Dutta Ramesh, Kulkarni Kartik, Steinman Alan M, Gardiner Phillip F, McDonald Gerren K, Giesbrecht Gordon G
Laboratory for Exercise and Environmental Medicine, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
Laboratory for Exercise and Environmental Medicine, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada; United States Public Health Service (Retired), Washington, DC.
Wilderness Environ Med. 2019 Jun;30(2):163-176. doi: 10.1016/j.wem.2019.02.006. Epub 2019 May 2.
We compared the effectiveness of 5 heated hypothermia wrap systems.
Physiologic and subjective responses were determined in 5 normothermic subjects (1 female) for 5 heated hypothermia wraps (with vapor barrier and chemical heat sources) during 60 min of exposure to a temperature of -22°C. The 5 systems were 1) user-assembled; 2) Doctor Down Rescue Wrap; 3) hypothermia prevention and management kit (HPMK); 4) MARSARS Hypothermia Stabilizer Bag; and 5) Wiggy's Victims Casualty Hypothermia Bag. Core and skin temperature, metabolic heat production, skin heat loss, and body net heat gain were determined. Subjective responses were also evaluated for whole body cold discomfort, overall shivering rating, overall temperature rating, and preferential ranking.
The Doctor Down and user-assembled systems were generally more effective, with higher skin temperatures and lower metabolic heat production; they allowed less heat loss, resulting in higher net heat gain (P<0.05). HPMK had the lowest skin temperature and highest shivering heat production and scored worse than the other 4 systems for the "whole body cold discomfort" and "overall temperature" ratings (P<0.05).
The user-assembled and Doctor Down systems were most effective, and subjects were coldest with the HPMK system. However, it is likely that any of the tested systems would be viable options for wilderness responders, and the choice would depend on considerations of cost; volume, as it relates to available space; and weight, as it relates to ability to carry or transport the system to the patient.
我们比较了5种加热式低温防护包裹系统的有效性。
在5名体温正常的受试者（1名女性）中，于-22°C的环境温度下暴露60分钟期间，对5种加热式低温防护包裹（带有防潮层和化学热源）测定生理和主观反应。这5种系统分别为：1）用户自行组装的；2）Doctor Down救援包裹；3）低温预防与管理套件（HPMK）；4）MARSARS低温稳定袋；5）Wiggy's受害者伤亡低温袋。测定了核心体温和皮肤温度、代谢产热、皮肤散热以及身体净热量增加情况。还对全身冷不适、总体寒战评分、总体温度评分和优先排名等主观反应进行了评估。
Doctor Down系统和用户自行组装的系统总体上更有效，皮肤温度较高且代谢产热较低；它们的热量散失较少，导致净热量增加较高（P<0.05）。HPMK的皮肤温度最低，寒战产热最高，在“全身冷不适”和“总体温度”评分方面比其他4种系统得分更差（P<0.05）。
用户自行组装的系统和Doctor Down系统最有效，而受试者在使用HPMK系统时感觉最冷。然而，任何一种测试系统都可能是野外救援人员的可行选择，选择将取决于成本、与可用空间相关的体积以及与携带或运输系统至患者的能力相关的重量等因素。
