[[quoteright:350:[[Manga/GunslingerGirl http://static.tvtropes.org/pmwiki/pub/images/chapter_037_164_7096.jpg]]]]

->[''[[AliceAndBob Alice]] collapses'']\\
'''Bob''': [''gathers Alice in his arms''] ''"Alice! What's wrong?"'' or if that's obvious ''"Hang in there! I'll get help."''\\
'''Alice''': ''"I'm cold... so cold..."''
-->-- Bob and the audience start to worry for real.

They're right to be bothered: Saying "I'm cold" means that a character is seriously unwell. [[HesDeadJim It can be a sign]] that a character will be KilledOffForReal and these are their LastWords. When a new, unknown character says this it can even mean that they are a ghost. This is also something dead people are traditionally expected to tell anyone they talk to on the telephone.

This is because ''death''... is ''cold''.

There's sense in the trope: cold skin is a sign of shock. Coldness can also indicate blood loss or impaired blood circulation and, of course, corpses lack body-warmth. Additionally, a person suffering from a rising fever will feel cold and shiver. A mythological reason might be that Purgatory (which can sometimes include wandering the earth as a ghost) was depicted as being a cold and miserably damp place. Sleepiness or BloodFromTheMouth tend to go hand in hand with this. Perversely, one emergency that often does not feature this is ''hypothermia'': cold becomes an emergency if the victim stops being able to feel it, or too tired to shiver; in fact, exposure victims are often found partly undressed because the lowering of their internal temperature makes them feel ''too warm''.

A common variant, also due to the above, is "I'm tired...so tired."

Is dangerously on the verge of becoming {{Narm}}.

See EvilIsDeathlyCold for a motif. Compare GhostlyChill; and see IncurableCoughOfDeath for another example of a symptom which is moderate in RealLife but presented as a sure sign of death in the world of tropes.

----
!Examples:

[[foldercontrol]]

[[folder:Advertising]]
* A recent Pillsbury Pizza Pop ad has a young man cradling the head of a ''robot'', whimpering his name, as the robot says that he can't feel his legs and is "so...cold". As it happens, an exploding pizza pop the robot was too slow to catch blew his body off.
[[/folder]]

[[folder:Anime and Manga]]
* In ''Manga/{{Naruto}}'', Sakura remarks how cold [[spoiler:Sasuke's]] body feels. [[spoiler:Apparently, that's one of the effects of the [[NotQuiteDead deathlike]] state he was put into.]]
* This happens in the manga version of ''ChronoCrusade''. A character [[spoiler:that is, Rosette Christopher]] collapses to the ground, near death, while a friend [[spoiler:or her love interest and partner, Chrono]] runs to her side. We see the scene through her eyes, unable to hear the words of the panicking friend, while she has a dying InnerMonologue that finishes with "It's getting cold, isn't it? You can use my scarf, if you want."
* Inverted in ''SailorMoon Sailor Stars'' where people are explicitly warm to the touch when they die. Lines that reference it are TearJerker material for fans. For example...
--> [[spoiler:'''Sailor Uranus:''' You're warm, Michiru]]
* Hiroki tends to use this phrase in a slightly more life-affirming way in ''JunjouRomantica''.
* Watch for a varation on this phrase in ''GunslingerGirl'': it's the first real cue (aside from two large bleeding bulletholes) that [[spoiler: Flanca]] [[AnyoneCanDie really might not make it]]. [[spoiler: [[BetterToDieThanBeKilled Instead of bleeding out quietly]] like a sane human being, though, her blood loss leads her to decide to reeact ''Film/ThelmaAndLouise''.]]
** Played straight with Hilshire and Roberta Guellfi, a prosecutor he's guarding from Padania assassins. She thinks she's dying and starts talking of how her death will inspire others. [[YouRemindMeOfX Because she reminds Hilshire of a previous]] LoveInterest he failed to save, Hilshire rallies her with a RousingSpeech and she survives.
[[/folder]]

