Which signs indicate severe hypothermia?

• A. Blue and puffy exposed skin, decreased vital signs, cessation of shivering
• B. Fever, sweating, and rapid pulse
• C. Flushed cheeks, normal respiration
• D. Cold hands only

Answer: (A)

In severe hypothermia, the body’s protective responses fail as core temperature drops, so you see clear, late-stage signs: skin becomes blue or dusky due to poor perfusion, and the exposed areas can look puffy from edema. The heart and lungs slow down, so vital signs decrease—bradycardia and slowed breathing are common. A key red flag is the cessation of shivering, which means the body's heat production has diminished as metabolic activity collapses. This combination—blue, puffy skin, low vital signs, and no shivering—fits severe hypothermia best.

Fever with sweating and a rapid pulse suggests heat illness or infection rather than hypothermia. Flushed cheeks with normal respiration don’t reflect the cooling crisis of severe hypothermia, and having cold hands only is an incomplete sign that could occur with milder exposure rather than a dangerous decline in core temperature.