Hypothermia and cold injuries in children and young people

Accidental hypothermia and cold injuries are rare but consistent occurrences within health care (Brändström et al, 2014; Kieboom et al, 2015). In a letter to the BMJ (Cronin de Chavez at al, 2013) highlighted the importance of considering hypothermia as an indicator of the severity of illness in children and young people; furthermore, the World Health Organization (WHO) (1997) has been highlighting the importance of hypothermia in the care of infants for a quarter of a century.

According to Zafren et al (2014), accidental hypothermia is the unintentional reduction in core body temperature below 35.00C. This is higher in neonates, with WHO (1997) defining neonatal hypothermia as a drop below 36.40C. The hypothalamus and integumentary system are responsible for the regulation and maintenance of body temperature; peripheral stimuli send messages to the hypothalamus, which in turn reacts to regulate heat—for example, vasodilation and activation of the sweat glands, which cools the body, or vasoconstriction and shivering, which assist in warming the body (Colbert et al, 2012; Peate, 2017). Hypothermia may be categorised as mild with temperatures between 32.00C and 34.90C; moderate with temperatures between 28.00C and 31.90C or severe, with temperatures below 280C, but as these definitions may vary and each has a range, ensuring documentation of precise numeric value remains important (Brändström et al, 2014). It is important to note that standard clinical thermometers may not read below 34.00C, therefore specialist thermometers may be necessary in emergency care settings.