[[folder:Comicbooks]]
* A scene in ''Comicbook/TheCrow'' which was never adapted into the film: This trope invoked because of shock, bloodloss, and death when Eric removes one of his first targets at the shins. Quite possibly the most unpleasant scene of the lot.
* Justified in the second ''ComicBook/SilverSurfer'' series, when Frankie Raye, a fire elemental, is fatally injured. Her flame then starts to dwindle before dying out.
[[/folder]]

[[folder:Fan Works]]
* [[http://www.tbillingsemergencyfanfic.com/christmasinlamedeerpart1.htm This]] ''{{Series/Emergency}}'' fic has one of the somewhat incorrect hypothermic person variety after Gage is dragged through the snow tied to a horse. He survives,though,
[[/folder]]

[[folder:Films -- Animated]]
* From ''WesternAnimation/SharkTale'' (mafia movie about fish) we have this exchange:
-->'''Frankie:''' ''[dying]'' Lenny, is that you?
-->'''Lenny:''' I'm here, Frankie.
-->'''Frankie:''' Come closer.
-->'''Lenny:''' What is it, Frankie?
-->'''Frankie:''' I'm so cold.
-->'''Lenny:''' That's because we're cold-blooded.
-->'''Frankie:''' ''[Frankie slaps Lenny]'' Moron. ''[dies]''
* [[spoiler:Fly]] in ''WesternAnimation/HelpImAFish!'' says a variation of this [[spoiler:after sustaining a bad injury due to a crab]].
-->[[spoiler:'''Fly]]:''' I-is it getting cold?
-->'''Chuck:''' Uh......Maybe.
* Said by [[spoiler:The Mole]] before he dies in ''WesternAnimation/SouthParkBiggerLongerAndUncut''.
[[/folder]]

