@article{ref1,
title="Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier",
journal="Wilderness and environmental medicine",
year="2015",
author="Henriksson, Otto and Lundgren, Peter J. and Kuklane, Kalev and Holmer, Ingvar and Giesbrecht, Gordon G. and Naredi, Peter and Bjornstig, Ulf",
volume="26",
number="1",
pages="11-20",
abstract="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. <br><br>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. <br><br>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). <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="1080-6032",
doi="10.1016/j.wem.2014.07.001",
url="http://dx.doi.org/10.1016/j.wem.2014.07.001"
}