Effect of Wet Clothing Removal Compared to Use of a Vapor Barrier in Accidental Hypothermia

Effect of Wet Clothing Removal in the Treatment of Accidental Hypothermia: A Human Crossover Field Study

The optimal method of prehospital insulation and rewarming of hypothermic patients have been subject of debate, and there is a substantial lack og high-quality evidence to guide providers.

One question concerns whether or not the patients clothing should be removed prior to being wrapped in an insulating model with a vapor barrier. Evaporative heat loss is one of four mechanisms of heat loss, and preventing evaporative heat loss should be a prioritized task for providers. Removal of wet clothing usually means subjecting the patient to the environment, but will reduce the evaporative heat loss considerably. An other alternative is to encapsulate the patient in a vapor barrier. Evaporative heat loss will stop when the humidity inside the vapor barrier reaches 100%.

We aim to investigate whether it is recommended to removed wet clothing or encase the patient in a vapor barrier.

Study Overview

• Status: Completed
• Conditions: Emergencies; Accidental Hypothermia
• Intervention / Treatment: Procedure: Wet clothing removal

• Study Type: Interventional
• Enrollment (Actual): 8
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Bergen, Norway
    • Haukeland University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age <18
• American Society of Anaesthesiologists class 1
• No nicotine use

Exclusion Criteria:

• Acute illness on study day, fever or malaise

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Wet clothing removal	Procedure: Wet clothing removal; The participants in the intervention group will have their clothing removed prior to insulation.
No Intervention: Vapor barrier

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean skin temperature	Change in mean skin temperature during rewarming phase	60 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective thermal comfort and shivering	Using a validated questionnaire at regular intervals	60 minutes

Collaborators and Investigators

• Sponsor: Haukeland University Hospital
• Investigators: Principal Investigator: Øyvind Thomassen, MD, PhD, Haukeland University Hospital

Publications and helpful links

General Publications

• Henriksson O, Lundgren PJ, Kuklane K, Holmer I, Giesbrecht GG, Naredi P, Bjornstig U. Protection against cold in prehospital care: wet clothing removal or addition of a vapor barrier. Wilderness Environ Med. 2015 Mar;26(1):11-20. doi: 10.1016/j.wem.2014.07.001.

Study record dates

Study Major Dates

• Study Start (Actual): March 20, 2017
• Primary Completion (Actual): March 21, 2017
• Study Completion (Actual): March 21, 2017

Study Registration Dates

• First Submitted: August 10, 2023
• First Submitted That Met QC Criteria: August 10, 2023
• First Posted (Actual): August 18, 2023

Study Record Updates

• Last Update Posted (Actual): August 18, 2023
• Last Update Submitted That Met QC Criteria: August 10, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Keywords: Accidental hypothermia; Mountain Medicine
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Body Temperature Changes; Emergencies; Hypothermia
• Other Study ID Numbers: 2017/150

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No