Australian Resuscitation Council (“ARC”) Guideline 9.3.3 “Hypothermia: First Aid Management” was published in February 2009, and Guideline 9.3.6 “Cold Injury” was published in March 2000 (the scope of this Guideline covers 'frostbite', 'frostnip', and more minor cold injuries such as 'chilblains' (pernio). The First Aid Sub-Committee of the ARC initiated a review of these Guidelines, which has included an extensive literature review and, as there is a paucity of relevant evidence from clinical trials, reference to expert opinion and other published guidelines. The ARC has considered progressive iterations of the updated Guidelines at its meetings in November 2018 and March 2019, and it is hoped that both Guidelines will be finalised and published as “co-badged” Australian and New Zealand Guidelines by mid-2019.
The audience for these Guidelines is any prehospital first responder, whether a layperson or a health professional, so the Guidelines must be pitched at a non-expert level. There is also an important distinction between “accidental hypothermia” and “induced hypothermia” as used in special circumstances in medical practice. An additional perspective was brought to the table by the Surf Life Saving, New Zealand Resuscitation Council, and Australian Ski Patrol representatives on the ARC, and as a result, it was decided to include some material on preparation for entry into cold environments and prevention of hypothermia and cold injuries. It was also thought important to include consideration of casualties who were alert and shivering and could easily be rewarmed without needing hospital treatment.