Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study
Abstract Background Prehospital care for cold-stressed and hypothermic patients focuses on effective insulation and rewarming. When encountering patients wearing wet clothing, rescuers can either remove the wet clothing before isolating the patient or isolate the patient using a vapor barrier. Wet c...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-024-00937-8 |
| _version_ | 1797276671862112256 |
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| author | Linn Therese Hagen Guttorm Brattebø Jörg Assmus Dipl-Math Øystein Wiggen Øyvind Østerås Sigurd Mydske Øyvind Thomassen |
| author_facet | Linn Therese Hagen Guttorm Brattebø Jörg Assmus Dipl-Math Øystein Wiggen Øyvind Østerås Sigurd Mydske Øyvind Thomassen |
| author_sort | Linn Therese Hagen |
| collection | DOAJ |
| description | Abstract Background Prehospital care for cold-stressed and hypothermic patients focuses on effective insulation and rewarming. When encountering patients wearing wet clothing, rescuers can either remove the wet clothing before isolating the patient or isolate the patient using a vapor barrier. Wet clothing removal increases skin exposure but avoids the need to heat the wet clothing during rewarming. Leaving wet clothing on will avoid skin exposure but is likely to increase heat loss during rewarming. This study aimed to evaluate the effect of wet clothing removal compared to containing the moisture using a vapor barrier on skin temperature in a prehospital setting. Methods This randomized crossover experimental field study was conducted in a snow cave in Hemsedal, Norway. After an initial cooling phase of 30 min while wearing wet clothes, the participants were subjected to one of two rewarming scenarios: (1) wet clothing removal and wrapping in a vapor barrier, insulating blankets, and windproof outer shell (dry group) or (2) wrapping in a vapor barrier, insulating blankets, and windproof outer shell (wet group). The mean skin temperature was the primary outcome whereas subjective scores for both thermal comfort and degree of shivering were secondary outcomes. Primary outcome data were analyzed using the analysis of covariance (ANCOVA). Results After an initial decrease in temperature during the exposure phase, the dry group had a higher mean skin temperature compared to the wet group after only 2 min. The skin-rewarming rate was highest in the initial rewarming stages for both groups, but increased in the dry group as compared to the wet group in the first 10 min. Return to baseline temperature occurred significantly faster in the dry group (mean 12.5 min [dry] vs. 28.1 min [wet]). No intergroup differences in the subjective thermal comfort or shivering were observed. Conclusion Removal of wet clothing in combination with a vapor barrier increases skin rewarming rate compared to encasing the wet clothing in a vapor barrier, in mild cold and environments without wind. Trial registration ClinicalTrials.gov ID NCT05996757, retrospectively registered 18/08/2023. |
| first_indexed | 2024-03-07T15:31:35Z |
| format | Article |
| id | doaj.art-465c4011122143e7a28c2fa70b4251f5 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-07T15:31:35Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-465c4011122143e7a28c2fa70b4251f52024-03-05T16:21:57ZengBMCBMC Emergency Medicine1471-227X2024-01-012411910.1186/s12873-024-00937-8Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field studyLinn Therese Hagen0Guttorm Brattebø1Jörg Assmus Dipl-Math2Øystein Wiggen3Øyvind Østerås4Sigurd Mydske5Øyvind Thomassen6Department of Anaesthesia and Intensive Care, Haukeland University HospitalDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalMountain Medicine Research Group, The Norwegian Air Ambulance FoundationSINTEF Technology and Society, Preventive Health ResearchDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalAbstract Background Prehospital care for cold-stressed and hypothermic patients focuses on effective insulation and rewarming. When encountering patients wearing wet clothing, rescuers can either remove the wet clothing before isolating the patient or isolate the patient using a vapor barrier. Wet clothing removal increases skin exposure but avoids the need to heat the wet clothing during rewarming. Leaving wet clothing on will avoid skin exposure but is likely to increase heat loss during rewarming. This study aimed to evaluate the effect of wet clothing removal compared to containing the moisture using a vapor barrier on skin temperature in a prehospital setting. Methods This randomized crossover experimental field study was conducted in a snow cave in Hemsedal, Norway. After an initial cooling phase of 30 min while wearing wet clothes, the participants were subjected to one of two rewarming scenarios: (1) wet clothing removal and wrapping in a vapor barrier, insulating blankets, and windproof outer shell (dry group) or (2) wrapping in a vapor barrier, insulating blankets, and windproof outer shell (wet group). The mean skin temperature was the primary outcome whereas subjective scores for both thermal comfort and degree of shivering were secondary outcomes. Primary outcome data were analyzed using the analysis of covariance (ANCOVA). Results After an initial decrease in temperature during the exposure phase, the dry group had a higher mean skin temperature compared to the wet group after only 2 min. The skin-rewarming rate was highest in the initial rewarming stages for both groups, but increased in the dry group as compared to the wet group in the first 10 min. Return to baseline temperature occurred significantly faster in the dry group (mean 12.5 min [dry] vs. 28.1 min [wet]). No intergroup differences in the subjective thermal comfort or shivering were observed. Conclusion Removal of wet clothing in combination with a vapor barrier increases skin rewarming rate compared to encasing the wet clothing in a vapor barrier, in mild cold and environments without wind. Trial registration ClinicalTrials.gov ID NCT05996757, retrospectively registered 18/08/2023.https://doi.org/10.1186/s12873-024-00937-8Accidental hypothermiaVapor barrierMountain medicineEmergency medicineWet clothingField study |
| spellingShingle | Linn Therese Hagen Guttorm Brattebø Jörg Assmus Dipl-Math Øystein Wiggen Øyvind Østerås Sigurd Mydske Øyvind Thomassen Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study BMC Emergency Medicine Accidental hypothermia Vapor barrier Mountain medicine Emergency medicine Wet clothing Field study |
| title | Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study |
| title_full | Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study |
| title_fullStr | Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study |
| title_full_unstemmed | Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study |
| title_short | Effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier: a human, randomized, crossover field study |
| title_sort | effect of wet clothing removal on skin temperature in subjects exposed to cold and wrapped in a vapor barrier a human randomized crossover field study |
| topic | Accidental hypothermia Vapor barrier Mountain medicine Emergency medicine Wet clothing Field study |
| url | https://doi.org/10.1186/s12873-024-00937-8 |
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