Doctor: When temperatures drop, children are among most vulnerable to hypothermia

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12-02-2025

Children are especially vulnerable to winter's chilly bite, and are more likely than adults to get into medical distress when exposed to the cold, said Dr. Jim Getzinger, an emergency department physician at Corewell Health William Beaumont University Hospital in Royal Oak.
Getzinger spoke the Detroit Free Press on Tuesday about the dangers of cold exposure as more details emerged about two children, ages 2 and 9, who appear to have frozen to death Monday while sleeping in a van in the parking structure of a Detroit casino.
The kids lived in the van with their mother, grandmother and three siblings, Detroit police said, after being evicted from an east-side apartment. As outdoor temperatures fell below 20 degrees in the early morning hours Monday, the van stopped running. About noon, police said the 9-year-old boy was no longer breathing, and soon after, the 2-year-old girl also became unresponsive.
The other three children were admitted to the hospital and were in stable condition Tuesday, police said.
Getzinger said it's kids who are among the most vulnerable in frigid temperatures.
"You're at higher risk if you're very young," he said. "You don't have as much body fat. ... Your body surface area is actually much higher compared to your mass, so you radiate heat a ton more than you would if you were a larger person. So children, especially small children, are at high risk of losing heat rapidly."
Also especially susceptible to the cold, he said, are: older people, anyone who is underweight, malnourished or dehydrated, along with people who have underlying medical conditions such as vascular disease, diabetes, heart disease and substance use disorder.
Multiple variables can affect how long it takes for a person to die from cold exposure, Getzinger said.
"It can be anywhere from minutes to a few hours," he said. "It all depends on what's going on ... what your underlying conditions are. ... It depends what you're wearing. If you have any wet clothing on, is the wind blowing over you? How cold is it? What's your nutrition status? Are you dehydrated? All these things can run the risk of making cold exposure much more deadly."
Getzinger has treated patients in the emergency department who've suffered from frost nip, frost bite, and hypothermia from cold exposure, but cases of severe hypothermia — that end with a person dying — are relatively rare, Getzinger said.
Hypothermia occurs in three stages — mild, moderate and severe.
The first stage, mild hypothermia, occurs when your core body temperature falls below 95 degrees Fahrenheit, Getzinger said.
"In that place, you're just shivering," he said. "Your body starts to try to burn more fuel to keep the temperature up. You'll feel your heart racing a little bit. You may breathe a bit faster. The blood vessels around the body try to conserve the heat for the main organs — such as your heart, your lungs.
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"And so what happens is you'll get constriction of the blood vessels. You'll get cold hands, cold feet. Your body is trying to reduce heat loss from the skin. You sometimes can get a little bit of fatigue. You might get a little stumbly. You might have difficulty with coordination just at that early stage."
The next stage is considered moderate hypothermia, and occurs with the core body temperature ranges between 82 and 90 degrees Fahrenheit.
At that stage, Getzinger says shivering can become less intense. "That's actually quite a bad sign," he said. "It means you're running out of energy to shiver. You often get very confused. Some people actually can start undressing because they (perceive that they are) hot. This is due to some problems in the brain where the temperature-regulating mechanism isn't working real well."
People may become very lethargic, feel muscle stiffness and lose coordination. Their speech may become slurred, he said, and they may have poor judgment.
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When the body's core temperature drops below 82 degrees Fahrenheit, it is considered severe or profound hypothermia. Getzinger said that is likely the stage of hypothermia the two children suffered when they died.
When a person's body is that severely chilled, shivering tends to stop altogether, and there is very shallow breathing, "if at all."
"You can have weak pulse, loss of consciousness. They can go into a coma," Getzinger said. "The risk of heart problems goes really high at that point. The heart becomes very irritable. You can have a cardiac arrest, and they might even look blue, cyanotic. They basically just are not even responding."
It's imperative, Getzinger said, for people to recognize the signs of hypothermia and intervene if a person appears to be acting strangely, taking off clothing in the cold, shivering uncontrollably, or stumbling or slurring their words.
"Please try to help them," Getzinger said. "Try to check to see if they're OK. Call 911. This is not something where I you can shrug it off and say, 'Oh, they're just being odd.' ... When we get really concerned is when they start getting confused. Your body, your enzymes don't work as well at lower temperatures. ... You don't do the things that could save you. You basically end up just sort of settling in and the exposure gets you more and more and more."
Seek medical help, if you can.
"We don't want you to put heating pads on people like this," Getzinger said. "Those can cause burns and can cause other issues. The big thing is to call 911 or get medical help as soon as possible."
While you wait for assistance to arrive, "try warm them passively," Getzinger said. "One of the ways to do that is actually skin to skin," which would be to use the heat from your own body to warm theirs with skin-to-skin contact. "If they're able to drink something, get them some something warm to drink. Put them in warm, dry blankets. If they're in anything wet, get that off of them and get them into something warm.
"Check on your neighbors. If you have elderly neighbors near you, check in on them, especially during these cold snaps just to make sure that they're OK. ... It's best to be as a community and help each other out."
The National Weather Service has issued a winter weather advisory for Wednesday for metro Detroit, predicting snow, freezing rain and sleet. Low temperatures are expected to fall into the teens again Thursday night.
Anyone who is unhoused or struggling with housing instability should not try to sleep outdoors or in a vehicle in these cold temperatures, Detroit city leaders said Tuesday.
There now is 24/7 assistance available, along with a new program that provides 110 beds at Drop-In Centers at Cass Social Services and Detroit Rescue Mission Ministries.
To get help, call the Detroit Housing Resource HelpLine 8 a.m.-6 p.m. Monday-Friday and 9 a.m-12 p.m. Saturdays at 866-313-2520. Anyone who needs after-hours assistance should go to the nearest police precinct to be connected with overnight housing services.
Contact Kristen Shamus: [e-mail]. Free Press staff writers Andrea May Sahouri, Nour Rahal and Nushrat Rahman contributed to this story.
This article originally appeared on Detroit Free Press: Kids more likely to die when exposed to cold temperatures, doctor says