The International Federation of Red Cross and Red Crescent Societies (IFRC) says anyone with suspected hypothermia needs immediate access to emergency medical care. Its 2025 guidelines define hypothermia as a core body temperature below 35°C and direct first-aid providers to stop further cooling, remove wet clothes and warm the person gradually.

Cold exposure is not limited to snow or mountains. The IFRC says hypothermia can develop indoors where heating is inadequate and can occur in relatively warm conditions when a person is wet and inactive.

Confusion or absent shivering requires urgent action

Shivering, poor coordination, slow movement, mild confusion, pale or ashen skin, and bluish lips, ears, fingers or toes can appear as the body cools. Worsening signs include disorientation, incoherent behavior, loss of memory, inability to walk or use the hands, and shivering that stops.

Call the local emergency service immediately when hypothermia is suspected. Stay with the person and monitor responsiveness and breathing while following the dispatcher's instructions. Do not interpret the end of shivering as recovery.

If the person becomes unresponsive and is not breathing normally, summon emergency help and start cardiopulmonary resuscitation (CPR). The IFRC advises continuing CPR in hypothermia because a response may remain possible even when defibrillation is unavailable. Use an automated external defibrillator if one is available and follow its prompts.

A person is wrapped in dry blankets after cold exposure (illustrative image)

Stop heat loss before attempting to add heat

Move the person away from wind, rain and cold surfaces into shelter if this can be done safely. Remove wet clothing gently, dry the person and replace it with dry garments. Cover the head and body with dry blankets, a sleeping bag or insulating clothing, and place insulation between the person and the ground.

Resuscitation Council UK lists dry insulation, wind protection, gentle wet-clothing removal and separation from cold ground as measures that prevent further cooling. These steps reduce continuing heat loss; they do not establish how severe the hypothermia is.

Handle the person carefully. The Wilderness Medical Society advises gentle handling because movement could trigger ventricular fibrillation when severe hypothermia has made the heart unstable. If moderate or severe hypothermia is possible, avoid unnecessary movement and do not ask the person to walk.

Two first-aid providers carefully move a person protected by blankets (illustrative image)

Match warming to responsiveness and shivering

A responsive person who is shivering vigorously can be warmed passively with dry insulation and protection from wind and moisture. If the person is fully responsive and can swallow safely, the IFRC says a warm sugary drink or high-energy food may be offered. Do not give food or drink to anyone with reduced responsiveness or difficulty swallowing.

When shivering has stopped, the IFRC recommends gradual active warming, preferably with an electric heating blanket when one is available. A heating pad or warm-water bottle can be used as an alternative only with a layer between the heat source and the skin. Monitor the person continuously and follow instructions from emergency responders.

The evidence behind active warming outside a medical setting remains limited. The IFRC's 2025 evidence review found no new studies in its 2024 update and based its recommendations on a small body of research plus clinical practice considerations.

Alcohol, rubbing and direct heat can cause harm

Do not use alcohol as a warming measure. The IFRC lists alcohol use as a factor that increases hypothermia risk and advises avoiding it in cold conditions. A sensation of warmth is not evidence that core temperature is recovering.

Do not rub the person's skin or place hot stones, heating pads or warm-water bottles directly against it. The IFRC warns that rubbing can damage skin and underlying tissue, while direct heat can cause burns. Do not delay emergency care while trying different warming methods.

A glass of alcohol sits unused beside winter clothing in a cold outdoor setting (illustrative image)

Children, pregnancy and chronic illness need separate judgment

Infants and children

APPI News could not find separate first-aid steps for infants or children in the cited 2025 IFRC and Resuscitation Council UK guidance at the time of writing. Do not assume that a child can describe confusion, swallowing difficulty or worsening cold stress reliably. Contact emergency services for suspected hypothermia and follow pediatric instructions from the dispatcher or clinician.

Pregnancy

The cited guidelines do not set out a separate warming sequence for pregnancy. A pregnant person with suspected hypothermia still needs emergency assessment; questions about warming devices, food, drink or medicines should be directed to the responding clinician rather than decided from general adult instructions.

Older adults, chronic illness and regular medicines

The IFRC notes that hypothermia can occur in poorly heated homes and that some medical conditions and medicines affect temperature regulation. Older adults, people with chronic illness and those taking regular medicines should receive the same immediate protection from further cooling while emergency services assess individual risks. Medication should not be started, stopped or changed as part of first aid.

An older adult sits indoors under a warm blanket near a heater (illustrative image)

Frequently asked questions

What is the first action for suspected hypothermia?
Call the local emergency service, stop further cold exposure, remove wet clothes gently and insulate the person from wind and cold ground. Monitor breathing and responsiveness while help is on the way.

Does stopped shivering mean the person is improving?
No. The IFRC lists absent shivering among signs that the condition is worsening. It calls for gradual active warming and immediate access to emergency medical care.

Can a warm drink help?
Only offer one when the person is fully responsive and can swallow safely. The IFRC suggests a warm sugary drink or high-energy food in that situation; reduced responsiveness or swallowing difficulty makes oral intake unsafe.

Should a person who looks lifeless be left without CPR?
No. If the person is unresponsive and not breathing normally, call emergency services and begin CPR. Continue until the person shows signs of life, trained responders take over or the emergency dispatcher gives different instructions.

Can alcohol be used to warm someone?
No. International first-aid guidance identifies alcohol as a risk factor and advises avoiding it in cold conditions.