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Severe hypothermia — DIPIMC MCQ

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HardEnvironmental MedicineSevere hypothermiaDIPIMCDipIMC

A hill walker is found after several hours in cold, wet conditions. Shivering has stopped, the GCS is falling, the measured core temperature is 28 degrees Celsius, the heart rate is slow and J waves are visible on the monitor.

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Correct answer: D — Handle the patient gently, insulate, keep horizontal and use active core rewarming while avoiding rough movement

In severe hypothermia the patient is handled gently and kept horizontal because the cold myocardium is highly irritable and rough movement can precipitate ventricular fibrillation; rewarming is directed at the core, and peripheral active rewarming is avoided to prevent afterdrop. Rapid limb rewarming or a hot bath (A and D) causes peripheral vasodilation and a fall in core temperature. Gentle handling, insulation and core rewarming are the cornerstones.

Reference: Resuscitation Council UK 2025 (hypothermia)