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Hypothermia cardiac arrest — ABEM Board MCQ

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HardEnvironmental emergenciesHypothermia cardiac arrestABEM Board

A 58-year-old man is pulled from an icy river and arrives pulseless. Triage acuity is ESI 1; core temperature is 26 C. Monitor shows ventricular fibrillation. CPR is ongoing, and he has no obvious lethal trauma. Which of the following is the most important immediate intervention?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Continue CPR and arrange active internal rewarming with extracorporeal support if available

Hypothermic cardiac arrest requires prolonged resuscitation and active rewarming; survival with good outcome is possible after rewarming.

Reference: Wilderness Medical Society hypothermia guideline; AHA ACLS 2025 special circumstances