II. Management: Methods of rewarming in wilderness
-
General
- Move the patient to warm, dry environment
- Remove wet clothing
- Avoid excessive movement (risk of Arrhythmia)
- Passive external rewarming
- Warm dry blanket
- Hot water bottle
- Wrapped hot rocks
- Warm next to another body
-
Active External Rewarming
- Radiant heat source
- Heat pads
- Immersion
- Active core rewarming
- Heated airway inhalation
- Heated IV fluids
- Gastrointestinal irrigation
- Peritoneal Dialysis
- Extracorporeal rewarming
- Diathermy
III. Management: Wilderness
- Mild Hypothermia
- Prevent further heat loss
- Remove wet clothing
- Move to warm environment
- Oral rehydration
- Severe Hypothermia
- Evacuation
- Gentle handling
- ABC Management and Cardiac monitor
IV. Prevention: Wilderness
- See Emergency Car Kit
- Plan the activity
- Appropriate clothing (with back up items)
- Dress in layers
- Avoid cotton
- Base layer of polypropylene or polyester (long underwear)
- Middle layer of wool or fleece
- Outer layer of shell that repels water but is breathable (e.g. gortex)
- Loose clothing and boots promote greater circulation
- Wear a hat
- Wear mittens (preferred over gloves)
- Wear extra socks (e.g. liner and wool sock) with a boot sized to accomodate the additional bulk
- Change socks daily or when wet
- Dress in layers
- Appropriate Food and Fluids
- Other measures
- Use Supplemental Oxygen at very high altitude (7500 meters or above 24,000 feet)