Literature DB >> 26948559

Portable Prehospital Methods to Treat Near-Hypothermic Shivering Cold Casualties.

Samuel J Oliver1, Jennifer L Brierley2, Philippa C Raymond-Barker2, Alberto Dolci2, Neil P Walsh2.   

Abstract

OBJECTIVE: 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 4 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-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.
RESULTS: During 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.
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.
Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  frostbite; hypothermia; multiple trauma; rewarming; thermogenesis; wilderness medicine

Mesh:

Year:  2016        PMID: 26948559     DOI: 10.1016/j.wem.2015.11.012

Source DB:  PubMed          Journal:  Wilderness Environ Med        ISSN: 1080-6032            Impact factor:   1.518


  4 in total

Review 1.  Accidental hypothermia-an update : The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

Authors:  Peter Paal; Les Gordon; Giacomo Strapazzon; Monika Brodmann Maeder; Gabriel Putzer; Beat Walpoth; Michael Wanscher; Doug Brown; Michael Holzer; Gregor Broessner; Hermann Brugger
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2016-09-15       Impact factor: 2.953

Review 2.  Multiple trauma management in mountain environments - a scoping review : Evidence based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Intended for physicians and other advanced life support personnel.

Authors:  G Sumann; D Moens; B Brink; M Brodmann Maeder; M Greene; M Jacob; P Koirala; K Zafren; M Ayala; M Musi; K Oshiro; A Sheets; G Strapazzon; D Macias; P Paal
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2020-12-14       Impact factor: 2.953

3.  Heat Balance When Climbing Mount Everest.

Authors:  Robert K Szymczak; Krzysztof Błażejczyk
Journal:  Front Physiol       Date:  2021-11-25       Impact factor: 4.566

4.  Death Zone Weather Extremes Mountaineers Have Experienced in Successful Ascents.

Authors:  Robert K Szymczak; Michał Marosz; Tomasz Grzywacz; Magdalena Sawicka; Marta Naczyk
Journal:  Front Physiol       Date:  2021-07-05       Impact factor: 4.566

  4 in total

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