title: Deep accidental hypothermia with core temperature below 24°c presenting with vital signs.
abstract: BACKGROUND
  According to the Swiss hypothermia clinical staging, patients with stage III are unconscious with preserved vital signs, with core temperature usually between 24° and 28°C. With stage IV, vital signs are absent with core temperature <24°C.
  
  
  OBJECTIVE
  To describe a patient presenting with HT stage III with vital signs but a core temperature of <24°C, and to search for similar patients in the medical literature.
  
  
  METHODS
  MEDLINE was used to search for cases of deep accidental hypothermia (<24°C) and preserved vital signs.
  
  
  RESULTS
  We found 22 cases in addition to our case (n=23). Median age was 44 years (IQR 36; range 4-83) and median core temperature 22°C (IQR 1.7; 17-23.8). Vital signs were often minimal. Seven patients developed ventricular fibrillation (VF). Twenty patients survived with excellent neurological outcome.
  
  
  CONCLUSIONS
  Vital signs can be present in hypothermic patients with core temperature <24°C. In deeply hypothermic patients, a careful check and prolonged check of vital functions should be made, as vital signs may be minimal. The clinical Swiss staging remains valuable in the prehospital evaluation of hypothermic patients; its correlation with core temperature should be better defined.
authors: 1 Emergency Service, University Hospital Centre , Lausanne, Switzerland .
authors: Mathieu
authors: M
authors: Pasquier
authors: Noemi
authors: N
authors: Zurron
authors: Barbara
authors: B
authors: Weith
authors: Pierre
authors: P
authors: Turini
authors: Fabrice
authors: F
authors: Dami
authors: Pierre-Nicolas
authors: PN
authors: Carron
authors: Peter
authors: P
authors: Paal
mesh_terms: D000435:Alcoholic Intoxication / Q000150:complications; D001794:Blood Pressure; D001831:Body Temperature; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017694:Rewarming
chemical_list: D010100:Oxygen