[[folder:Films -- Live-Action]]
* In ''Film/PiratesOfTheCaribbeanTheCurseOfTheBlackPearl'', after the title curse is broken, rendering Barbossa and his men mortals again, Jack Sparrow shoots Barbossa and he says, "I feel... cold." (falls over) Bonus points on this one, because this is the very first thing Barbossa felt since he turned immortal and he actually sounds happy to be able to feel something.
* ''Film/RoboCop2''. The child criminal Hob has been badly shot up by the Cain cyborg. When Robocop finds him, Hob says that he feels cold. Robocop tells him that he's going into shock.
* Lampshaded when, in ''Film/LethalWeapon3'', annoying sidekick Leo struggles with the BigBad for a gun, and is shot in the shoulder for his efforts. He thinks he's dying because he feels numb and cold all over... which is only natural, since he was lying on the ice of a hockey rink.
* An especially creepy example occurs in ''Film/EventHorizon'', when Dr. Weir first encounters an apparition of his dead wife. Makes sense when we realize she [[spoiler:killed herself by cutting her wrists]].
* Spoofed in ''Film/LoadedWeapon1'' where Destiny utters this line at the end of the movie, Colt then removes a bag of ice that was on her for [[RuleOfFunny no good reason]].
* In the live-action ''Film/{{Casper}}'' movie, Kat tells the title character that he feels cold. Also, it's later revealed that [[spoiler:Casper's death was caused from being out in the cold too long]].
* In the movie ''Film/ConanTheBarbarian1982'' (1982) the last words said by Valeria as she died in Conan's arms were: "I'm cold, so cold, keep me warm."
* Parodied in ''Film/TropicThunder'' - Tugg Speedman, in an IronicEcho, says that he can't feel his legs; Lazarus has to point out that he's fine, it's just that his legs are knee deep in a pool of cold, muddy water.
* An interesting version happens in ''Film/ReturnOfTheLivingDead''. After two of the main characters are exposed to Trioxin, they start feeling crappy and complain about the cold. Near the climax they feel better as zombies.
* Subverted in ''Film/{{Titanic}}'' where Rose says "I'm so cold," and later "I can't feel my body." It's already a foregone conclusion that she survives, as she is the narrator for the whole movie, plus she's drenched and floating on a bit of wreckage in the icy North Atlantic, she's not just mystically drifting closer to mortality.
* Said by [[spoiler:Kayla Silver Fox]] at the end of ''Film/XMenOriginsWolverine''.
* ''[[Film/RedDawn1984 Red Dawn]]''. When ActionGirl Toni is fatally wounded by [[DeathFromAbove Hind gunships]] she asks Jed to leave her a hand grenade to kill herself with, saying "I don't want to be cold". She doesn't use it though; just [[BoobyTrap leaves the grenade under her body]] to kill the first DirtyCommunist that tries to move her.
** Likely also a CallBack to the movie's [[DiscussedTrope discussion]] on HeWhoFightsMonsters: One of the kids is warned that his hatred of the Russians will burn him up inside. The kid replies nonchalantly that it keeps him warm.
* Tobias in ''Film/DarkFloors'' spent most of the movie being "cold", [[spoiler:as well as coming back as a zombie to save Sarah.]]
--> [[spoiler: '''Tobias:''' I'm not cold anymore, Sarah]]
* ''PoltergeistIII'' had a sequence where Lara Flynn Boyle comes back from the other side and exclaims how cold she is, so her family tries to warm her up in the shower. [[spoiler:Except, of course, that it wasn't really her. It was her mirror-double and she was faking for attention.]]
* ''Film/PointBreak'': Played straight and [[DiscussedTrope discussed]]: [[spoiler: Roach]] complains of being cold after being shot.
* ''Film/{{Frantic}}''. The last words of Michelle, the Paris street waif who has been helping the protagonist search for his kidnapped wife, fatally wounded in the film's climax.
* In ''Film/VerticalLimit'', [[spoiler:Tom [=MacLaren=]]] basically says this. Justified in that he's severely wounded and dying of hypothermia halfway up K2. He's really in trouble when he ''stops'' feeling cold.
* Parodied in ''Film/TheMask''. The Mask, dressed like a cowboy, is shot in the chest and falls into the shooter's arms, overly dramatically telling him he's "so cold" while coughing, and saying his last wishes before dying dramatically. [[spoiler:He then receives an Oscar for his performance, while the shooter starts weeping.]]
* The "I'm tired" variant serves as Annie's dying words in ''Imitation Of Life'' (1959).
* Said verbatim by Emu O'Hara in the film adaptation of ''Film/CryingFreeman''. Completely justified, as she has taken a few bullets and suffers from a large blood loss.
* Played straight as an arrow in ''Film/MulhollandFalls'' with the death of Elleroy.
[[/folder]]

