These defects are exacerbated by phenothiazines and correlate with hypothermia risk. Besides inadequate environmental heating in the winter, contributory factors include diminished perception of cold and poor heat conservation mechanisms. Accidental hypothermia develops over many hours to several days. Symptoms and Signs Patients are at high risk for death and for a clinical syndrome mimicking stroke or metabolic derangement. Hallucinations, combativeness, and resistance to aid may occur.
Hypothermic patients have hands, feet, and abdomen that are cold to the touch.
Shivering is strikingly absent, respirations are shallow and infrequent, slow pulse and low BP with atrial and ventricular arrhythmias are common, and the face may be puffy and pink. More commonly, ECG shows baseline oscillation produced by a fine rapid muscle tremor that is often mistaken for electrical interference or voluntary motion. This fine tremor is usually not grossly apparent. It is probably the elderly hypothermic patient's physiologic equivalent of shivering. Neurologic signs of tremor, ataxia, pathologic and depressed reflexes, coma, seizures, and a marked increase in muscle tone may occur.