The literature is full of extraordinary survival stories of patients with accidental hypothermia. These case reports and retrospective reviews have expanded our understanding of what the human body can endure. The sheer number of rewarming methods described in the literature provides the emergency clinician with seemingly countless options. Unfortunately, there is a paucity of randomized controlled trials comparing various treatments and rewarming techniques, likely due to the rarity of this condition. Ethical limitations preclude simulating severe accidental hypothermia in healthy individuals in the laboratory setting. Canine and porcine models offer some additional data, but clinical translatability is always a question. Because of the lack of quality clinical evidence, it is not possible to provide strong recommendations on management of patients with accidental hypothermia.
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