Raising the temperature would only inflict more damage through re-initiating deleterious biochemical activity (acute ischemia / immune-inflammatory cascade leading to MODS etc) which would indeed be irreversible.

I think a patient can be cold and dead. If there chest is frozen … frozen like a piece of frozen meat in the freezer they are dead. If they have ice in their upper airway they are dead.

Jeremy the presence or absence of shivering and the patient’s level of consciousness are very useful for determining if the patient is in mild or severe hypothermia. Additionally an oral temp is going to be difficult to obtain in a uncontrollably shivering patient or a patient that is V P or U on the AVPU scale. With the exception of cardiac drug administration all of the treatments Steve has described are independent of knowing the patient’s temp.

Awesome post as always. In my system we don’t use thermometers. Would you say this is a detriment in anyway? Or better because then if forces us to focus on the person and not on the thermometer.

Also, local protocol says we should passively rewarm a patient unless transport to the hospital is greater than 30 minutes. Any ideas on what we could do to best help them other than taking off wet clothing and covering them with a blanket?