Paradoxical Undressing (Hypothermia Complication)

General Features:

• The inappropriate removal of clothing with an associated hypothermia.

Clinical Features:

• Typically occurs during moderate to severe hypothermia.
• Occurs as the person becomes disoriented, confused & combative.
• Removal of clothing increases the rate of heat loss.

Epidemiology:

• Associated with 20% - 50% of hypothermia deaths.

Pathophysiology:

• Possibly caused by cold-induced malfunction of the hypothalamus.
• Other contributors may be peripheral vascular smooth muscle fatigue leading to paradoxical vasodilatation & a feeling of warmth from the surge of warmer central blood to the extremities.
• This vasodilalation may fool the person into feeling hot.
• Removal of clothing increases the rate of heat loss.

Public Health Issues:

• Recognised issue in mountain rescue & survival training.
• May be misinterpreted as evidence of a sexual assault in urban victims.

Image: from Ger Meinema (cc)
Tags: Cold - Hypothalamus - Hypothermia - Paradoxial Undressing - Vasodilalation
Posted by Medicalchemy
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