Which statement is true for severe hypothermia management?

• A. Do not attempt active rewarming in moderate/severe hypothermia
• B. Aggressive active external rewarming is recommended
• C. Rewarming should be attempted only with warmed IV fluids immediately
• D. Hypothermia is not life-threatening

Answer: (A)

In severe hypothermia, the way you rewarm matters because the heart and nervous system are exquisitely sensitive to temperature changes. Rapid or aggressive rewarming in the field can push cold blood from the periphery back into the core too quickly (afterdrop) and can provoke dangerous rhythms or hemodynamic instability. Because of that risk, the safest and most effective approach is to focus on gentle, controlled rewarming and rapid transport to a setting where definitive, monitored rewarming can occur. This means keeping the patient dry, insulated, and with a heat source applied to the center of the body, while avoiding forceful or prolonged active rewarming in the field. Warming should be aligned with hospital-based care, where warmed IV fluids, warmed oxygen, and other core-rewarming techniques can be used safely. The key idea is to rewarm gradually and under controlled conditions rather than applying aggressive measures in the field.