[[folder:Literature]]
* In ''Literature/CatchTwentyTwo'', the rear gunner, [[PunnyName Snowden]], who Yossarian tries and fails to save mutters this repeatedly as Yossarian tries to patch up his leg. Yossarian thinks this is because they're high in the sky in the tail of a plane with holes shot it in it. It's also because the gunner has been nearly shot in half - though is still alive - and Yossarian doesn't realize he's had his gut torn open by shrapnel which got underneath his flak jacket.
-->Snowden: "I'm cold . . . I'm so cold . . ."
-->Yossarian: "Don't worry. Don't worry, you're gonna be fine."
-->Snowden: "I'M ''COLD!''"
-->Yossarian: [panicky] "IT'S VERY WARM ON THIS PLANE!"
* While he never says the trope, the Marquis de Carabas from ''Literature/{{Neverwhere}}'' describes death as "very dark, and very cold".
* ''Literature/{{Animorphs}}'' has this in a rather [[IncrediblyLamePun chilling]] portion with this exchange:
--> So cold. Just... Can you just get me a blanket or... I'm scared. Does that... Does that make you happy, Andalite?
--> '''Jake:''' No. No, it doesn't make me happy.
* Although he never [[LiteraryAgentHypothesis records himself]] saying these exact words, [[Literature/LordOfTheRings Frodo]] spends a lot of the time after he has been stabbed with the Morgul knife shivering and describing how cold he feels.
* ''Literature/WutheringHeights''.
-->'I heard distinctly the gusty wind, and the driving of the snow; I heard, also, the fir bough repeat its teasing sound, and ascribed it to the right cause: but it annoyed me so much, that I resolved to silence it, if possible; and, I thought, I rose and endeavoured to unhasp the casement....'I must stop it, nevertheless!' I muttered, knocking my knuckles through the glass, and stretching an arm out to seize the importunate branch; instead of which, my fingers closed on the fingers of a little, ice-cold hand! The intense horror of nightmare came over me: I tried to draw back my arm, but the hand clung to it, and a most melancholy voice sobbed, 'Let me in - let me in!' 'Who are you?' I asked, struggling, meanwhile, to disengage myself. 'Catherine Linton,' it replied, shiveringly....'I'm come home: I'd lost my way on the moor!'
* From ''Literature/FoolMoon'':
--> '''Harry''' ([[spoiler: after Murphy nonfatally shoots him]]): I'm so cold.
--> '''Murphy''' (angry): We're ''all'' cold, moron....it must be below forty, already, and we're wet besides.
* In ''TheSecretsOfTheImmortalNicholasFlamel'', Prometheus does a variation of this with: "I'm tired now, so tired. It will be good to rest." He then [[TearJerker proceeds to die in the arms of his daughter]]. Bonus points because the aforementioned daughter had just '''revived''' him, but he made her let him die.
* Last words of a Drachelander (German-descended) knight in the first book of the ''Literature/WorldOfTiers'' series, after he was swarmed by enemies and the protagonist arrived just too late to save him: "'''siz kalt''."
* Creator/BillBryson discusses the dangers of hypothermia to Appalachian Trail hikers in ''A Walk In The Woods'', and the 'Paradoxical Undressing' phenomena (see below). He also recounts a day when he went off hiking and forget to pack his waterproofs. He gets soaked by the incessant drizzle and starts to lose track of time... [[spoiler: it turns out that his watch had stopped.]]
* In the ''{{Redwall}}'' series book ''Lord Brocktree'', [[spoiler:Fleetscut]] dies with a smile on his face; "Funny. [[BigEater Don't feel hungry anymore]]. Jolly cold, wot!"
* Justified by Demnor in [[TalesOfTheBranionRealm The Stone Prince]] even ''before'' he nearly dies of battle wounds; he's a RebelPrince, and his very angry mother is the [[GodEmperor avatar]] of a fire god, able to withdraw Its warmth from her son.
* Inverted in TheLostFleet: Geary feels incredibly cold after being revived from 100 years of being a HumanPopsicle.
* ''The Bronze Horseman'' by Paullina Simons. Tatiana says this after Alexander rescues her from a bombed out building, but it's because she's in shock from several broken bones, not because she's near death. Shock ''can'' be life-threatening if not treated, but fortunately Alexander is there to [[IntimateHealing share his bodily warmth]].
[[/folder]]

