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General cooling of the body
Last reviewed: 07.07.2025
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General cooling of the body is a violation of the thermal balance, accompanied by a decrease in body temperature below normal values. This is a condition of the body that occurs as a result of exposure to cold and a decrease in body temperature below 34 °C.
General cooling has three degrees of severity - mild, moderate and severe.
Symptoms of general cooling
General hypothermia of mild severity is characterized by a body temperature in the rectum of 35-32 °C. Consciousness is preserved or clouded, the skin is pale or cyanotic, some slowing of the pulse is characteristic in some patients to 60 per minute, normal or moderately elevated blood pressure. Patients complain of weakness, drowsiness, fatigue, dizziness, headache. Their speech is quiet and slow. They are inhibited, adynamic.
General cooling of moderate (stuporous) severity develops when the body temperature drops to 32-26 °C. This stage is characterized by pronounced drowsiness, depressed consciousness, speech impairment, and lack of facial expressions. The skin is cold, pale, sometimes with a cyanotic tint or marbled color. Bradycardia occurs (pulse 52-32 per minute of weak filling and tension), blood pressure is normal or slightly lowered, the number of respiratory cycles does not exceed 12 per minute, breathing is shallow.
General hypothermia of a severe (convulsive) degree occurs at a body temperature below 28-26 °C. Consciousness is completely absent, the skin is cold, pale, with a cyanotic tint. The muscles are tense, convulsive contraction of the masticatory muscles is possible, often with biting of the tongue. The upper limbs are bent at the elbow joints, it is not possible to straighten them in many patients. The lower limbs are half-bent, sometimes extended. The abdominal muscles are also tense. Breathing is shallow, often snoring, rare (up to 3-4 respiratory cycles per minute). The pulse is weak, palpable only in large arteries, rare (no more than 32-34 per minute). Blood pressure is reduced or not detectable. The pupils are constricted, their reaction to light is sluggish or completely absent. Involuntary urination is possible. When body temperature drops below 25-23 °C, the victim dies from cardiac arrest, cerebral or pulmonary edema.
This is the clinical picture of general cooling during hypothermia. After warming up, many patients develop a feeling of fatigue and headache. Catarrhal phenomena in the nasopharynx, pharynx, sometimes bronchitis, tracheobronchitis, pneumonia join in. Some patients develop hyperthermia, neuropsychiatric disorders (delirium, lethargy, hallucinations), and cardiovascular dysfunction (arrhythmia, tachycardia). The most severe complications of this period are cerebral edema, pulmonary edema, and acute renal failure.
Treatment of general cooling
Treatment of the victim with general cooling is aimed at the fastest possible warming and restoration of normal body temperature.
Non-drug treatment
The patient is placed in a warm bath with water temperature of 35 °C. Gradually the water is heated to 38-40 °C (not higher!) and maintained at this level until the patient is warmed up. The warming procedure takes from 30 minutes to 2 hours with mandatory constant monitoring of the victim's body temperature. Warming is carried out until the temperature in the rectum rises to 35 °C. During the procedure, the patient's body is massaged using soapy sponges or washcloths. The victim must be given hot tea or coffee to drink.
Drug treatment
Infusion of 40% glucose solution - 40-60 ml with ascorbic acid, heated to 35-40 °C, is performed. In order to accelerate warming and for desensitization, intravenous administration of 10% calcium chloride - 5-10 ml is advisable. To eliminate acidosis, a 5% sodium bicarbonate solution is administered - 200-300 ml. In case of hypotension, infusion of dextrans (polyglucin) in a dose of 400-800 ml, cardiovascular agents [lily of the valley herb glycoside (korglikon), inosine (riboxin), cocarboxylase, caffeine] are prescribed; analgesics and antihistamines, antiplatelet agents [pentoxifylline (trental), dipyridamole (curantil)], vitamins C, B, PP, anticoagulants [sodium heparin (heparin) 100-200 U/kg x day) are prescribed. In case of respiratory dysfunction, artificial ventilation is used. After bringing the patient out of the state of hypothermia, treatment is aimed at preventing possible complications (bronchitis, tracheobronchitis, pneumonia, nephritis). In the development of cerebral and pulmonary edema, corticosteroid hormones (hydrocortisone, prednisolone), osmotic diuretics [furosemide (lasix), mannitol] are used.
What is the forecast for the overall cooling?
General cooling has a favorable prognosis, patients return to work. In case of deep frostbite with damage to large segments of the extremities - persistent disability.