A 45-year-old male is brought to the emergency department by ski patrol after being found unresponsive in a snowbank. He was missing for approximately 4 hours in ambient temperatures of -10°C (14°F). On the scene, he was pulseless; cardiopulmonary resuscitation (CPR) was initiated immediately. He was intubated in the field. The transport time was 45 minutes with ongoing mechanical chest compressions. He has no known past medical history.

On arrival, the patient is comatose with ice cold skin. He is intubated, and mechanical CPR is in progress. Temperature is 24^o C (75.2^o F).