10.1067/j.cpsurg.2014.07.004. PMID 25242454. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
New Scientist (2007). "The word: Paradoxical undressing – being-human". New Scientist. Archived from the original on February 9, 2008. Retrieved June 18, 2008. https://www.newscientist.com/channel/being-human/mg19426002.600-the-word-paradoxical-undressing.html
Turk, EE (June 2010). "Hypothermia". Forensic Science, Medicine, and Pathology. 6 (2): 106–15. doi:10.1007/s12024-010-9142-4. PMID 20151230. S2CID 265786920. /wiki/Doi_(identifier)
Ramsay, David; Michael J. Shkrum (2006). Forensic Pathology of Trauma (Forensic Science and Medicine). Totowa, NJ: Humana Press. p. 417. ISBN 1-58829-458-7. 1-58829-458-7
Ramsay, David; Michael J. Shkrum (2006). Forensic Pathology of Trauma (Forensic Science and Medicine). Totowa, NJ: Humana Press. p. 417. ISBN 1-58829-458-7. 1-58829-458-7
Rothschild MA, Schneider V (1995). "'Terminal burrowing behaviour'—a phenomenon of lethal hypothermia". International Journal of Legal Medicine. 107 (5): 250–6. doi:10.1007/BF01245483. PMID 7632602. S2CID 29253926. /wiki/Doi_(identifier)
Carter N, Green MA, Milroy CM, Clark JC (1995). "Letter to the editor: Terminal burrowing behaviour — a phenomenon of lethal hypothermia". International Journal of Legal Medicine. 108 (2). Berlin / Heidelberg: Springer: 116. doi:10.1007/BF01369918. PMID 8547158. S2CID 11047611. /wiki/Doi_(identifier)
Rothschild MA, Schneider V (1995). ""Terminal burrowing behaviour"--a phenomenon of lethal hypothermia". International Journal of Legal Medicine. 107 (5): 250–6. doi:10.1007/BF01245483. PMID 7632602. S2CID 29253926. /wiki/Doi_(identifier)
Lallanilla, Marc (December 2013). "Get Naked and Dig: The Bizarre Effects of Hypothermia". Live Science. Archived from the original on March 3, 2016. Retrieved December 14, 2022. https://web.archive.org/web/20160303223353/http://www.livescience.com/41730-hypothermia-terminal-burrowing-paradoxical-undressing.html
Rothschild MA, Schneider V (1995). "'Terminal burrowing behaviour'—a phenomenon of lethal hypothermia". International Journal of Legal Medicine. 107 (5): 250–6. doi:10.1007/BF01245483. PMID 7632602. S2CID 29253926. /wiki/Doi_(identifier)
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1870. ISBN 978-0-323-05472-0. 978-0-323-05472-0
Baumgartner EA, Belson M, Rubin C, Patel M (2008). "Hypothermia and other cold-related morbidity emergency department visits: United States, 1995-2004". Wilderness Environ Med. 19 (4): 233–7. doi:10.1580/07-WEME-OR-104.1. PMID 19099327. S2CID 27657065. /wiki/Doi_(identifier)
Centers for Disease Control Prevention (CDC) (March 2006). "Hypothermia-related deaths—United States, 1999–2002 and 2005". Morbidity and Mortality Weekly Report. 55 (10): 282–4. PMID 16543884. /wiki/PMID_(identifier)
Walls, Ron; Hockberger, Robert; Gausche-Hill, Marianne (March 9, 2017). Rosen's emergency medicine : concepts and clinical practice. Walls, Ron M.,, Hockberger, Robert S.,, Gausche-Hill, Marianne (Ninth ed.). Philadelphia. ISBN 9780323390163. OCLC 989157341.{{cite book}}: CS1 maint: location missing publisher (link) 9780323390163
James Li (October 21, 2021). Joe Alcock (ed.). "Hypothermia: Background, Pathophysiology, Etiology". Medscape. https://emedicine.medscape.com/article/770542-overview
"BMJ Best Practice". bestpractice.bmj.com. Retrieved November 15, 2018. https://bestpractice.bmj.com/topics/en-us/654/epidemiology
James Li (October 21, 2021). Joe Alcock (ed.). "Hypothermia: Background, Pathophysiology, Etiology". Medscape. https://emedicine.medscape.com/article/770542-overview
