1. 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 (March 2015)
DOI: /j.wem
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2. 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  , 11-20DOI: ( /j.wem )
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3. 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  , 11-20DOI: ( /j.wem )
Copyright © 2015 Wilderness Medical Society Terms and Conditions

4. 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  , 11-20DOI: ( /j.wem )
Copyright © 2015 Wilderness Medical Society Terms and Conditions

5. 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  , 11-20DOI: ( /j.wem )
Copyright © 2015 Wilderness Medical Society Terms and Conditions

6. 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  , 11-20DOI: ( /j.wem )
Copyright © 2015 Wilderness Medical Society Terms and Conditions