Unifying Concepts

Swiss Staging of Hypothermia

Hypothermia may be determined clinically on the basis of vital signs with the use of the Swiss staging system.

Staging of hypothermia

Stage Clinical Symptoms Core temperature
Hypothermia I patient alert, shivering about 35-32ºC [95-89,6º F]
Hypothermia II patient drowsy, non-shivering about 32-28ºC [89,6-82,4º F]
Hypothermia III patient unconscious about 28-24ºC [82,4-75,2º F]
Hypothermia IV patient not breathing < 24º C [< 75,2º F]

Measurement of body core temperature is helpful, but not mandatory. The risk of cardiac arrest increases as the core temperature drops below 32 °C, and increases substantially if the temperature is less than 28 °C. To convert values for temperature to degrees Fahrenheit, multiply by 9/5 and add 32.



  1. Durrer B, Brugger H, Syme D; International Commission for Mountain Emergency Medicine. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Alt Med Biol. 2003 Spring;4(1):99-103. [Medline]
  2. Brown D, Brugger H, Boyd J, Paal P. Accidental Hypothermia. N Engl J Med 2012;367:1930-1938. [Medline]


Created Nov 15, 2012

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