How should I manage a patient with mild hypothermia in the practice be

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Management of mild hypothermia in the practice setting before hospital referral:

Measure and document the patient's core temperature accurately, preferably using a site that provides a direct or reliable estimate of core temperature (e.g., tympanic, temporal, or rectal thermometers) to confirm hypothermia (core temperature below 36.0°C) .
Keep the patient comfortably warm by providing adequate insulation such as cotton sheets, blankets, or a duvet, and encourage the patient to wear warm clothing and cover exposed skin to conserve heat .
Initiate active warming measures if possible, such as using warmed blankets or forced-air warming devices if available, aiming to raise the core temperature to at least 36.0°C before considering transfer .
Monitor the patient’s temperature regularly during warming, at least every 30 minutes, to assess response and avoid overcooling or overheating .
Ensure the ambient environment is warm (at least 21°C) to prevent further heat loss .
Encourage oral warm fluids if the patient is conscious and able to swallow safely, to support rewarming and hydration .
Assess for any underlying causes or complications that may require urgent hospital referral, such as cardiovascular instability, altered mental status, or worsening hypothermia despite warming .
If the patient’s temperature remains below 36.0°C despite initial warming, or if there are signs of moderate or severe hypothermia or complications, arrange urgent hospital referral for advanced care .

How should I manage a patient with mild hypothermia in the practice before considering hospital referral?