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Comparison of three different prehospital wrapping methods for preventing hypothermia--a crossover study in humans.

Thomassen Ø, Færevik H, Østerås Ø, Sunde GA, Zakariassen E, Sandsund M, Heltne JK, Brattebø G - Scand J Trauma Resusc Emerg Med (2011)

Bottom Line: Skin temperature was significantly higher 15 minutes after wrapping using Hibler's method compared with wrapping with ambulance blankets / quilts or bubble wrap.The subjects reported more shivering, they felt colder, were more uncomfortable, and had an increased heat production when using bubble wrap compared with the other two methods.Bubble wrap was the least effective insulating method, and seemed to require significantly higher heat production to compensate for increased heat loss.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway. oyvind.thomassen2@helse-bergen.no

ABSTRACT

Background: Accidental hypothermia increases mortality and morbidity in trauma patients. Various methods for insulating and wrapping hypothermic patients are used worldwide. The aim of this study was to compare the thermal insulating effects and comfort of bubble wrap, ambulance blankets / quilts, and Hibler's method, a low-cost method combining a plastic outer layer with an insulating layer.

Methods: Eight volunteers were dressed in moistened clothing, exposed to a cold and windy environment then wrapped using one of the three different insulation methods in random order on three different days. They were rested quietly on their back for 60 minutes in a cold climatic chamber. Skin temperature, rectal temperature, oxygen consumption were measured, and metabolic heat production was calculated. A questionnaire was used for a subjective evaluation of comfort, thermal sensation, and shivering.

Results: Skin temperature was significantly higher 15 minutes after wrapping using Hibler's method compared with wrapping with ambulance blankets / quilts or bubble wrap. There were no differences in core temperature between the three insulating methods. The subjects reported more shivering, they felt colder, were more uncomfortable, and had an increased heat production when using bubble wrap compared with the other two methods. Hibler's method was the volunteers preferred method for preventing hypothermia. Bubble wrap was the least effective insulating method, and seemed to require significantly higher heat production to compensate for increased heat loss.

Conclusions: This study demonstrated that a combination of vapour tight layer and an additional dry insulating layer (Hibler's method) is the most efficient wrapping method to prevent heat loss, as shown by increased skin temperatures, lower metabolic rate and better thermal comfort. This should then be the method of choice when wrapping a wet patient at risk of developing hypothermia in prehospital environments.

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Related in: MedlinePlus

Metabolic heat production. Metabolic heat production. Values are means ± SD (n = 7). * Significantly higher heat production by shivering occurred with the BW method compared with either the HM and ABQ methods (P < 0.05)
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Figure 3: Metabolic heat production. Metabolic heat production. Values are means ± SD (n = 7). * Significantly higher heat production by shivering occurred with the BW method compared with either the HM and ABQ methods (P < 0.05)

Mentions: A significant difference was found between the three methods in metabolic heat production due to shivering over time (Figure 3). The metabolic rate was similar between conditions during rest, and increased 1.6 fold after 30 min of cooling under all conditions. Thirty and sixty minutes after wrapping, the test subjects wrapped in BW had a significantly larger heat production due to shivering, than those wrapped with HM or ABQ, demonstrated in increased metabolic rate.


Comparison of three different prehospital wrapping methods for preventing hypothermia--a crossover study in humans.

Thomassen Ø, Færevik H, Østerås Ø, Sunde GA, Zakariassen E, Sandsund M, Heltne JK, Brattebø G - Scand J Trauma Resusc Emerg Med (2011)

Metabolic heat production. Metabolic heat production. Values are means ± SD (n = 7). * Significantly higher heat production by shivering occurred with the BW method compared with either the HM and ABQ methods (P < 0.05)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3142217&req=5

Figure 3: Metabolic heat production. Metabolic heat production. Values are means ± SD (n = 7). * Significantly higher heat production by shivering occurred with the BW method compared with either the HM and ABQ methods (P < 0.05)
Mentions: A significant difference was found between the three methods in metabolic heat production due to shivering over time (Figure 3). The metabolic rate was similar between conditions during rest, and increased 1.6 fold after 30 min of cooling under all conditions. Thirty and sixty minutes after wrapping, the test subjects wrapped in BW had a significantly larger heat production due to shivering, than those wrapped with HM or ABQ, demonstrated in increased metabolic rate.

Bottom Line: Skin temperature was significantly higher 15 minutes after wrapping using Hibler's method compared with wrapping with ambulance blankets / quilts or bubble wrap.The subjects reported more shivering, they felt colder, were more uncomfortable, and had an increased heat production when using bubble wrap compared with the other two methods.Bubble wrap was the least effective insulating method, and seemed to require significantly higher heat production to compensate for increased heat loss.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway. oyvind.thomassen2@helse-bergen.no

ABSTRACT

Background: Accidental hypothermia increases mortality and morbidity in trauma patients. Various methods for insulating and wrapping hypothermic patients are used worldwide. The aim of this study was to compare the thermal insulating effects and comfort of bubble wrap, ambulance blankets / quilts, and Hibler's method, a low-cost method combining a plastic outer layer with an insulating layer.

Methods: Eight volunteers were dressed in moistened clothing, exposed to a cold and windy environment then wrapped using one of the three different insulation methods in random order on three different days. They were rested quietly on their back for 60 minutes in a cold climatic chamber. Skin temperature, rectal temperature, oxygen consumption were measured, and metabolic heat production was calculated. A questionnaire was used for a subjective evaluation of comfort, thermal sensation, and shivering.

Results: Skin temperature was significantly higher 15 minutes after wrapping using Hibler's method compared with wrapping with ambulance blankets / quilts or bubble wrap. There were no differences in core temperature between the three insulating methods. The subjects reported more shivering, they felt colder, were more uncomfortable, and had an increased heat production when using bubble wrap compared with the other two methods. Hibler's method was the volunteers preferred method for preventing hypothermia. Bubble wrap was the least effective insulating method, and seemed to require significantly higher heat production to compensate for increased heat loss.

Conclusions: This study demonstrated that a combination of vapour tight layer and an additional dry insulating layer (Hibler's method) is the most efficient wrapping method to prevent heat loss, as shown by increased skin temperatures, lower metabolic rate and better thermal comfort. This should then be the method of choice when wrapping a wet patient at risk of developing hypothermia in prehospital environments.

Show MeSH
Related in: MedlinePlus