II. Causes: Environmental exposure
- Cold water immersion or Submersion
- Cold Exposure
III. Causes: Altered Thermoregulation
- Endocrinopathy
- Hypothyroidism including Myxedema Coma
- Adrenal Insufficiency
- Pituitary or Hypothalamus dysfunction
- Diabetic Ketoacidosis (or Alcoholic Ketoacidosis)
- Lactic Acidosis
- Central neurologic disorders
- Peripheral neurologic disorders
- Miscellaneous causes
- Anorexia Nervosa
- Shivering impaired (e.g. medications)
- Hypoglycemia or Malnutrition
- Extremes of age (very young or very old)
IV. Causes: Increased Heat Loss
- Septic Shock and other shock states
- Dermatitis
- Severe Burn Injury
- Severe skin exfoliation
- Severe Psoriasis
- Iatrogenic
- Therapeutic Hypothermia
- Over-correction of Heat Illness
- Cold fluid infusion
V. Causes: Substances
- Impact both increased heat loss and altered Thermoregulation
- Alcohol Intoxication
- Phenothiazines
- Benzodiazepines or Barbiturates