What is an indicator of severe hypothermia?

Severe hypothermia is characterized by a significant drop in body temperature, which leads to a range of physiological and neurological changes. The indicator of "no shivering and confusion" is particularly crucial because, as the body temperature drops, shivering—a natural response to generate heat—ceases. The body becomes unable to maintain its core temperature properly, which can result in confusion or altered mental status as the neurological functions begin to fail. This combination of no shivering and confusion signals that the hypothermia has progressed to a severe state and requires immediate medical attention. Recognizing this symptom is critical for wilderness responders, as it can help them prioritize and implement life-saving interventions quickly.