[[folder:Live-Action TV]]
* Subverted on ''Series/{{Smallville}}''. Eric says something like this when he is drained of Clark's powers, but he survived.
* Subverted in ''Series/{{Firefly}}'' where Kaylee says something like this after being shot, but she recovers without complication. She says it not because of impending death, but because she's going in to shock from the traumatic injury.
* In the ''Series/{{Charmed}}'' episode "All Hell Breaks Loose," when Piper is shot by a sniper and is close to death, she says, "Prue, I'm cold. [[ICantFeelMyLegs I can't - I can't - I can't feel my legs.]] [[PleaseDontLeaveMe Don't go.]] I love you."
* In the ''Series/DoctorWho'' episode "Age of Steel" a downed Cyberman whose emotions are restored says this. And this is revealed to have been a bride about to go to a wedding.
* [[PlayingWithATrope Played with]] in "White Light Fever", an episode of the revived ''TheOuterLimits'' series. An old, rich, selfish man who nearly died says that death feels cold. When he dies, he meets an innocent girl who died earlier as a result of his selfishness, and asks to go with her. She says he can't because they're not going to the same place; where she's going, it's ''warm''. Then she says that she always thought it was [[FireAndBrimstoneHell the other way around]].
* The pilot of ''LookAroundYou'' uses this trope in the conversation with intelligent calcium, where the aforementioned substance answers the scientist's question of "how do you feel?" with "cold". The scientist then forces the obvious conclusion by capping the test tube, suffocating the intelligent calcium inside.
* ''Series/StarTrekVoyager'' featured an episode where Kes kept shifting backwards in time. Whenever she said this, it was an indication that she was about to shift.
* When a ''Series/ColdCase'' villain flashes back to his first kill (inadvertent, as he merely let the woman die rather than outright harming her), he remember a woman trapped in a well, frantically treading water and babbling, "Cold. . .so cold".
* In ''{{Warehouse 13}}'', this is the sign of the artifact of season 3's ''Insatiable'' affecting someone. Other side effects include an insatiable hunger and eventual death from hypothermia.
* Wesley on ''Series/{{Angel}}'' "The Thin Dead Line", after the zombie cop shoots him. He doesn't die, though.
-->'''Wesley''': Is anyone else cold?
[[/folder]]

[[folder:Music]]
* "[[http://www.obsidianshell.com/div_en.php?p=lyrics#19 Second Birth]]" by Obsidian Shell starts with "So cold... am I dying?"
[[/folder]]

[[folder:Radio]]
* An infamous ''Radio/TheStephanieMillerShow'' sketch ends with WesternAnimation/YogiBear's {{sidekick}} Boo Boo being killed off by SarahPalin; this phrase is part of his death scene.
* Somewhat subverted in the radio play version of the second (or fifth) ''Franchise/StarWars'' movie, ''Film/TheEmpireStrikesBack'', when Luke (still played by Creator/MarkHamill) nearly freezes to death in the ice planet Hoth. As Han Solo finds him delirious in the snow, Luke moans about being cold, followed by "Warmer now," which causes a deeply concerned Han to yell "No, Luke, that means you're freezing!"
[[/folder]]

[[folder:Theatre]]
* In the musical ''{{Rent}}'' Mimi complains of being cold in the finale, where she appears to be on the edge of death but subverted in that she doesn't actually die.
* Invoked, then poignantly subverted in Puccini's Opera ''LaBoheme'' (the 'original' ''{{Rent}}''). As she lies dying, Mimi is 'cold, so cold' and longs at least to warm her hands. Her friends rush out to buy her a fur muff. She is happy, and murmurs as she drifts off to sleep that she feels warm at last. These are her last words - she dies quietly, while the dramatic focus is on the other characters.
* In ''Theatre/LesMiserables'', the dying Fantine tells Valjean that 'the night grows ever colder'. Whether this is an actual temperature change or the trope is debatable.
[[/folder]]

