Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier
2015 (English)In: Wilderness & environmental medicine (Print), ISSN 1080-6032, Vol. 26, no 1, 11-20 p.Article in journal (Refereed) Published
OBJECTIVE: The purpose of this study was to evaluate the effect of wet clothing removal or the addition of a vapor barrier in shivering subjects exposed to a cold environment with only limited insulation available.
METHODS: Volunteer subjects (n = 8) wearing wet clothing were positioned on a spineboard in a climatic chamber (-18.5°C) and subjected to an initial 20 minutes of cooling followed by 30 minutes of 4 different insulation interventions in a crossover design: 1) 1 woolen blanket; 2) vapor barrier plus 1 woolen blanket; 3) wet clothing removal plus 1 woolen blanket; or 4) 2 woolen blankets. Metabolic rate, core body temperature, skin temperature, and heart rate were continuously monitored, and cold discomfort was evaluated at 5-minute intervals.
RESULTS: Wet clothing removal or the addition of a vapor barrier significantly reduced metabolic rate (mean difference ± SE; 14 ± 4.7 W/m(2)) and increased skin temperature rewarming (1.0° ± 0.2°C). Increasing the insulation rendered a similar effect. There were, however, no significant differences in core body temperature or heart rate among any of the conditions. Cold discomfort (median; interquartile range) was significantly lower with the addition of a vapor barrier (4; 2-4.75) and with 2 woolen blankets (3.5; 1.5-4) compared with 1 woolen blanket alone (5; 3.25-6).
CONCLUSIONS: In protracted rescue scenarios in cold environments with only limited insulation available, wet clothing removal or the use of a vapor barrier is advocated to limit the need for shivering thermogenesis and improve the patient's condition on admission to the emergency department.
Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 26, no 1, 11-20 p.
hypothermia, heat loss, thermal insulation, emergency medical services
Public Health, Global Health, Social Medicine and Epidemiology Sport and Fitness Sciences
IdentifiersURN: urn:nbn:se:umu:diva-100365DOI: 10.1016/j.wem.2014.07.001ISI: 000350268800003PubMedID: 25712295OAI: oai:DiVA.org:umu-100365DiVA: diva2:791777