Various methods exist for
rewarming hypothermia casualties. Most of these methods necessitate sophisticated medical equipment or vigorous hemodynamic and electrolytic monitoring. Therefore, only a few methods remain suitable for pre-hospital scenarios. The current work reviews the literature regarding these pre-hospital
rewarming methods, focusing on their efficacy and compatibility to the cold pre-hospital environment with its limited resources. By relying on endogenous heat producing mechanisms and by isolating the victim, one can achieve fairly efficient
rewarming for mild
hypothermia (rectal temperature of 32 degrees C-35 degrees C) casualties. Many consider this as an independent
rewarming method (passive or endogeneous
rewarming method), advisable for mild
hypothermia cases. There are also many active
rewarming methods, suitable for pre-hospital treatment. These methods, however, suppress the endogenous heat producing mechanisms, and therefore are not more efficient than passive
rewarming for mild
hypothermia cases. In moderate or severe
hypothermia casualties,
hypothermia (rectal temperature below 32 degrees C) however, is characterized by suppressed or deficient endogenous heat producing mechanisms. Passive
rewarming is not enough in these cases, necessitating the addition of active, central or peripheral
rewarming methods. Studies regarding the use of various active
rewarming methods in severe
hypothermia casualties revealed low
rewarming efficacy for the low heat capacity methods, such as warm air inhalation, and a high
rewarming efficacy for the high heat capacity methods, such as forced air methods.