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Cold weather response tips for EMS

Move with purpose to prevent an apparatus crash, slip or fall, and protect the patient from increased discomfort


Paramedics wheel a patient into the hospital after driving through a blizzard to reach her.

Michael Beck/Stony Brook Hospital via AP

Even though winter seems like it has been here for months, we still have quite a while to go in the northern hemisphere before spring arrives. While cold and snow may be great for winter sports and holiday spirit, they make emergency response more complex and potentially dangerous.

I have lived in the frozen tundra of Wisconsin for most of my life. These are seven of my cold weather response tips.

1. Your safety is number one

Always have cold-weather gear with you in the ambulance. I like to keep a small duffel bag that includes windproof/water-resistant pants, a thermal liner for my uniform coat and a sweatshirt. I keep a fleece hat and heavy fleece gloves on my person at all times. A good pair of boots is critical to keeping your feet warm and dry.

2. Slow down

Reduce your speed and increase your following distance when driving any emergency vehicle on snow- and ice-covered roads. Decelerate first by removing your foot from the accelerator and then gently braking.

Over-correction is always a risky maneuver when driving an ambulance. It’s an even greater risk on wet, slick or icy roads. Make gentle steering corrections at speeds appropriate to conditions to minimize the chance of a rollover or skidding into oncoming traffic.

3. Move with purpose

Plan the lifts down the front porch steps, over the snow/ice-covered sidewalk, and through the snow-filled driveway to the ambulance in the road before leaving the house. Move slower and more purposefully when walking on snow- and ice-covered surfaces. A simple trip or fall could at the least give you wet pants. At worst, it could cause you to drop or tip your patient.

4. Protect the patient

Use a blanket on the stretcher instead of a thin sheet below the patient and add an extra blanket or three over the patient. Shape a large bath towel as a hood around the patient’s head. Pull the towel over the patient’s face if it is snowing or sleeting, but tell the patient why you are covering their face and ask for their permission.

5. Set temperature for the patient

Adjust the thermostat in the ambulance’s patient care compartment so it is uncomfortably warm for EMS providers. Patients compromised by injury, illness or age are rarely too warm.

6. Blast the heat When you roll to a call

When you park the ambulance in the apparatus bay, which might be a cool 50ºF, between calls, set the patient care compartment at its highest warmth and turn the fan to blast. When you roll to your next call, the patient care compartment and the equipment stored in it will begin warming to a more tolerable temperature for the patient. If your car has a remote starter, do the same thing so your vehicle warms up for the few minutes you let it run before leaving the station.

Bonus tip: Goose feather blizzard

Never, ever cut through goose down clothing inside the ambulance. If you do have to cut goose down clothing, Jay Creswell, EMT-P, shares this tip, “Hook up a normal saline bag to an IV line and wet the down as you cut the coat. Down clumps when it is wet so the mess is negligible.”

Finally, check out this column on improving patient heat retention and heat gain while minimizing heat loss and watch this video demonstration of how to create a hypowrap to help any patient in a cold environment minimize heat loss and retain the heat they are producing.

This article was originally published on Jan. 6, 2010. It has been updated.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.