Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier
Author
Summary, in English
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/m2) 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.
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/m2) 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.
Department/s
Publishing year
2015
Language
English
Pages
11-20
Publication/Series
Wilderness & Environmental Medicine
Volume
26
Issue
1
Document type
Journal article
Publisher
Elsevier
Topic
- Production Engineering, Human Work Science and Ergonomics
Keywords
- hypothermia heat loss thermal insulation emergency medical services
Status
Published
Research group
- Thermal Environment Laboratory
ISBN/ISSN/Other
- ISSN: 1080-6032