Efficacy of warming systems in mountain rescue: an experimental manikin study
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ORIGINAL PAPER
Efficacy of warming systems in mountain rescue: an experimental manikin study Paweł Podsiadło 1 Tomasz Darocha 6
Ewa Zender-Świercz 2 3 & Hermann Brugger
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Giacomo Strapazzon 3
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Sylweriusz Kosiński 4
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Marek Telejko 5
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Received: 18 May 2020 / Revised: 17 August 2020 / Accepted: 25 August 2020 # The Author(s) 2020
Abstract Mountain accident casualties are often exposed to cold and windy weather. This may induce post-traumatic hypothermia which increases mortality. The aim of this study was to assess the ability of warming systems to compensate for the victim’s estimated heat loss in a simulated mountain rescue operation. We used thermal manikins and developed a thermodynamic model of a virtual patient. Manikins were placed on a mountain rescue stretcher and exposed to wind chill indices of 0 °C and − 20 °C in a climatic chamber. We calculated the heat balance for two simulated clinical scenarios with both a shivering and non-shivering victim and measured the heat gain from gel, electrical, and chemical warming systems for 3.5 h. The heat balance in the simulated shivering patient was positive. In the non-shivering patient, we found a negative heat balance for both simulated weather conditions (− 429.53 kJ at 0 °C and − 1469.78 kJ at − 20 °C). Each warming system delivered about 300 kJ. The efficacy of the gel and electrical systems was higher within the first hour than later (p < 0.001). We conclude that none of the tested warming systems is able to compensate for heat loss in a simulated model of a non-shivering patient whose physiological heat production is impaired during a prolonged mountain evacuation. Additional thermal insulation seems to be required in these settings. Keywords Hypothermia . Rewarming . Mountain rescue . Thermal manikin . Wind chill index . Cold exposure
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00484-020-02008-6) contains supplementary material, which is available to authorized users. * Paweł Podsiadło [email protected] 1
Department of Emergency Medicine, Jan Kochanowski University, ul. IX Wieków Kielc 19a, 25-516 Kielce, Poland
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Department of Building Physics and Renewable Energy, Faculty of Environmental, Geomatic and Energy Engineering, Kielce University of Technology, Kielce, Poland
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Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Faculty of Civil Engineering and Architecture, Kielce University of Technology, Kielce, Poland
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Department of Anesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
Hypothermia is commonly encountered in mountain rescue operations. Casualties are usually immobilized due to injury and exposed to cold, wind, and humidity (McLennan and Ungersma 1983; Guly 1996; Smith 2006). Exhaustion and energy depletion are frequent, even among uninjured mountaineers, and may cause hypothermia (Hearns 2003). Metabolic heat
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