Mild | Moderate | Severe | |
Neurologic | Confusion, slurred speech, impaired judgment, amnesia | Lethargy, hallucinations, loss of pupillary reflexes, EEG abnormalities | Loss of cerebrovascular regulation, decline in EEG activity, coma, loss of ocular reflexes |
Cardiovascular | Tachycardia, increased cardiac output and systemic vascular resistance | Progressive bradycardia (unresponsive to atropine); decreased cardiac output and BP; atrial and ventricular arrhythmias, J (Osborn) wave on ECG | Decline in BP and cardiac output, ventricular fibrillation (<28°C; 82.4°F) and asystole (<20°C; 68°F) |
Respiratory | Tachypnea, bronchorrhea | Hypoventilation, decreased oxygen consumption and CO2 production, loss of cough reflex | Pulmonary edema, apnea |
Renal | Bladder atony, cold diuresis | Cold diuresis | Decreased renal perfusion, oliguria |
Musculoskeletal | Increased shivering | Decreased shivering (<32°C; 89.6°F) muscle rigidity | Patient may appear dead ("pseudo-rigor mortis") |
Metabolic | Increased metabolic rate, hyperglycemia | Decreased metabolic rate, hyper- or hypoglycemia | |
Hematologic | Increase in hematocrit, decreased platelet count and white blood cell count, bleeding diathesis, DIC | ||
Gastrointestinal | Ileus, pancreatitis, gastric stress ulcers, hepatic dysfunction |
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