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Accidental hypothermia is not a frequent cause of death in Australia. Moreover it is rare to have an admission to hospital with a core temperature below 32°C. Among the cases described in the literature, it is clear that temperature and prognosis are related. Our patient presented with severe accidental hypothermia and even though the admission core temperature was below 26 degrees she was successfully discharged from hospital after active re-warming with three different devices. She had laboratory and ECG findings associated with severe hypothermia.

The key feature of John Hunter Hospital Birth Centre is that consumer input influences the philosophy and protocols of the unit through a management executive. The executive includes representatives from all groups who use the Birth Centre, including general practitioners, visiting midwives, obstetricians and staff midwives, as well as 50% consumer representation. This has resulted in a unique Birth Centre with open and flexible entry criteria. Since its opening in February 1991, 1,492 women have been admitted to John Hunter Hospital Birth Centre, and of these 1,221 (82%) gave birth there. This figure is greater than any other Birth Centre utilization rate in Australia (1-4). An examination of outcomes for 1992 indicates that neither the higher than usual utilization rate nor the open entry criteria has compromised safety for either women or their infants.

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