Editing Hypothermia (section)

==Prognosis==
It is usually recommended not to declare a person dead until their body is warmed to a near normal body temperature of greater than {{convert|32|C|F}},<ref name="NEJM 2012" /> since extreme hypothermia can suppress heart and brain function.<ref>{{cite journal |vauthors=Iyer A, Rajkumar V, Sadasivan D, Bruce J, Gilfillan I | title=No one is dead until warm and dead | journal=The Journal of Thoracic and Cardiovascular Surgery | volume=134 | issue=4 | pages=1042–3 | year=2007 | pmid=17903527 | doi=10.1016/j.jtcvs.2007.05.028 | doi-access=free }}</ref> This is summarized in the common saying "You're not dead until you're warm and dead."<ref>{{cite journal |last1=Foggle |first1=John L. |title=Accidental Hypothermia: 'You're Not Dead Until You're Warm and Dead' |journal=Rhode Island Medical Journal |date=February 2019 |volume=102 |issue=1 |pages=28–32 |pmid=30709071}}</ref> Exceptions include if there are obvious fatal injuries or the chest is frozen so that it cannot be compressed.<ref name="ACLS 2005" /> If a person was buried in an [[avalanche]] for more than 35 minutes and is found with a mouth packed full of snow without a pulse, stopping early may also be reasonable.<ref name="NEJM 2012" /> This is also the case if a person's blood potassium is greater than 12&nbsp;mmol/L.<ref name="NEJM 2012" />

Those who are stiff with pupils that do not move may survive if treated aggressively.<ref name="NEJM 2012" /> Survival with good function also occasionally occurs even after the need for hours of CPR.<ref name="NEJM 2012" /> Children who have near-[[drowning]] accidents in water near {{convert|0|C|F}} can occasionally be revived, even over an hour after losing consciousness.<ref>{{cite journal |vauthors=Bolte RG, Black PG, Bowers RS, Thorne JK, Corneli HM | title=The use of extracorporeal rewarming in a child submerged for 66 minutes | journal=[[Journal of the American Medical Association]] | volume=260 | issue=3 | pages=377–379 | year=1988 | pmid=3379747 | doi=10.1001/jama.260.3.377 }}</ref><ref>Life after Death: How seven kids came back from the dead https://www.bbc.co.uk/news/av/stories-50630441/life-after-death-how-seven-kids-came-back-from-the-dead</ref> The cold water lowers the [[metabolism]], allowing the brain to withstand a much longer period of [[Hypoxia (medical)|hypoxia]]. While survival is possible, [[Mortality rate|mortality]] from severe or profound hypothermia remains high despite optimal treatment. Studies estimate mortality at between 38%<ref name="Trauma 2008">{{cite journal |vauthors=Morita S, Seiji M, Inokuchi S, Sadaki I, Inoue S, Shigeaki I, Akieda K, Kazuki A, Umezawa K, Kazuo U, Nakagawa Y, Yoshihide N, Yamamoto I, Isotoshi Y | title=The efficacy of rewarming with a portable and percutaneous cardiopulmonary bypass system in accidental deep hypothermia patients with hemodynamic instability | journal=The Journal of Trauma and Acute Care Surgery | volume=65 | issue=6 | pages=1391–5 | date=December 2008 | pmid=19077632 | doi=10.1097/TA.0b013e3181485490 }}</ref><ref>{{cite journal |vauthors=Vassal T, Benoit-Gonin B, Carrat F, Guidet B, Maury E, Offenstadt G | title=Severe accidental hypothermia treated in an ICU: prognosis and outcome | journal=Chest | volume=120 | issue=6 | pages=1998–2003 | date=December 2001 | pmid=11742934 | doi=10.1378/chest.120.6.1998 | s2cid=10672639 }}</ref> and 75%.<ref name="Care 1999"/>

In those who have hypothermia due to another underlying health problem, when death occurs it is frequently from that underlying health problem.<ref name="NEJM 2012" />