When a hypothermic patient arrives in the ED, the emergency clinician should complete a focused but thorough history including the duration and type of exposure, whether the patient was found indoors or outdoors, and any history of immersion or suspected hypoxic insults. If possible, obtain information on underlying medical conditions and current medications that may predispose the patient to hypothermia. Inquire about suspected trauma, alcohol or drug use, and potential ingestions or overdose. In a multicenter survey detailing 428 cases of accidental hypothermia in the United States, 44% of patients had a predisposing underlying illness, 18% had associated infection, 19% had associated trauma, and 6% had associated overdose.21
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