Depending on the situation, eMedicineHealth reports, death by hypothermia can take hours, days, or even weeks. However, it's noted that exposure to freezing water can cause death quicker than exposure to air. Per WXYZ, falling through ice into water is almost certainly a death sentence. Hypothermia can set in within two minutes, which can cause death in under an hour. That being said, Outside Magazine states that the initial onset of hypothermia is painful. This is due to the body working overtime to stay warm and the eventual loss of control and bodily functions. Moreover, there can also be pain associated with frostbite.
Described as feeling like "pins and needles" (via Cleveland Clinic), this can occur when any part of the skin is exposed to the cold for an extended period of time. Nevertheless, there is a silver lining to it all. KTRE states that at a certain point, freezing to death becomes pain-free and in many cases, the victim can feel "serene." In 2006, climber Kelly James died from hypothermia on Mount Hood in Oregon.
John Sohl, director of search and rescue in Utah, explained that although it took James days to die, it was unlikely he felt anything. As Sohl put it, "The victim will get into sort of a dreamlike state" (via KTRE). As his body began to lose consciousness from the cold, James essentially slipped into a coma. Sohl, who once experienced hypothermia, went on to say that "Of all the ways to go, this would not be the worst."
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