James Li (October 21, 2021). Joe Alcock (ed.). "Hypothermia: Background, Pathophysiology, Etiology". Medscape. https://emedicine.medscape.com/article/770542-overview
Walls, Ron; Hockberger, Robert; Gausche-Hill, Marianne (March 9, 2017). Rosen's emergency medicine : concepts and clinical practice. Walls, Ron M.,, Hockberger, Robert S.,, Gausche-Hill, Marianne (Ninth ed.). Philadelphia. ISBN 9780323390163. OCLC 989157341.{{cite book}}: CS1 maint: location missing publisher (link) 9780323390163
Mihic J, Koob G, Mayfield J, Harris A, Brunton L, Hilal-Dandan R, Knollmann B (2017). "Ethanol". 's: The Pharmacological Basis of Therapeutics (13 ed.). McGraw-Hill Education. ISBN 978-1259584732. 978-1259584732
Danzl D, Jameson L, Fauci A, Kasper D, Hauser S (2018). "Hypothermia and Peripheral Cold Injuries". Harrison's Principles of Internal Medicine (20th ed.). McGraw-Hill Education. ISBN 978-1259644030. 978-1259644030
Mihic J, Koob G, Mayfield J, Harris A, Brunton L, Hilal-Dandan R, Knollmann B (2017). "Ethanol". 's: The Pharmacological Basis of Therapeutics (13 ed.). McGraw-Hill Education. ISBN 978-1259584732. 978-1259584732
Danzl D, Jameson L, Fauci A, Kasper D, Hauser S (2018). "Hypothermia and Peripheral Cold Injuries". Harrison's Principles of Internal Medicine (20th ed.). McGraw-Hill Education. ISBN 978-1259644030. 978-1259644030
Mihic J, Koob G, Mayfield J, Harris A, Brunton L, Hilal-Dandan R, Knollmann B (2017). "Ethanol". 's: The Pharmacological Basis of Therapeutics (13 ed.). McGraw-Hill Education. ISBN 978-1259584732. 978-1259584732
Danzl D, Jameson L, Fauci A, Kasper D, Hauser S (2018). "Hypothermia and Peripheral Cold Injuries". Harrison's Principles of Internal Medicine (20th ed.). McGraw-Hill Education. ISBN 978-1259644030. 978-1259644030
Mihic J, Koob G, Mayfield J, Harris A, Brunton L, Hilal-Dandan R, Knollmann B (2017). "Ethanol". 's: The Pharmacological Basis of Therapeutics (13 ed.). McGraw-Hill Education. ISBN 978-1259584732. 978-1259584732
Walls, Ron; Hockberger, Robert; Gausche-Hill, Marianne (March 9, 2017). Rosen's emergency medicine : concepts and clinical practice. Walls, Ron M.,, Hockberger, Robert S.,, Gausche-Hill, Marianne (Ninth ed.). Philadelphia. ISBN 9780323390163. OCLC 989157341.{{cite book}}: CS1 maint: location missing publisher (link) 9780323390163
Sterba, JA (1990). Field Management of Accidental Hypothermia during Diving. US Navy Experimental Diving Unit Technical Report (Report). Navy Experimental Diving Unit Panama City Fla. Archived from the original on July 27, 2011. Retrieved June 11, 2008. https://web.archive.org/web/20110727224238/http://archive.rubicon-foundation.org/4248
Sterba, JA (1990). Field Management of Accidental Hypothermia during Diving. US Navy Experimental Diving Unit Technical Report (Report). Navy Experimental Diving Unit Panama City Fla. Archived from the original on July 27, 2011. Retrieved June 11, 2008. https://web.archive.org/web/20110727224238/http://archive.rubicon-foundation.org/4248
Cheung SS, Montie DL, White MD, Behm D (September 2003). "Changes in manual dexterity following short-term hand and forearm immersion in 10 degrees C water". Aviation, Space, and Environmental Medicine. 74 (9): 990–3. PMID 14503680. Archived from the original on June 29, 2011. Retrieved June 11, 2008. http://www.ingentaconnect.com/content/asma/asem/2003/00000074/00000009/art00013
