Hypothermia is a serious condition in the winter, especially with bitter cold temperatures. Those at particular risk often include the elderly or homeless who may not have adequate access to heat or shelter, newborn infants, or people caught outside for unanticipated lengths of time, such as sports enthusiasts or those involved in a motor vehicle accident . Excessive alcohol intake can also contribute to risk of hypothermia. Hypothermia is a medical emergency and prompt treatment is essential. The main symptoms include a change in mental status, such as confusion, dizziness, mood change, and slurred speech. Early hypothermia presents with vigorous shivering, hyperventilation, and racing heart. As the body temperature drops further, mental status deteriorates into a stupor, pupils become fixed and dilated, and the pulse rate slows, putting the patient at risk for lethal arrhythmias. If untreated, further progression can lead to coma and death. Treatment should always begin with preventing further heat loss, removing any wet clothing and covering the person with warm dry blankets or clothing, placing an external heat source such as hot water bottles in the armpits, groin, and abdomen, and contacting 911 immediately. If a person is unresponsive, CPR should be performed until emergency personnel arrive. Anyone treated for even mild hypothermia should be taken to the emergency room for monitoring until normal core temperature is achieved. Prevention of hypothermia is essential. Pack extra blankets, clothing and footwear, along with food and water if traveling, and check on elderly family or neighbors if severe cold is anticipated. If required to be outside, dress in layers, drink warm non-alcoholic liquids and take frequent breaks to go inside and warm up. Visit ebrownmd.com for more information.