Otto Henriksson, MD, Peter J

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Presentation transcript:

Protection Against Cold in Prehospital Care: Wet Clothing Removal or Addition of a Vapor Barrier Otto Henriksson, MD, Peter J. Lundgren, MD, Kalev Kuklane, PhD, Ingvar Holmér, PhD, Gordon G. Giesbrecht, PhD, Peter Naredi, MD PhD, Ulf Bjornstig, MD PhD Wilderness & Environmental Medicine Volume 26, Issue 1, Pages 11-20 (March 2015) DOI: 10.1016/j.wem.2014.07.001 Copyright © 2015 Wilderness Medical Society Terms and Conditions

Figure 1 Metabolic rate during 4 insulation protocols in a cold environment (mean, n = 8) was significantly lower during last 20 minutes of insulation with wet clothing removal (WCR) + 1 woolen blanket (WB): blue line; vapor barrier (VB) + 1 WB: green line; and 2 woolen blankets (WB ×2): red line; compared with 1 WB alone: black line (P < .05). Wilderness & Environmental Medicine 2015 26, 11-20DOI: (10.1016/j.wem.2014.07.001) Copyright © 2015 Wilderness Medical Society Terms and Conditions

Figure 2 Core body (esophageal) temperature change from insulation applied during 4 insulation protocols in a cold environment (mean, n = 8). WB, woolen blanket (black line); WCR, wet clothing removal + WB (blue line); VB, vapor barrier + WB (green line); WB ×2, two woolen blankets (red line). Wilderness & Environmental Medicine 2015 26, 11-20DOI: (10.1016/j.wem.2014.07.001) Copyright © 2015 Wilderness Medical Society Terms and Conditions

Figure 3 Mean skin temperature change from insulation applied during 4 insulation protocols in a cold environment (mean, n = 8). There was significantly higher rewarming with wet clothing removal (WCR) + woolen blanket (WB): blue line; vapor barrier (VB) + WB: green line; and 2 woolen blankets (WB ×2): red line; compared with 1 WB alone: black line (P < .05). Wilderness & Environmental Medicine 2015 26, 11-20DOI: (10.1016/j.wem.2014.07.001) Copyright © 2015 Wilderness Medical Society Terms and Conditions

Figure 4 Heart rate during 4 insulation protocols in a cold environment (mean, n = 8). WB, woolen blanket (black line); WCR, wet clothing removal + WB (blue line); VB, vapor barrier + WB (green line); WB ×2, two woolen blankets (red line). Wilderness & Environmental Medicine 2015 26, 11-20DOI: (10.1016/j.wem.2014.07.001) Copyright © 2015 Wilderness Medical Society Terms and Conditions

Figure 5 Cold discomfort at initial cooling (10–20 minutes) and with insulation applied (30–50 minutes) during 4 insulation protocols in a cold environment (median; IQR, separated in time for simplicity, n = 8) was significantly lower during the last 20 minutes of insulation with vapor barrier (VB) + woolen blanket (WB): green line, and 2 woolen blankets (WB ×2): red line, compared with 1 WB alone: black line (P < .05). The change with wet clothing removal (WCR) + WB: blue line, was not statistically significant. Wilderness & Environmental Medicine 2015 26, 11-20DOI: (10.1016/j.wem.2014.07.001) Copyright © 2015 Wilderness Medical Society Terms and Conditions