Sterba, JA (1990). Field Management of Accidental Hypothermia during Diving. US Navy Experimental Diving Unit Technical Report (Report). Navy Experimental Diving Unit Panama City Fla. Archived from the original on July 27, 2011. Retrieved June 11, 2008. https://web.archive.org/web/20110727224238/http://archive.rubicon-foundation.org/4248
Sterba, JA (1990). Field Management of Accidental Hypothermia during Diving. US Navy Experimental Diving Unit Technical Report (Report). Navy Experimental Diving Unit Panama City Fla. Archived from the original on July 27, 2011. Retrieved June 11, 2008. https://web.archive.org/web/20110727224238/http://archive.rubicon-foundation.org/4248
"Hypothermia safety". United States Power Squadrons. January 23, 2007. Archived from the original on December 8, 2008. Retrieved February 19, 2008. https://web.archive.org/web/20081208180845/http://www.usps.org/national/ensign/uspscompass/compassarchive/compassv1n1/hypothermia.htm
Sinking of the RMS Titanic#CITEREFButler1998 /wiki/Sinking_of_the_RMS_Titanic#CITEREFButler1998
Vittone M (October 21, 2010). "The Truth About Cold Water". Survival. Mario Vittone. Archived from the original on January 14, 2017. Retrieved January 24, 2017. http://mariovittone.com/2010/10/the-truth-about-cold-water/
"Hypothermia safety". United States Power Squadrons. January 23, 2007. Archived from the original on December 8, 2008. Retrieved February 19, 2008. https://web.archive.org/web/20081208180845/http://www.usps.org/national/ensign/uspscompass/compassarchive/compassv1n1/hypothermia.htm
"Article Page 13". IJATT. https://journals.humankinetics.com/previewpdf/view/journals/ijatt/1/4/article-p13.xml
Hanania NA, Zimmerman JL (1999). "Accidental hypothermia". Critical Care Clinics. 15 (2): 235–49. doi:10.1016/s0749-0704(05)70052-x. PMID 10331126. /wiki/Doi_(identifier)
Nuckton TJ, Claman DM, Goldreich D, Wendt FC, Nuckton JG (October 2000). "Hypothermia and afterdrop following open water swimming: the Alcatraz/San Francisco Swim Study". American Journal of Emergency Medicine. 18 (6): 703–7. doi:10.1053/ajem.2000.16313. PMID 11043627. /wiki/Doi_(identifier)
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. pp. 1869–1870. ISBN 978-0-323-05472-0. 978-0-323-05472-0
Broman M, Källskog O (1995). "The effects of hypothermia on renal function and haemodynamics in the rat". Acta Physiologica Scandinavica. 153 (2): 179–184. doi:10.1111/j.1748-1716.1995.tb09849.x. PMID 7778458. /wiki/Doi_(identifier)
Broman M, Källskog O, Kopp UC, Wolgast M (1998). "Influence of the sympathetic nervous system on renal function during hypothermia". Acta Physiologica Scandinavica. 163 (3): 241–249. doi:10.1046/j.1365-201x.1998.00356.x. PMID 9715736. /wiki/Doi_(identifier)
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Hanania NA, Zimmerman JL (1999). "Accidental hypothermia". Critical Care Clinics. 15 (2): 235–49. doi:10.1016/s0749-0704(05)70052-x. PMID 10331126. /wiki/Doi_(identifier)
Marx 2010 p.1869
"Workplace Safety & Health Topics: Cold Stress". National Institute for Occupational Safety and Health. Archived from the original on March 14, 2014. Retrieved March 21, 2014. https://www.cdc.gov/niosh/topics/coldstress/
Sessler DI, Moayeri A, Støen R, Glosten B, Hynson J, McGuire J (1990). "Thermoregulatory vasoconstriction decreases cutaneous heat loss". Anesthesiology. 73 (4): 656–60. doi:10.1097/00000542-199010000-00011. PMID 2221434. https://doi.org/10.1097%2F00000542-199010000-00011
Sample, Ian (December 18, 2008). "Scientists debunk myth that most heat is lost through head | Science". The Guardian. London. Archived from the original on September 5, 2013. Retrieved June 23, 2010. https://www.theguardian.com/science/2008/dec/17/medicalresearch-humanbehaviour