[[folder:Video Games]]
* This is a common death line in ''FireEmblem''.
* In ''BaldursGate'', this is Imoen's last words before her hit points drop to zero.
* In ''BaldursGate 2'', "I feel so cold" are Aerie's last words before ''her'' hit points drop to zero.
** There's also a ghost in the expansion who complains of this. He won't say anything else until you light a fire in the hearth for him.
* Shai-Gen Corporation cronies in ''{{Crackdown}}'' tend to spout this as they die. Even if they died from immolation.
* Justified in the ''VideoGame/GoldenSun'' series-- the [[PlayingWithFire Fire Clan]] members who say it are freezing to death, having been deprived of the strength to warm themselves or escape.
* One of the enemy officer death lines in the ''DynastyWarriors / SamuraiWarriors'' crossover ''Warriors Orochi'' is 'Such a cold embrace...'
* In ''PathwaysIntoDarkness'', one of the dead Nazis you encounter has completely forgotten about everything ''except'' that death is cold.
* In one of the ''{{Slayers}}'' videogames, the gang barely manages to rescue [[spoiler:Amelia]], but when they do, she says "I feel...so cold..."
* ''MadWorld'' works this trope into the form of a song, aptly titled ''So Cold'', which takes over the previously boastful boss theme halfway through the final fight.
** Aside from the name this is a SubvertedTrope because, despite being a monochrome game, the boss TurnsRed
* In ''ApolloJustice'', Apollo actually watches someone die... and the victim says 'I'm cold... so cold' as he tells Apollo who the witness is.
* In ''Shannara'', [[spoiler:Shella, as she lies dying,]] says to Jak 'I'm cold...so cold'
* Among the many [[MemeticMutation theories]] for why VideoGame/{{Touhou}}es wear such silly hats is that it prevents them ''from freezing to death.''
* At a certain spot in ''VideoGame/AmnesiaTheDarkDescent'' you'll hear this phrase as a disembodied whisper.
* The skeletons from later parts of ''VideoGame/TheyHunger'' sometimes mutter, "...Cold..."
* In some unused dialogue in ''VideoGame/Left4Dead'' that [[WhatCouldHaveBeen would have been used]] in a cutscene immediately after completing the "No Mercy" campaign implies that the helicopter pilot had been infected before he picked them up, and was about to make the transformation mid-flight. The pilot then uses the "I'm cold" line.
** It was cut it from the game because the developers felt that it would be like punishing the players for completing the campaign.
*** In the DLC campaign "Crash Course", it's revealed that the chopper they were in ended up crashing, anyway. They still all survived. Unscathed, too.
[[/folder]]

[[folder:Webcomics]]
* Played for laughs in [[http://www.giantitp.com/comics/oots0091.html this]] ''[[Webcomic/TheOrderOfTheStick Order of the Stick]]'' interlude.
* In ''SluggyFreelance'' a man has this reaction after having to [[http://beta.sluggy.com/daily.php?date=080405 put gym shorts on a Duh-Mentor]].
** Subverted elsewhere, when it turns out Jane's been playing with the thermostat to make Gwynn think she's died and risen as a zombie.
* Subverted in ''{{Terinu}}''. When the title character is badly wounded, he starts feeling ''warmer'' as he slips into shock, since his body is losing the ability regulate temperature correctly. The comic's author is a nurse, so this counts as a case of ShownTheirWork.
* A variant is spoken by one of the drowned children in [[http://tvtropes.org/pmwiki/pmwiki.php/Webcomic/SolsticeTwins Solstice Twins]] as seen [[http://www.solsticetwins.co.uk/?id=17/ here]].
[[/folder]]

