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Accidental hypothermia — MCCQE Part 1 MCQ

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ModerateHypothermiaAccidental hypothermiaMCCQE Part 1

74-year-old man presents with found outdoors in winter. Core temperature is 29°C and pulse is slow but present. Which of the following is the most appropriate next step?

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Correct answer: A — Handle gently, rewarm actively and monitor for arrhythmia

Handle gently, rewarm actively and monitor for arrhythmia is best because moderate hypothermia requires careful rewarming and cardiac monitoring. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Rough handling can precipitate ventricular fibrillation.

Reference: Canadian emergency medicine guidance