Stothers JK (1981). "Head insulation and heat loss in the newborn". Archives of Disease in Childhood. 56 (7). Royal Coll Paediatrics: 530–534. doi:10.1136/adc.56.7.530. PMC 1627361. PMID 7271287. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1627361
Chaput de Saintonge DM, Cross KW, Shathorn MK, Lewis SR, Stothers JK (September 2, 1979). "Hats for the newborn infant". British Medical Journal. 2 (6190): 570–1. doi:10.1136/bmj.2.6190.570. PMC 1596505. PMID 387172. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1596505
Lang N, Bromiker R, Arad I (November 2004). "The effect of wool vs. cotton head covering and length of stay with the mother following delivery on infant temperature". International Journal of Nursing Studies. 41 (8): 843–846. doi:10.1016/j.ijnurstu.2004.03.010. PMID 15476757. /wiki/Doi_(identifier)
"Hypothermia - Symptoms and causes". Mayo Clinic. Archived from the original on January 12, 2014. https://web.archive.org/web/20140112115658/http://www.mayoclinic.org/diseases-conditions/hypothermia/basics/prevention/CON-20020453
How to build an Igloo, survive a blizzard, finish your mission on time Archived 2014-02-01 at the Wayback Machine This web page gives basic instructions for westerners. http://wildearth.org/blog/how-to-build-an-igloo-survive-a-blizzard-finish-your-mission-on-time
Cold Weather Survival, Shelkters Archived 2014-01-18 at the Wayback Machine This has instructions about building different types of shelter http://www.wilderness-survival.net/cold-7.php
United States Coast Guard. "Rescue and Survival Systems Manual" (PDF). United States Coast Guard. Retrieved January 31, 2017. https://www.uscg.mil/directives/cim/10000-10999/CIM_10470_10G.pdf
Lallanilla, Marc (December 2013). "Get Naked and Dig: The Bizarre Effects of Hypothermia". Live Science. Archived from the original on March 3, 2016. Retrieved December 14, 2022. https://web.archive.org/web/20160303223353/http://www.livescience.com/41730-hypothermia-terminal-burrowing-paradoxical-undressing.html
"Hypothermia - Symptoms and causes". Mayo Clinic. Archived from the original on January 12, 2014. https://web.archive.org/web/20140112115658/http://www.mayoclinic.org/diseases-conditions/hypothermia/basics/prevention/CON-20020453
"Hypothermia". nhs.uk. October 18, 2017. Archived from the original on January 12, 2014. https://web.archive.org/web/20140112115021/http://www.nhs.uk/Conditions/Hypothermia/Pages/Prevention.aspx
"Hypothermia (cont.)". Archived from the original on January 12, 2014. https://web.archive.org/web/20140112153020/http://www.onhealth.com/hypothermia/page5.htm
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Tintinalli J (2004). Emergency Medicine: A Comprehensive Study Guide, Sixth edition. McGraw-Hill Professional. p. 1181. ISBN 0-07-138875-3. 0-07-138875-3
"Hypothermia". nhs.uk. October 18, 2017. Retrieved November 17, 2018. https://www.nhs.uk/conditions/hypothermia/
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (November 2, 2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (November 2, 2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (November 2, 2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Auerbach PS, ed. (2007). Wilderness medicine (5th ed.). St. Louis, Mo.: Elsevier Mosby. pp. Chapter 5. ISBN 978-0-323-03228-5. 978-0-323-03228-5
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (November 2, 2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (November 2, 2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Tveita T (October 2000). "Rewarming from hypothermia. Newer aspects on the pathophysiology of rewarming shock". International Journal of Circumpolar Health. 59 (3–4): 260–6. PMID 11209678. /wiki/PMID_(identifier)
