Department of Emergency Medicine, University of Colorado, Anschutz Medical Campus, Mail Stop B-215, 12401 17th Avenue, Aurora, CO, 80045, USA; International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland. Electronic address: email@example.com.
Clinical staging of accidental hypothermia is used to guide out-of-hospital treatment and transport decisions. Most clinical systems utilize core temperature, by measurement or estimation, to stage hypothermia, despite the challenge of obtaining accurate field measurements. Recent studies have demonstrated that field estimation of core temperature is imprecise. We propose a revision of the original Swiss Staging system. The revised system uses the risk of cardiac arrest, instead of core temperature, to determine the staging level. Our revised system simplifies assessment by using the level of responsiveness, based on the AVPU scale, and by removing shivering as a stage-defining sign.