Hypothermia on Mount Rinjani: Symptoms, First Aid, and When to Seek Emergency Help

The climbing route to the summit of Mount Rinjani exposes climbers to strong winds, rain, and night temperatures approaching freezing point, so cases of hypothermia on Mount Rinjani are a real risk for climbers who are exhausted, drenched or not wearing adequate clothing. This article provides important information regarding the symptoms, first aid measures, and emergency protocols regarding hypothermia on Mount Rinjani, based on the latest medical guidelines and research.

What Is Hypothermia?

• Accidental hypothermia = an involuntary drop in core body temperature below 35°C (Procter, Brugger, & Burtscher, 2018).
• Three stages of severity:
  • Mild: 32–35°C
  • Moderate: 28–32°C
  • Severe: below 28°C (Procter et al., 2018)
• Causes include direct exposure to cold (wind, rain, cold air at altitude) or secondary factors such as fatigue, injury, or impaired consciousness (Procter et al., 2018).
• A climber does not need to fall into water to develop hypothermia, inactivity while wet and windblown can drop body temperature by about 1°C in just 30 minutes (Procter et al., 2018).
• This is in accordance with the conditions that commonly occur on Mount Rinjani: cold winds at the peak, clothes soaked with sweat, and rest before sunrise.

Recognizing Hypothermia on Mount Rinjani Symptoms

Since carrying a thermometer is impractical for most climbers, guides can use the AVPU scale,  which is based on level of consciousness, to assess severity in the field (Musi et al., 2021):

• Alert, Clear consciousness, may still shiver → low risk (mild hypothermia)
• Verbal, Confused, slurred speech, poor coordination when responding to sounds → moderate risk
• Pain / Unconscious with vital signs → high risk of cardiac arrest
• Unconscious, no vital signs → hypothermic cardiac arrest; cardiac arrest due to hypothermia; requires immediate resuscitation and evacuation (Musi et al., 2021)

Key point: shivering is not a reliable indicator of severity, since it varies between individuals and usually stops as body temperature drops further (Musi et al., 2021). Watch for confusion, stumbling, and drowsiness instead.

First Aid Steps

• Get out of wind and rain; remove wet clothing if possible.
• Insulate the body with dry layers, a sleeping bag, or emergency blanket, insulation and gradual rewarming are core field treatments (Podsiadło et al., 2017).
• Handle the person gently, avoid rough movement or vigorous rubbing, especially in severe cases.
• Recheck consciousness regularly using the AVPU scale; a decline in consciousness indicates an increased risk of cardiac arrest (Musi et al., 2021).
• Never leave the person alone; arrange descent or evacuation as soon as safely possible.
• Note: even professional mountain rescue teams often lack advanced equipment, only 36% carry a thermometer that can read core temperature on-site, so simple insulation and shelter remain the most reliable first response (Podsiadło et al., 2017).

When to Seek Emergency Help

Evacuate the person immediately if they:

• Becomes confused or no longer respond normally to voice
• Loses consciousness
• Shows irregular breathing or a weak/absent pulse

Poor weather preparation and fatigue are the main drivers of mild hypothermia progressing to moderate or severe stages (Omidi et al., 2025), and severe cases can lead to cardiac arrest, requiring emergency transport to a facility capable of advanced rewarming (Musi et al., 2021).

See Also: Mount Rinjani Accident Why Better Medical Support is Becoming Essential for Hikers

Preventing Hypothermia Mount Rinjani Risks

• Wear windproof, warm layers suitable for summit temperatures nearing freezing.
• Maintain hydration and caloric intake throughout the trek.
• Avoid prolonged inactivity while wet or exposed to wind.
• Check weather forecasts before attempting the summit push.
• Trekking guides should prepare gear checks and train staff to recognize early symptoms, similar to how event organizers reduce cold-related risk (Procter et al., 2018).

Understanding how hypothermia Mount Rinjani cases develop and knowing how to assess levels of consciousness and quickly administer basic first aid can prevent manageable, mild cases from escalating into life-threatening emergencies.

References

• Procter, E., Brugger, H., & Burtscher, M. (2018). Accidental hypothermia in recreational activities in the mountains: A narrative review. Scandinavian Journal of Medicine & Science in Sports, 28(12), 2464–2472.
• Podsiadło, P., Darocha, T., Kosiński, S., Sałapa, K., Ziętkiewicz, M., Sanak, T., Turner, R., & Brugger, H. (2017). Severe hypothermia management in mountain rescue: A survey study. High Altitude Medicine & Biology, 18(4), 411–416.
• Musi, M. E., Sheets, A., Zafren, K., Brugger, H., Paal, P., Hölzl, N., & Pasquier, M. (2021). Clinical staging of accidental hypothermia: The Revised Swiss System. Recommendation of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Resuscitation, 162, 182–187.
• Omidi, A., Hawley, G. D., Kain, D., Jazuli, F., Meconnen, M., Polemidiotis, M., Do, N. P., Egbewumi, O., & Boggild, A. K. (2025). What is new in altitude- and cold-related illnesses of travel: Appraisal and summary of the updated guidelines from the Wilderness Medical Society. International Journal of Environmental Research and Public Health, 22(2), 284.

Writer: dr. Salmaa Nurul Aulia Dewi - General Practitioner & Chief Medical Officer Nusa Medica Clinic Gili Air