What are the key clinical signs and symptoms to recognize hypothermia in a primary care setting?

Key clinical signs and symptoms to recognize hypothermia in a primary care setting include:

• Core body temperature below 35°C, often measured with a low-reading thermometer.
• Shivering, which is an early and common sign as the body attempts to generate heat.
• Cold, pale, or cyanotic skin due to peripheral vasoconstriction.
• Slurred speech or mumbling, indicating central nervous system depression.
• Slow, shallow breathing and bradycardia (slow heart rate), reflecting reduced metabolic activity.
• Impaired coordination, clumsiness, or stumbling, which may progress to confusion or drowsiness.
• Fatigue or lethargy, with possible loss of consciousness in severe cases.
• In severe hypothermia, paradoxical undressing or paradoxical confusion may be observed.

Recognition in primary care relies on clinical suspicion in patients exposed to cold environments or with risk factors such as older age, alcohol use, or chronic illness. Measurement of temperature is essential but may be challenging; thus, clinical signs are critical for early identification and prompt management ¹ (Paal et al., 2022).