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

- 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. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6151a6.htm (access: 2018.09.10).

- National records of Scotland. Hypothermia Deaths. Main points. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-vents/deaths/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/annurev.ph.53.030191.000443, 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