Wilderness Medical Society snowmass 2005 Page 307
Evaluation and Treatment of Hypothermia, Colin K. Grissom, M.D.
page 11
Table 4. Rewarming Methods
Usefulness
Mild Hypothermia
Vigorous shivering
Warm food / drink
Body-to-body contact
(Giesbrecht 1994)
Exercise
(Giesbrecht 1987)
Chemical or electrical heating pads
Warm water bottles
Moderate Hypothermia
Warm, humidified oxygen
(Goheen 1997)
Warm IV fluids
Warm bath immersion
(Hoskin 1986)
Arteriovenous anastomoses (AVA) rewarming
(immersion of extremities in a warm water
bath or negative pressure applied to an
extremity)
Forced air warming (Bair Hugger)
(Giesbrecht 1998; Koller 1997)
Severe Hypothermia
Body cavity lavage (pleural, gastric, or
peritoneal)
Extracorporeal circulation
(Gentilello 1990; Gentilello 2001; Walpoth
1997)
Rewarming rate 0.5 to 1.5 ° C/hr when insulation is
provided
Recommended for conscious patients with mild
hypothermia, limited rewarming but calories are
important for shivering thermogenesis
Limited, may stop shivering, probably only useful
for mild hypothermia with inadequate shivering
Effective with rewarming rates equal to or greater
than shivering but may increase afterdrop severalfold
Limited, may stop shivering, no advantage over
shivering alone, may be combined with other
modalities in a non-shivering hypothermic patient
Useful to reduce afterdrop and heat loss, but not
efficient for rewarming, useful to combine with other
rewarming modalities
Little heat, but prevents further heat loss
Effective but not recommended in the field,
inadequate access to a critically ill patient,
rewarming rate 5°C/hr
Effective, rewarming rate 6°C/hr or greater
(Grahn 1998; Vanggaard 1999)
Efficient, easy to apply in a critically ill patient,
rewarming rates 1.0 to 2.5 ° C/hr in non-shivering
patients
Effective for severe hypothermia, increases
rewarming rate when combined with other
modalities
Effective, rewarming rates of 3-9°C/hr depending on
the method used
