Portable prehospital methods to treat near-hypothermic shivering cold casualties

Oliver, S.J., Brierley, J.L., Raymond-Barker, P.C., Dolci, A. and Walsh, N.P. 2016. Portable prehospital methods to treat near-hypothermic shivering cold casualties. Wilderness & Environmental Medicine. 27 (1), pp. 125-130. doi:10.1016/j.wem.2015.11.012

TitlePortable prehospital methods to treat near-hypothermic shivering cold casualties
AuthorsOliver, S.J., Brierley, J.L., Raymond-Barker, P.C., Dolci, A. and Walsh, N.P.
Abstract

Objectives To 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 four large chemical-heat pads (MPS+HP: Blizzard Heat) to treat cold casualties.
Methods Portable cold casualty treatment methods were compared by examining core and skin temperature, metabolic heat production and thermal comfort during a 3-h, 0°C cold-air exposure in seven shivering, near-hypothermic men (35.4°C). The hot drink (70°C, ~400ml, ~28kJ) was consumed at 0, 1 and 2 h during the cold-air exposure.
Results During the cold-air exposure, core-rewarming and thermal comfort were similar on all trials (P = 0.45 and P = 0.36, respectively). However, skin temperature was higher (10-13%, P <0.001, large effect sizes d > 2.7) and metabolic heat production lower (15-39%, P < 0.05, large effect sizes d > 0.9) 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 = 0.05, large effect size d = 0.9). The addition of the hot drink to polyethylene survival bag did not increase skin temperature or lower metabolic heat production.
Conclusions Near-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.

KeywordsRewarming; Hypothermia; Thermogenesis; Multiple Trauma; Frostbite; Wilderness Medicine.
JournalWilderness & Environmental Medicine
Journal citation27 (1), pp. 125-130
ISSN1080-6032
Year2016
PublisherElsevier
Accepted author manuscriptPortable prehospital methods to treat near-hypothermic shivering cold casualties.docx
Digital Object Identifier (DOI)doi:10.1016/j.wem.2015.11.012
Web address (URL)https://www.researchgate.net/publication/285143591_Portable_prehospital_methods_to_treat_near-hypothermic_shivering_cold_casualties
Publication dates
Published04 Mar 2016

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