It is recognized that some people die from hypothermia even though they are alive and uninjured when rescued. The traditional explanation is that this is due to ventricular fibrillation resulting from the afterdrop of core temperature. This hypothesis was based on inadequate measurement and failure to consider the physiology of cold. It should now be discarded. Most deaths after rescue occur through an imbalance between the active vascular capacity and the circulating fluid volume i.e. relative hypovolemia or fluid overload. The actual mechanism in any individual case depends both on the history of the cooling and the method of rewarming used. Some deaths will however occur due to continued cooling of the body or to ventricular fibrillation precipitated by rough handling.
Cold - hypothermia - hypovolaemia - fluid overload - ventricular fibrillation
