The case of a 17‐year‐old girl brought into the emergency department (ED) having been found in a field semi‐clad and overtly hypothermic is reported. A weak carotid pulse, agonal breathing and fixed dilated pupils were noted. On arrival in the ED she was in asystolic cardiopulmonary arrest. Initial core body temperature was 18°C. After 4 h of closed cardiopulmonary resuscitation and rewarming using a haemofiltration circuit, she made a full recovery with no adverse neurological sequelae. In this case report, the importance of prolonged resuscitation in cardiopulmonary arrest secondary to acute severe environmental hypothermia and the successful use of a haemofiltration circuit to deliver active core rewarming are highlighted
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