[[folder:Western Animation]]
* In ''WesternAnimation/AvatarTheLastAirbender'', this doesn't actually ''happen'', but is the topic of a ghost story Katara tells to the Gaang. Of course, said story ''is'' set at ''the South Pole'', and the death did occur during a weeks-long blizzard.
* In ''HarveyBirdmanAttorneyAtLaw'', the Jetsons arrive in Birdman's office, but have to ''walk'' to his desk, as there is no conveyor belt. Eventually, Astro collapses during the trek, saying "Ro rold, ro rold..."
* In ''WesternAnimation/TheSimpsons'' episode "Home Sweet Homediddly-Dum-Doodily", when Bart is discovered to have head lice on class picture day (as a result of playing with a [[EverythingsBetterWithMonkeys monkey]] Milhouse found), he comments "Nothing ever happens to Milhouse." We then see Milhouse standing there pale, wrapped in a blanket, muttering "Cold, so very, very cold."
** In a recent episode, the GPS from Homer's car says "So cold, so cold..." after Homer rips it out and throws it in a nearby fountain.
* Happens in an episode of ''WesternAnimation/{{Ben 10}}'' when Ben offers another character a piece of chocolate, which ended up poisoning him due to him ingesting foreign food.
* Ren says this in an episode of ''ThePiratesOfDarkWater''. [[JustifiedTrope Justified]] in that Tula was purposefully [[HeroicSacrifice lowering his body temperature]] [[MakesSenseInContext in order to kill him]] [[OurGhostsAreDifferent so they could save Ioz]].
* In one episode of ''WesternAnimation/TheVentureBrothers'', a group that seems [[ScoobyDoo oddly]] [[ShoutOut familiar]] infiltrates Dr. Venture's mansion and snoops around. At the end, they run afoul of a berserking Brock Sampson, who promptly kills the Fred, Shaggy and Scooby equivalents. As Shaggy dies, gutshot and bleeding out on the floor, he whimpers, "So cold, man...."
* A disturbing example from an obscure BBC children's cartoon called ''The Brollys'', about a boy making friends with a man and a woman who control the weather. While most of the weather is rather pleasant, the ice and snow brings with it the terrifying Jack Frost, who not only freezes Mr. and Mrs. Brolly, but also tries to kill the little boy by [[http://www.youtube.com/watch?v=ZLnmWVhrWKk making him succumb to sleeping in the cold]].
* In the WesternAnimation/DannyPhantom episode ''Urban Jungle'', Danny complains about being really, '''really''' cold, despite the warm weather. Later, this turns out to be a sign of his [[ElementalPowers ice powers]] awakening.
** Also, Danny's [[SpiderSense ghost-sense]], which is mentioned to be related to his ice powers, apparently feels like the sudden chill caused by a ghost's presence.

[[/folder]]

[[folder:Real Life]]
* Victims of shock frequently complain of feeling cold, and cold clammy (diaphoretic) skin is a major sign of shock, along with rapid heart rate and low blood pressure. Sudden complaint of cold in a trauma patient or one with known risk of shock (from infection, heart failure, internal bleeding, etc) is a very ominous sign indeed.
* Cold itself is also a leading contributor to morbidity and mortality in shock patients, as it forms one of the three bases of the "trauma triad" or "triad of death": cold induces massive shivering as the patient attempts to maintain body heat, which generates lactic acid buildup in the bloodstream through anaerobic metabolism, which in turn impairs tissue oxygenation and promotes coagulopathy (inability to clot blood properly). Survival rates in this situation are dismal. Modern care of the shock victim frequently involves aggressive rewarming measures in addition to the usual protocols (fluid and/or blood product replacement, pressors where indicated, etc) in recognition of the risks of this outcome.
* In cases of drowning and hypothermia, severe cold serves as a protective mechanism in a euvolemic victim (i.e. one not in shock to begin with). Below a certain point (usually around 32 C), low core temperatures drastically slow metabolism, preserving organs from hypoxic damage, and occasionally allowing successful resuscitation in a victim who would otherwise be long past saving. To that end, an old aphorism of emergency medicine states that hypothermia victims "aren't dead till they're warm and dead." The same effect is also exploited in active cooling therapies for heart attack and stroke patients, in which the patient is deliberately rendered hypothermic in the ICU to protect the heart or brain from further ischemic insult. This has also been used as an effective treatment for those suffering from spinal injuries.
* In severe hypothermia cases, the victim may engage in 'paradoxical undressing' wherein they remove all their clothes. No one has experienced this and survived but it has been suggested that at such a late stage the blood vessels close to the skin 'give up' and widen as they do when experiencing heat causing the victim to feel too hot and strip. In this case, I'm hot... so hot might be more appropriate!
[[/folder]]

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