Recognising Hypothermia for Student Nurses
Learn how to recognise a low body temperature, assess associated physiological changes and understand when hypothermia may indicate significant illness or patient deterioration.
What is hypothermia?
Hypothermia describes an abnormally low core body temperature. A core temperature below 35°C is commonly used to define hypothermia, although measurement method, clinical context and patient condition must all be considered.
Low core temperature
A core body temperature below 35°C is commonly used as the definition of hypothermia.
Look for a fall
A steadily falling temperature can be important even before a severe degree of hypothermia develops.
Whole-patient assessment
Consciousness, pulse, breathing, blood pressure and skin findings help determine the significance of the temperature.
What should you assess?
Confirm the temperature
Use appropriate equipment and follow local procedures, especially where an unexpectedly low reading has been obtained.
Review the trend
Compare the reading with earlier measurements and establish whether temperature is stable, falling or beginning to recover.
Assess consciousness
Look for confusion, drowsiness, slowed responses or reduced responsiveness.
Assess circulation
Review pulse, blood pressure, skin, capillary refill and peripheral temperature.
Assess breathing
Check respiratory rate, work of breathing and oxygen saturation as part of the wider assessment.
Consider the cause
Think about environment, acute illness, infection, medication, exposure and other relevant clinical factors.
Measurement method matters
Peripheral temperature measurements may not always accurately reflect core temperature. Follow local guidance when confirming clinically important low readings.
What might hypothermia look like?
| Finding | What you may notice | Clinical significance |
|---|---|---|
| Shivering | The patient may visibly shake or report feeling intensely cold. | Shivering is a physiological attempt to generate heat and may occur earlier in hypothermia. |
| Cold skin | Peripheral skin feels unusually cold. | Peripheral vasoconstriction may accompany heat loss and reduced peripheral circulation. |
| Altered mental state | Confusion, unusual behaviour, drowsiness or slowed responses. | Neurological change may indicate more significant physiological disturbance. |
| Bradycardia | The pulse may become slower as hypothermia becomes more severe. | Heart-rate changes should be interpreted with circulation and overall stability. |
| Respiratory change | Breathing pattern or respiratory rate may alter. | Significant hypothermia can affect several physiological systems. |
| Poor coordination | The patient may become unsteady, weak or less coordinated. | Functional and neurological changes can increase risk and may indicate worsening hypothermia. |
Severe illness can produce a low temperature
Patients with significant infection or systemic deterioration do not always develop fever. A low temperature in an acutely unwell patient should not be falsely reassuring.
Who may be more vulnerable?
- Older adults, particularly those who are frail.
- People exposed to cold environments for prolonged periods.
- Patients with reduced mobility who cannot keep themselves warm.
- Patients with reduced consciousness.
- People who are wet or have experienced significant heat loss.
- Patients with severe infection or systemic illness.
- People affected by certain medications, substances or metabolic problems.
- Patients with inadequate clothing, heating or environmental protection.
Prevention matters
Basic nursing care can make an important difference. Consider warmth, dry clothing, blankets, dignity and environmental factors while following the patient's clinical plan and local procedures.
When low temperature becomes more concerning
Mental state changes
Confusion, drowsiness or reduced responsiveness significantly increase concern.
Pulse or BP change
Bradycardia, hypotension or poor perfusion may accompany more significant physiological disturbance.
Other observations worsen
Respiratory or other NEWS2 changes may indicate broader deterioration rather than isolated cold exposure.
Putting the observations together
Example
An older patient had a temperature of 36.4°C earlier in the day.
Their temperature is now 34.8°C. They are drowsier than before and respond more slowly when spoken to.
Their blood pressure has fallen and their peripheral skin feels cool.
The concern is not simply the temperature reading. It is the combined pattern of hypothermia, altered consciousness and circulatory deterioration.
As a student nurse, recognise the change, obtain accurate observations and escalate concerns promptly to the appropriate registered practitioner.
Hypothermia assessment errors to avoid
- Assuming the patient is simply cold. Consider acute illness and deterioration.
- Ignoring a falling trend. Temperature changes over time may be significant.
- Looking only at temperature. Assess consciousness, circulation and breathing.
- Assuming no fever means no infection. Severe infection can present with low temperature.
- Failing to confirm an unexpected low reading. Check technique and measurement method appropriately.
- Delaying escalation when the patient is deteriorating. Treat the whole clinical picture seriously.
Recognise → assess → communicate → escalate
Notice the temperature fall
Identify hypothermia or a meaningful decrease from the patient's previous temperature.
Look at the whole patient
Review consciousness, circulation, breathing, environment and associated physiological changes.
Report the pattern
Explain the temperature trend together with symptoms, observations and any deterioration clearly.
Recognising Tachypnoea for Student Nurses
Learn how to recognise an increased respiratory rate, assess breathing more effectively and understand why tachypnoea can be one of the earliest signs of patient deterioration.
Continue to Recognising Tachypnoea →