Swiss Staging of Hypothermia

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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