I read your links and in http://sailingsource.com/ice/articles/selfrescue.htm
A warm shower is almost always in order after a 32 degree swim. If a victim is having difficulty walking, talking or has a noticeable pallor or weak pulse in his extremities, call a rescue squad. Try to rewarm the victim in a shower or bath
What I have read, is that you shoud NEVER take victom to shower or bath.
Because shower/bath makes blood circulating much faster and the cold blood goes to hearth and that can be fatal.
more info from next links (which are in finnish)http://www2.fimr.fi/fi/palvelut/jaapalv ... uhkaa.htmlhttp://22.214.171.124/sm/pelastus/finopas ... Hypotermiahttp://www.tky.hut.fi/~teepakki/retkeil ... /hypo.html
about same is said in englishhttp://www.hypothermia.org/fieldchart.htm
which says that you can take shower only if body temp is above 35C
So warm shower is not so good idea?
Good points. Your long experience in managing things in hypothermic environments in Finland is showing. Looking at the symptoms described in the reference that you mentioned:
A warm shower is almost always in order after a 32 degree swim. If a victim is having difficulty walking, talking or has a noticeable pallor or weak pulse in his extremities, call a rescue squad. Try to rewarm the victim in a shower or bath"
The symptoms don't preclude severe hypothermia and as such putting a victim into a bath can be dangerous for the reasons that you give. Thanks for catching this. I will delete the reference from my original posting.
I just came across a reference in English from Alaska that provides the same precaution that you mentioned for severe hypothermia cases (as constrasted to mild).
Assessment of Patient
If the patient is cold and has any of the following signs or symptoms, he is considered to have severe hypothermia:
a. Temperature of 90Ã‚Â° F (32.2Ã‚Â° C) or less.
b. Depressed vital signs, such as a slow pulse and/or slow respiration.
c. Altered level of consciousness, including slurred speech, staggering gait, decreased mental skills, or the lack of response to verbal or painful stimuli.
d. No shivering in spite of being very cold. (Note: This sign is potentially unreliable and may be altered by alcohol intoxication.)
If the patient is cold and does not have any of these signs or symptoms, he is considered to have mild hypothermia.
Treatment for Severe Hypothermia with Signs of Life (e.g. Pulse and Respirations Present
Treat the patient as outlined in sections B and C above with the following exceptions:
a. Do not put severely hypothermic patients in a shower or bath.
b. Do not give a patient oral fluids unless he or she is capable of swallowing and protecting his or her airway.
Treat patients who are hypothermic very gently (do not rub or manipulate extremities).
Treatment for Mild Hypothermia
Treat the patient as outlined in Section B.
If there is no way to get to a medical facility, rewarm the patient gradually by:
a. Placing patient in as warm an environment as possible.
b. Increasing heat production through exercise and calorie/fluid replacement. This method of adding heat is particularly important when emergency care is not readily available as in remote or prolonged transport environment.
c. Rewarming passively through the application of insulated heat packs to high heat transfer/loss areas such as the head, neck, underarms, sides of the chest wall, and groin, and heavy insulation to prevent further heat loss.
d. Considering warm showers and warm bath if the patient is alert. (FOR MILD HYPOTHERMIA ONLY)
e. Placing patient in a sleeping bag and providing contact with a warm body. The patient should not be placed a sleeping bag with another individual who is hypothermic. This method should be considered a last resort since it may endanger the rescuer and is less efficient than other methods.
Encourage the patient to drink warm fluids as soon as he, or she, is capable of swallowing and protecting his or her airway.
Still, considering some of the deceptive symptoms of severe vs. mild hypothermia (e.g. " ... including slurred speech, staggering gait, decreased mental skills ... ") your general prohibition on using baths to warm ANY hypothermia aside from the most obviously mild case, makes sense.
Another reference of treating hypothermia victims from Princeton University appears at:
It further states:
"Do not expose a severely hypothermic victim to extremes of heat."
Thanks for your input!