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Warm EMS equipment for a warm patient

When assessing and treating patients in a cold environment, do these simple things to help prevent heat loss and improve heat retention


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

Michael Beck/Stony Brook Hospital via AP

Being cold is a common patient complaint. When assessing and treating patients in a cold environment, do these simple things to help prevent heat loss and improve heat retention.

1. Prevent heat loss

Cover the patient with an insulating layer, but remember that conductive heat loss into the bathroom linoleum, concrete garage floor or road pavement is a fast method for heat loss. Insulate your patient from the ground.

2. Keep equipment warm

Minimize time that backboard or stretcher sits in the cold before the patient is placed on it. If it is 10ºF the backboard will quickly be 10ºF. A backboard does not rewarm quickly when a patient is loaded on to it. If you don’t believe me, just ask the patient or lie on a cold backboard for 30 minutes.

3. Pad the board

Warm or cold, always cover the backboard with a blanket to provide insulation and cushioning for the patient.

4. Crank the heat

Turn on the heat in the patient care compartment at the start of the call so it is warm when the patient is actually loaded. When you reach the point of being uncomfortably warm is likely when the patient is just starting to feel not cold. Communicate to the patient about their comfort throughout transport.

5. Keep the oxygen tank inside the insulation

For extended extrication package the portable oxygen tank in the insulation with the patient. Run the oxygen tubing through the insulating layers near the patient’s body so warm oxygen is delivered to the patient. Leaving the oxygen tank and tubing exposed will deliver cool or cold oxygen to the patient.

Adjust the heat in the patient care comfort to keep the patient warm and comfortable. Add additional insulations to the patient as requested. If you frequently transport patients that have a cold challenge, mild hypothermia, or severe hypothermia look at products designed to enhance patient heat retention and minimize heat loss.

Read next: Cold weather response tips for EMS

This article was originally published Nov. 23, 2009. 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.