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Accidental hypothermia — MCCQE Part 1 MCQ

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HardAltered Level of ConsciousnessAccidental hypothermiaMCCQE Part 1

A 44-year-old homeless man is found outdoors in winter. Core temperature is 29°C, pulse is 42/min, BP is 86/50 mmHg, and he is confused. ECG shows Osborn waves. What is the most appropriate next step in management?

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Correct answer: C — Handle gently and initiate active rewarming with cardiac monitoring

Moderate hypothermia requires gentle handling, active rewarming, and continuous cardiac monitoring because rough movement can precipitate arrhythmias. Bradycardia can be physiologic in hypothermia and does not imply death. Defibrillation is reserved for shockable rhythms. Exercise or hot showers are unsafe in a confused unstable patient.

Reference: Wilderness Medical Society; Canadian emergency medicine hypothermia resources