Hypothermia natural history, complications and prognosis

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Complications

Paradoxical Undressing

20% to 50% of hypothermal deaths are associated with, or even caused by, a phenomenon known as paradoxical undressing. When this occurs, the hypothermic victim becomes seriously confused and starts discarding clothing they have been wearing, a counter-productive action which increases the rate of temperature loss. There have been several published case studies of victims throwing off their clothes before help reached them.

Rescuers who are trained in mountain survival techniques have been taught to expect this effect. However, the phenomenon still regularly leads police to incorrectly assume that urban victims of hypothermia have been subjected to a sexual assault.

One explanation for the effect is a cold-inducted malfunction of the hypothalamus, the part of the brain that regulates body temperature. Another explanation is that the muscles contracting peripheral blood vessels become exhausted and relax, leading to a sudden surge of blood (and heat) to the extremities, fooling the victim into feeling warm.

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