Kondratiev TV, Myhre ES, Simonsen O, Nymark TB, Tveita T (February 2006). "Cardiovascular effects of epinephrine during rewarming from hypothermia in an intact animal model". Journal of Applied Physiology. 100 (2): 457–64. doi:10.1152/japplphysiol.00356.2005. PMID 16210439. S2CID 748884. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Auerbach PS, ed. (2011). "Accidental Hypothermia". Wilderness medicine (6th ed.). Philadelphia, PA: Elsevier/Mosby. pp. Chapter 5. ISBN 978-1437716788. 978-1437716788
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
McCullough L, Arora S (December 2004). "Diagnosis and treatment of hypothermia". American Family Physician. 70 (12): 2325–32. PMID 15617296. /wiki/PMID_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, Jeejeebhoy FM, Gabrielli A (2010). "Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S829–61. doi:10.1161/CIRCULATIONAHA.110.971069. PMID 20956228. https://doi.org/10.1161%2FCIRCULATIONAHA.110.971069
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Iyer A, Rajkumar V, Sadasivan D, Bruce J, Gilfillan I (2007). "No one is dead until warm and dead". The Journal of Thoracic and Cardiovascular Surgery. 134 (4): 1042–3. doi:10.1016/j.jtcvs.2007.05.028. PMID 17903527. https://doi.org/10.1016%2Fj.jtcvs.2007.05.028
Foggle, John L. (February 2019). "Accidental Hypothermia: 'You're Not Dead Until You're Warm and Dead'". Rhode Island Medical Journal. 102 (1): 28–32. PMID 30709071. /wiki/PMID_(identifier)
ECC Committee, Subcommittees and Task Forces of the American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24 Suppl): IV–136. doi:10.1161/CIRCULATIONAHA.105.166550. PMID 16314375. Archived from the original on March 24, 2011. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-136
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Bolte RG, Black PG, Bowers RS, Thorne JK, Corneli HM (1988). "The use of extracorporeal rewarming in a child submerged for 66 minutes". Journal of the American Medical Association. 260 (3): 377–379. doi:10.1001/jama.260.3.377. PMID 3379747. /wiki/Journal_of_the_American_Medical_Association
Life after Death: How seven kids came back from the dead https://www.bbc.co.uk/news/av/stories-50630441/life-after-death-how-seven-kids-came-back-from-the-dead https://www.bbc.co.uk/news/av/stories-50630441/life-after-death-how-seven-kids-came-back-from-the-dead
Morita S, Seiji M, Inokuchi S, Sadaki I, Inoue S, Shigeaki I, Akieda K, Kazuki A, Umezawa K, Kazuo U, Nakagawa Y, Yoshihide N, Yamamoto I, Isotoshi Y (December 2008). "The efficacy of rewarming with a portable and percutaneous cardiopulmonary bypass system in accidental deep hypothermia patients with hemodynamic instability". The Journal of Trauma and Acute Care Surgery. 65 (6): 1391–5. doi:10.1097/TA.0b013e3181485490. PMID 19077632. /wiki/Doi_(identifier)
Vassal T, Benoit-Gonin B, Carrat F, Guidet B, Maury E, Offenstadt G (December 2001). "Severe accidental hypothermia treated in an ICU: prognosis and outcome". Chest. 120 (6): 1998–2003. doi:10.1378/chest.120.6.1998. PMID 11742934. S2CID 10672639. /wiki/Doi_(identifier)
Hanania NA, Zimmerman JL (1999). "Accidental hypothermia". Critical Care Clinics. 15 (2): 235–49. doi:10.1016/s0749-0704(05)70052-x. PMID 10331126. /wiki/Doi_(identifier)
Brown DJ, Brugger H, Boyd J, Paal P (November 2012). "Accidental hypothermia". The New England Journal of Medicine. 367 (20): 1930–8. doi:10.1056/NEJMra1114208. PMID 23150960. S2CID 205116341. /wiki/Doi_(identifier)
