Once a temperature of 30 °C (86 °F) has been reached, normal ACLS protocols should be followed. Prognosis
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. 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 persons 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.
Epidemiology
Between 1995 and 2004 in the United States, an average of 1560 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 8000. History
Hypothermia has played a major role in the success or failure of many military campaigns, from Hannibals loss of nearly half his men in the Second Punic War (218 B.C.) to the near destruction of Napoleons 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.