# Adult hypothermia

Warm, handle the slow pulse deliberately, and follow the hypothermic-arrest pathway when indicated.

Population: Adult / adolescent. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: See the linked OCEMS source for revision and implementation dates..
Canonical page: https://www.ocmedic.com/guides/hypothermia/
Official source: [SO-E-025 — Thermal](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12029.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Key cautions & base contact

- Use the longer 30–45 second pulse assessment specified for apparent hypothermic arrest.
- Do not merge ordinary bradycardia treatment into the source’s hypothermic-with-a-pulse pathway.

## Source documents

- [SO-E-025 — Thermal](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12029.pdf)

## Patient with a pulse

- Remove wet clothing, cover to conserve heat, and initiate available active warming. Monitor and document the rhythm.
- Expect a slow heart rate and weak pulse. The thermal order directs against trying to reverse hypothermic bradycardia in the field.

## Apparent arrest

- When not obviously dead, assess for a pulse for 30–45 seconds before initiating CPR. If no pulse is detected, follow the adult cardiac-arrest standing order.
- Assist ventilation with BVM without hyperventilation. Continue warming and limit unnecessary interruptions in resuscitation.

## Contact and transport

- Contact base when further stabilization orders are needed. The hypothermia pathway directs against field pronouncement.
- Provide transport to the nearest ERC, with ALS escort for the apparent-arrest branch. Continue monitoring for rhythm and perfusion changes.

## Handoff

- Report environmental exposure, wet clothing, initial and serial pulse findings, warming measures, arrest/ROSC times if applicable, and all resuscitation treatment.
- Keep the thermal diagnosis visible during handoff so the slow rate is not mistaken for an unrelated routine bradycardia presentation.