A case report of hypothermia in the wilderness

Accidental hypothermia due to environmental exposure is a common condition encountered in the wilderness setting. I report a case of hypothermia that occurred in New Hampshire to a 42-year-old, poorly prepared mountaineer. He presented with ataxia, impaired judgment, oliguria, and slight confusion, suggestive of mild to moderate hypothermia. He was treated in the field using passive and active external rewarming methods and 1 active internal method. The signs, symptoms, and progression of hypothermia are reviewed, and treatment options are discussed, with an emphasis on management of hypothermia in the wilderness setting. Additionally, more complicated treatment modalities are canvassed, as these are of use to rescue teams and expeditions. Current controversies regarding the treatment of hypothermia, resuscitation efforts, and potential complications are also mentioned.