Baumgartner EA, Belson M, Rubin C, Patel M (2008). "Hypothermia and other cold-related morbidity emergency department visits: United States, 1995-2004". Wilderness Environ Med. 19 (4): 233–7. doi:10.1580/07-WEME-OR-104.1. PMID 19099327. S2CID 27657065. /wiki/Doi_(identifier)
"Hypothermia-Related Mortality – Montana, 1999–2004". Archived from the original on April 24, 2009. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5615a3.htm#tab
"BMJ Best Practice". bestpractice.bmj.com. Retrieved November 15, 2018. https://bestpractice.bmj.com/topics/en-us/654/epidemiology
"BMJ Best Practice". bestpractice.bmj.com. Retrieved November 15, 2018. https://bestpractice.bmj.com/topics/en-us/654/epidemiology
"BMJ Best Practice". bestpractice.bmj.com. Retrieved November 15, 2018. https://bestpractice.bmj.com/topics/en-us/654/epidemiology
"BMJ Best Practice". bestpractice.bmj.com. Retrieved November 15, 2018. https://bestpractice.bmj.com/topics/en-us/654/epidemiology
Guly, H (January 2011). "History of accidental hypothermia". Resuscitation. 82 (1): 122–5. doi:10.1016/j.resuscitation.2010.09.465. PMC 3060344. PMID 21036455. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060344
Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. p. 1868. ISBN 978-0-323-05472-0. 978-0-323-05472-0
"Findings: Titanic victims in 'cold shock'". May 24, 2002. Archived from the original on November 29, 2014. Retrieved November 22, 2014. http://www.timeshighereducation.co.uk/169325.article
John Updike (July 1, 2002). "Remember the Lusitania". The New Yorker. Archived from the original on November 29, 2014. Retrieved November 22, 2014. http://www.newyorker.com/magazine/2002/07/01/remember-the-lusitania
Soomer H, Ranta H, Penttilä A (2001). "Identification of victims from the M/S Estonia". International Journal of Legal Medicine. 114 (4–5): 259–262. doi:10.1007/s004140000180. PMID 11355406. S2CID 38587050. /wiki/Doi_(identifier)
Guly, H (January 2011). "History of accidental hypothermia". Resuscitation. 82 (1): 122–5. doi:10.1016/j.resuscitation.2010.09.465. PMC 3060344. PMID 21036455. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060344
Berger, RL (May 17, 1990). "Nazi science—the Dachau hypothermia experiments". The New England Journal of Medicine. 322 (20): 1435–40. doi:10.1056/NEJM199005173222006. PMID 2184357. https://doi.org/10.1056%2FNEJM199005173222006
"Cold Takes More Infant Lives in Gaza, Adding to the War's Civilian Toll". December 30, 2024. Archived from the original on December 30, 2024. Retrieved December 31, 2024. http://web.archive.org/web/20241230134715/https://www.nytimes.com/2024/12/30/world/middleeast/gaza-baby-deaths-cold.html
"Sixth baby dies from severe cold in Gaza as Israel raids hospitals". Al Jazeera. Retrieved December 31, 2024. https://www.aljazeera.com/news/2024/12/30/sixth-baby-freezes-to-death-in-gaza-as-israel-raids-hospitals
Conolly S, Arrowsmith JE, Klein AA (July 2010). "Deep hypothermic circulatory arrest". Continuing Education in Anaesthesia, Critical Care & Pain. 10 (5): 138–142. doi:10.1093/bjaceaccp/mkq024. Most patients tolerate 30 min of DHCA without significant neurological dysfunction, but when this is extended to longer than 40 min, there is a marked increase in the incidence of brain injury. Above 60 min, the majority of patients will suffer irreversible brain injury, although there are still a small number of patients who can tolerate this. https://doi.org/10.1093%2Fbjaceaccp%2Fmkq024