It is recognized that some people die from hypothermia even though they are alive
and uninjured when rescued. The traditional explanation is that this is due to ventricular
fibrillation resulting from the afterdrop of core temperature. This hypothesis was
based on inadequate measurement and failure to consider the physiology of cold. It
should now be discarded. Most deaths after rescue occur through an imbalance between
the active vascular capacity and the circulating fluid volume i.e. relative hypovolemia
or fluid overload. The actual mechanism in any individual case depends both on the
history of the cooling and the method of rewarming used. Some deaths will however
occur due to continued cooling of the body or to ventricular fibrillation precipitated
by rough handling.
Cold - hypothermia - hypovolaemia - fluid overload - ventricular fibrillation
