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Wilderness Environ Med · Mar 2016
Portable Prehospital Methods to Treat Near-Hypothermic Shivering Cold Casualties.
- Samuel J Oliver, Jennifer L Brierley, Philippa C Raymond-Barker, Alberto Dolci, and Neil P Walsh.
- Extremes Research Group, School of Sport, Health and Exercise Sciences, Bangor University, Bangor, United Kingdom. Electronic address: s.j.oliver@bangor.ac.uk.
- Wilderness Environ Med. 2016 Mar 1; 27 (1): 125-30.
ObjectiveTo compare the effectiveness of a single-layered polyethylene survival bag (P), a single-layered polyethylene survival bag with a hot drink (P+HD), a multi-layered metalized plastic sheeting survival bag (MPS: Blizzard Survival), and a multi-layered MPS survival bag with 4 large chemical heat pads (MPS+HP: Blizzard Heat) to treat cold casualties.MethodsPortable cold casualty treatment methods were compared by examining core and skin temperature, metabolic heat production, and thermal comfort during a 3-hour, 0°C cold air exposure in 7 shivering, near-hypothermic men (35.4°C). The hot drink (70°C, ~400 ml, ~28 kJ) was consumed at 0, 1, and 2 hours during the cold air exposure.ResultsDuring the cold air exposure, core rewarming and thermal comfort were similar on all trials (P = .45 and P = .36, respectively). However, skin temperature was higher (10%-13%; P < .001; large effect sizes d > 2.7) and metabolic heat production lower (15%-39%; P < .05; large effect sizes d > .9) on MPS and MPS+HP than P and P+HD. The addition of heat pads further lowered metabolic heat production by 15% (MPS+HP vs MPS; P = .05; large effect size d = .9). The addition of the hot drink to polyethylene survival bag did not increase skin temperature or lower metabolic heat production.ConclusionsNear-hypothermic cold casualties are rewarmed with less peripheral cold stress and shivering thermogenesis using a multi-layered MPS survival bag compared with a polyethylene survival bag. Prehospital rewarming is further aided by large chemical heat pads but not by hot drinks.Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
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