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Hypothermia handling — DIPIMC MCQ

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ModerateEnvironmental MedicineHypothermia handlingDIPIMCDipIMC

A 70-year-old is found collapsed outdoors in winter, conscious but confused and shivering, with a core temperature of 30 degrees Celsius. As you prepare to move him, which principle is most important to reduce the risk of precipitating cardiac arrest?

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

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Correct answer: D — Handle gently and keep him horizontal

The myocardium is irritable in moderate to severe hypothermia, and rough handling or sudden movement can precipitate ventricular fibrillation, so the patient is moved gently and kept horizontal while being insulated and rewarmed. Exertion such as walking, vigorous rubbing or a hot bath can cause cold peripheral blood to return to the core (afterdrop) or trigger arrhythmia. Alcohol worsens heat loss through vasodilatation. Pearl: remove wet clothing, insulate well, and rewarm gradually while avoiding unnecessary movement.

Reference: Resuscitation Council UK Guidelines 2025 (Special Circumstances); JRCALC Clinical Guidelines