Abstract
Hypothermia confronts clinicians with an array of unfamiliar challenges and decisions. Confusion has been increased by conflicting recommendations in several areas of controversy. After a focused review, this report seeks to summarize current understanding of rewarming and other therapies in hypothermia, concentrating on areas of apparent controversy. Recommendations are made regarding appropriate rewarming strategies, considering both theoretical and actual effectiveness. Logistic problems that hobble rewarming efforts are discussed, and practical solutions are suggested. The risks and benefits of treatments, including external rewarming, cardiac compressions, orotracheal intubation, and administration of room-temperature intravenous fluid, are considered. Finally, the adage, “No one is dead until they're warm and dead.” is revisited.
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