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 if available ¹.
• Shivering, which is an early and common sign as the body attempts to generate heat ¹.
• Cold, pale, and sometimes cyanotic skin due to peripheral vasoconstriction ¹.
• Slurred speech, slow or shallow breathing, and impaired coordination or clumsiness indicating central nervous system depression (Paal et al., 2022).
• Confusion, lethargy, or decreased level of consciousness, which may progress to coma in severe cases ¹; (Paal et al., 2022).
• Bradycardia and weak pulse reflecting cardiovascular depression ¹; (Paal et al., 2022).
• Reduced reflexes and muscle rigidity can also be present, complicating neurological assessment (Paal et al., 2022).
• In severe hypothermia, paradoxical undressing or paradoxical confusion may be observed, although this is more common in accidental hypothermia cases outside clinical settings (Paal et al., 2022).

In summary, primary care clinicians should suspect hypothermia in patients presenting with a history of cold exposure and these characteristic signs, especially when core temperature measurement confirms hypothermia. Early recognition is critical to initiate appropriate management and referral ¹; (Paal et al., 2022).