Sudden cardiac arrest accompanied by severe accidental hypothermia - modifications of the standard cardiopulmonary resuscitation procedure

Rafał Czyż, Marcin Leśkiewicz, Patrycja Czyż


Severe accidental hypothermia is associated with a high mortality rate. This is related to the fact that assessment and treatment may be difficult: the severity of determining the presence of pulse and breathing, the significant sensitivity of the patient to a change in body position, difficulty in the instrumental protection of airways, ease of ventricular fibrillation occurrence and many other risks. A well-prepared medical team, coordinated actions based on current medical guidelines and recommendations, give a chance to save patients even after a few hours of cardiopulmonary resuscitation. Despite the availability of advanced devices for heating and supporting cardiovascular function in patients with cardiac arrest with coexisting hypothermia, basic activities such as isolation and protection against heat loss are critical important rescue tasks necessary for effective treatment of the patient.
In connection with the above, this article summarizes current information about sudden cardiac arrest with coexisting hypothermia. The following aspects were discussed: definition, epidemiology, diagnosis and assessment of hypothermia severity and modifications of standard resuscitation algorithm in the case of coexisting hypothermia.


accidental hypothermia, body temperature, core temperature, rewarming, cardiopulmonary resuscitation, CPR in special circumstances

Full Text:



- Truhlář A, Deakin C.D, Soar J. et. al.: European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation. 2015; 95: 148-201.

DOI: 10.1016/j.resuscitation.2015.07.017, indexed in Pubmed: 26477412.

- Guly H.: History of accidental hypothermia. Resuscitation. 2011; 82 (1): 122-5.

DOI: 10.1016/j.resuscitation.2010.09.465, indexed in Pubmed: 21036455.

- Centers for Disease Control and Prevention. QuickStats: Number of Hypothermia - Related Deaths, by Sex - National Vital Statistics System, United States, 1999–2011. (access: 2018.09.10).

- National records of Scotland. Hypothermia Deaths. Main points. (access: 2018.09.10).

- Kosiński S, Darocha T, Gałązkowski R, Drwiła R. Accidentalhypothermia in Poland -estimation of prevalence, diagnostic methods and treatment. Scand J Trauma Resusc Emerg Med, 2015; 23: 13.

DOI: 10.1186/s13049-014-0086-7, indexed in Pubmed: 25655922.

- Brown D.J, Brugger H, Boyd J, Paal P.: Accidental hypothermia. N Engl J Med. 2012; 367: 1930-1938.

DOI: 10.1056/NEJMra1114208, indexed in Pubmed: 23150960.

- Durrer B, Brugger H, Syme D.: The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Alt Med Biol. 2003; 4 (1): 99-103.

DOI: 10.1089/152702903321489031, indexed in Pubmed: 12713717.

- Pasquier M, Zurron N, Weith B, et. al.: Deep accidental hypothermia with core temperature below 24°c presenting with vital signs. High Alt Med Biol. 2014; 15 (1): 58-63.

DOI: 10.1089/ham.2013.1085, indexed in Pubmed: 24527793.

- Paal P, Gordon L, Strapazzon G, et. al.: Accidental hypothermia–an update: The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scand J Trauma Resusc Emerg Med. 2016; 24: 111.

DOI: 10.1186/s13049-016-0303-7, indexed in Pubmed: 27633781.

- Wood S.C.: Interactions between hypoxia and hypothermia. Annu Rev Physiol. 1991; 53: 71-85.

DOI: 10.1146/, indexed in Pubmed: 2042977.

- Lexow K.: Severe accidental hypothermia: survival after 6 hours 30 minutes of cardiopulmonary resuscitation. Arctic Med Res. 1991; 50, 6: 112-4.

Indexed in Pubmed: 1811563.

- Paal P, Milani M, Brown D, et. al.: Termination of cardiopulmonary resuscitation in mountain rescue. High Alt Med Biol. 2012; 13 (3): 200-8.

DOI: 10.1089/ham.2011.1096, indexed in Pubmed: 2994520.

- Handrigan M.T, Wright R.O, Becker B.M. et. al.: Factors and methodology in achieving ideal delivery temperatures for intravenous and lavage fluid in hypothermia. Am J Emerg Med. 1997; 15 (4): 350-3.

DOI: 10.1016/S0735-6757(97)90122-4, indexed in Pubmed: 9217522



  • There are currently no refbacks.

Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:

Journal Language(s): English 

PBN Poland



Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2 Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase


Universal Impact Factor 1.78 for year 2012. (

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski