Ice & Cold

Recognize the signs of hypothermia in a companion

You recognize hypothermia by watching for changes in your companion’s shivering, hand control, speech, judgment, and responsiveness during cold exposure. Check whenever someone becomes unusually quiet, clumsy, confused, or unable to keep pace, including in wet, windy weather above freezing. The temperature bands below are approximate guides, not measurements you can infer from symptoms; act on the person’s condition rather than waiting for a thermometer reading. Confusion, loss of coordination, or reduced responsiveness means you should treat the situation as a medical emergency.

Ice & Cold 5 min practice Beginner Use this skill anywhere cold, wind, wet clothing, or contact with cold ground can drain body heat. Pay particular attention after immersion, during exposed stops, and when exhaustion prevents your companion from keeping warm.

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Topic summary

Key takeaways

You notice and describe changes in speech, hand function, judgment, and responsiveness rather than checking shivering alone.
You distinguish an alert, coordinated person who can swallow safely from someone who needs emergency assistance.
You promptly shelter and insulate your companion, including beneath their body.
You handle an impaired companion gently, arrange assisted evacuation, and continue monitoring breathing and responsiveness.
Avoid: Assuming that stopped shivering means improvement is dangerous; reassess speech, coordination, and responsiveness and treat deterioration as an emergency.
Avoid: Relying on a forehead or ordinary household thermometer can falsely reassure you; base field decisions on symptoms and the exposure history.

Intended uses

Ice & Cold skill (Beginner, ~5 min practice)
Requires: Sleeping bag or insulated emergency wrap, Sleeping pad, Tarp or other windproof shelter, Communication device for emergency assistance, Wrapped warm packs or warm-water bottles

Climate suitability

Use this skill anywhere cold, wind, wet clothing, or contact with cold ground can drain body heat. Pay particular attention after immersion, during exposed stops, and when exhaustion prevents your companion from keeping warm.

Safety: Do not leave a confused or drowsy companion alone, and request rescue early rather than making them walk out. If they are unresponsive and not breathing normally, follow emergency-dispatch instructions; breathing can be extremely slow in severe hypothermia, so check carefully for up to one minute before starting CPR and use an AED if available.

Required tools

Sleeping bag or insulated emergency wrap
Sleeping pad
Tarp or other windproof shelter
Communication device for emergency assistance
Wrapped warm packs or warm-water bottles

Required materials

Dry replacement clothing
Quick-energy food
Warm, sweet, nonalcoholic drink

Step-by-step

Mild (95–90°F core): shivering, clumsy hands, slow decision-making, sometimes 'the umbles' — stumbles, mumbles, fumbles, grumbles.
Why: 1. Mild (95–90°F core): shivering, clumsy hands, slow decision-making, sometimes 'the umbles' — stumbles, mumbles, fumbles, grumbles. Recognizing these early changes lets you stop heat loss before your companion becomes unable to care for themselves; the temperature range is only an approximate guide.
Moderate (90–82°F core): shivering may stop, confusion increases, coordination collapses, speech slurs.
Why: 2. Moderate (90–82°F core): shivering may stop, confusion increases, coordination collapses, speech slurs. These changes indicate a dangerous decline in brain and muscle function, so do not mistake less shivering for recovery or wait for every sign to appear.
Severe (below 82°F core): no shivering, unresponsive or unconscious, weak pulse, very slow breathing.
Why: 3. Severe (below 82°F core): no shivering, unresponsive or unconscious, weak pulse, very slow breathing. Vital signs may be difficult to detect, so do not assume an apparently lifeless person is dead, and arrange immediate emergency assistance.
For mild: stop, insulate, add calories and warm sweet drinks, get moving once rewarmed.
Why: 4. For mild: stop, insulate, add calories and warm sweet drinks, get moving once rewarmed. Shelter and insulation limit further cooling, while food and drink support heat production only if your companion is fully alert and swallowing normally; resume gentle movement only after alertness and coordination return and conditions permit.
For moderate or severe: treat as a medical emergency, handle very gently, insulate against further heat loss, and evacuate. Rough handling can trigger cardiac arrest.
Why: 5. For moderate or severe: treat as a medical emergency, handle very gently, insulate against further heat loss, and evacuate. Rough handling can trigger cardiac arrest, so keep your companion horizontal where practical, minimize unnecessary movement, and arrange an assisted evacuation rather than having them walk.

Common mistakes

Assuming that stopped shivering means improvement is dangerous; reassess speech, coordination, and responsiveness and treat deterioration as an emergency.
Relying on a forehead or ordinary household thermometer can falsely reassure you; base field decisions on symptoms and the exposure history.
Giving alcohol or feeding someone who is confused or drowsy creates additional risks; offer food and warm sweet drinks only to someone fully alert and able to swallow normally.
Rubbing limbs or putting a severely hypothermic person in hot water is unsafe; handle gently, insulate, and avoid aggressive limb warming.
Assuming severe hypothermia requires passive rewarming only can withhold useful heat; while awaiting rescue, add safely wrapped external warmth to the chest, upper back, and armpits when available, avoiding direct skin contact and checking for burns.

Troubleshooting

If you cannot tell whether hypothermia is mild or moderate, then treat it as the more serious condition and request emergency assistance.
If clothing is wet, then first create shelter from wind and precipitation, gently replace wet clothing with dry layers when practical, and insulate underneath as well as around your companion.
If a mildly affected companion does not clearly improve with shelter, insulation, and appropriate food and drink, then seek evacuation rather than continuing the trip.
If your companion insists they are fine but cannot answer simple questions clearly or manage ordinary hand tasks, then rely on the observed impairment and stop further exposure.

Field practice drill

In a sheltered, comfortable place, spend about five minutes taking turns describing simulated symptoms without actually getting cold. Ask your companion where they are and what the group should do next, listen to their speech, and have them operate a zipper while seated. Name the suspected severity, explain whether food and drink are safe, and demonstrate how you would place insulation beneath and around them and call for help. Repeat with a different symptom pattern.

Indicators of success

You notice and describe changes in speech, hand function, judgment, and responsiveness rather than checking shivering alone.
You distinguish an alert, coordinated person who can swallow safely from someone who needs emergency assistance.
You promptly shelter and insulate your companion, including beneath their body.
You handle an impaired companion gently, arrange assisted evacuation, and continue monitoring breathing and responsiveness.

Related outdoor skills

Educational reference only. Wilderness conditions change fast — practice in low-stakes settings, take a certified wilderness first-aid course, and confirm regional regulations before you rely on any of these skills in the field.