Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Hypothermia most often occurs because of prolonged exposure to cold weather. Inadequate clothing for conditions may not provide enough insulation for the body to prevent heat loss. Immersion in water hastens hypothermia, and just a few minutes in cold water may be fatal.
What are the risk factors for hypothermia?
There are numerous factors that increase the risk of hypothermia:
Age: The very young and very old may be less able to generate heat. The elderly with underlying medical conditions such ashypothyroidism or Parkinson's disease that limit the ability of the body to regulate temperature are less able to generate heat. Infants don't generate heat as efficiently, and with their relatively large head size compared to the body, they are at risk for increased heat loss by radiation.
Mental status: Impaired judgment and mental function can lead to cold exposure. Patients with Alzheimer's disease are prone to wander and become exposed to the elements.
Substance abuse: Alcohol and drug abuse increase the risk of hypothermia in two ways. First, impaired judgment can lead to cold exposure. Additionally, alcohol and similar drugs can dilate blood vessels near the skin (vasodilation) and decrease the efficiency of the shivering mechanism, both of which decrease the body's ability to compensate for cold exposure.
Medical conditions: Underlying medical conditions can also lead to accidental hypothermia.
Patients with hormonal abnormalities (thyroid, adrenal, pituitary), and those with peripheral neuropathy (due to diabetes or other conditions) or may be less able to feel the cold and generate a shivering response.
Patients with spinal cord injuries, similarly, may not be able to adequately shiver.
Patients who have suffered strokes or brain tumors may have impaired thermal regulation centers in the brain.
Overwhelming infection andsepsis may both present with a lowered temperature instead of fever. People with diabetes who have very low blood sugar can appear unconscious and very cold.
Medications: Some medications can increase the risk of hypothermia by limiting the shivering mechanism including some psychiatric medications.