As the temperature decreases, further physiological systems falter and heart rate, respiratory rate, and blood pressure all decrease..
Difficulty in speaking, sluggish thinking, and amnesia start to appear; inability to use hands and stumbling is also usually present. Cellular metabolic processes shut down. Below 30 °C (86 °F), the exposed skin becomes blue and puffy, muscle coordination becomes very poor, walking becomes almost impossible, and the person exhibits incoherent/irrational behavior including terminal burrowing or even a stupor.
Pulse and respiration rates decrease significantly, but fast heart rates (ventricular tachycardia, atrial fibrillation) can occur. Major organs fail. Clinical death occurs.