• Preventing cardiac arrest - if the casualty is extremely cold but still has a perfusing rhythm, interventions should focus on assessment and support of airway, breathing and circulation, preventing further heat loss, rewarming and careful transport to a hospital.
• The casualty should be removed from the cold environment.
• Cold, wet clothing should be removed when it is practical. If the temperature is less than 25°C or there is wind, it may be better to leave wet garments on and wrap the casualty in blankets to avoid increased exposure (Auerbach 1995).
• Blankets and insulating equipment may be used to protect against further heat loss.
• Rough movement and activity can precipitate VF and should be avoided.
• Urgent procedures such as tracheal intubation or insertion of central venous catheters should be done gently and carefully while monitoring the heart rhythm closely.
• Core temperature and cardiac rhythm must be monitored.
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