Effect of Wet Clothing Removal Compared to Use of a Vapor Barrier in Accidental Hypothermia

Effect of Wet Clothing Removal in the Treatment of Accidental Hypothermia: A Human Crossover Field Study

The optimal method of prehospital insulation and rewarming of hypothermic patients have been subject of debate, and there is a substantial lack og high-quality evidence to guide providers. One question concerns whether or not the patients clothing should be removed prior to being wrapped in an insulating model with a vapor barrier. Evaporative heat loss is one of four mechanisms of heat loss, and preventing evaporative heat loss should be a prioritized task for providers. Removal of wet clothing usually means subjecting the patient to the environment, but will reduce the evaporative heat loss considerably. An other alternative is to encapsulate the patient in a vapor barrier. Evaporative heat loss will stop when the humidity inside the vapor barrier reaches 100%. We aim to investigate whether it is recommended to removed wet clothing or encase the patient in a vapor barrier.

Inclusion Criteria: Age <18 American Society of Anaesthesiologists class 1 No nicotine use Exclusion Criteria: Acute illness on study day, fever or malaise

Henriksson O, Lundgren PJ, Kuklane K, Holmer I, Giesbrecht GG, Naredi P, Bjornstig U. Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier. Wilderness Environ Med. 2015 Mar;26(1):11-20. doi: 10.1016/j.wem.2014.07.001.