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Summary of categorisations and rewarming strategies.
Essentially, you only move to active core rewarming if you have haemodynamic instability not responding to conservative techniques.
Bear in mind that in the hypothermic state you don’t need a pulse, blood pressure or conscious state of a normothermic patient. Depending on how cold you are this is to be expected. Re-warming is the aim and you should expect an improvement in these parameters.
Clearly, as signs of life fade away, more and more aggressive intervention is required.
The coldest accidental hypothermic patient resuscitated started at 16.5 degrees!