Winter Preparedness For Emergency Crews

Winter Preparedness for Emergency Crews

Winter places extreme pressure on emergency services. Call volumes rise, weather conditions deteriorate, and handover delays at A&E become routine. As a result, crews are caring for patients for longer periods, often in cold, exposed, and unpredictable environments.

These pressures significantly increase the risk of patient deterioration — particularly from hypothermia, which worsens the longer a patient remains cold and unattended.

In this blog, we share our insights on how emergency crews can stay prepared for winter challenges and keep patients safe during the coldest months.

Biggest Causes of Hypothermia in Winter

Cold Exposure (Environmental)

Low air temperatures, wind chill, rain, snow, and damp clothing all accelerate heat loss. Wind and moisture dramatically increase convective and evaporative heat loss, even at temperatures just above freezing.

Prolonged Immobility After Falls or Injury

People who fall and cannot get up are at very high risk. Lying on cold ground, reduced muscle activity, and pain or injury preventing movement significantly reduce heat production.

Trauma and Shock

Trauma increases hypothermia risk through blood loss, impaired thermoregulation, exposure during assessment, and administration of cold IV fluids. Hypothermia is part of the trauma triad of death.

Wet Clothing and Evaporative Heat Loss

Rain, snow, immersion, or sweat strips heat far faster than air. Even mildly wet clothing can lead to rapid heat loss in cold conditions due to evaporation.

Delays in Emergency Response and Hospital Handover

Long ambulance response times, extended waits outside A&E, corridor care, and limited access to active warming mean patients can remain cold and immobile for hours.

In 2023/24, only 72% of A&E patients were seen within four hours, and 10% waited over 12 hours. Wait times of this length are contradictory to the development and progression of hypothermia. Hypothermia cases have also risen, with an 82% increase in recent years. 5,371 hypothermia cases were recorded in 2022, increasing the risk of poor outcomes during long hospital waits.

A&E delays mean patients are waiting much longer before receiving hospital care. According to BMA, NHS bed occupancy remains above safe levels at 92.5%, leading to corridor care and extended waits in ambulances and temporary spaces.

Age-Related Vulnerability

Older adults have reduced metabolic heat production, poorer circulation, and a blunted shivering response. Hypothermia can occur indoors, even without extreme cold.

Alcohol and Drug Use

Alcohol causes vasodilation, increasing heat loss, while drugs impair judgement and awareness. Both increase the risk of falls and prolonged exposure.

Inadequate Clothing or Shelter

Homelessness, fuel poverty, and insufficient clothing or shelter significantly increase winter hypothermia risk, especially during cold snaps and overnight temperatures.

Key Takeaway – In winter, hypothermia most often results from a combination of cold exposure, immobility, vulnerability, and delays in care. Early passive warming at first contact is critical to prevent deterioration.

Managing Hypothermia in Winter: A Guide for First Responders

First responders manage winter hypothermia risk by preventing heat loss early, minimising exposure, and maintaining thermal protection throughout delays. The most effective approaches are practical, fast, and realistic in high-pressure environments.

Below are the key ways first responders can manage hypothermia in winter, structured from first contact → transport → handover.

🕒 Act Early – Assume Risk

Hypothermia often begins before it is clinically obvious. Treat trauma, elderly, immobile, and shocked patients as high risk by default. Apply passive warming at first contact rather than waiting for a low temperature reading.

🌬 Reduce Environmental Exposure

Shield patients from wind, rain, and snow. Move to sheltered areas or vehicles where possible and minimise time spent exposed during assessment. Wind and moisture significantly accelerate heat loss.

🧱 Insulate From the Ground

Place insulation beneath the patient immediately. Mats, bags, stretchers, or folded blankets prevent conductive heat loss. Never leave patients directly on cold ground, concrete, or metal surfaces.

🛏 Use Warming Solutions Effectively

Wrap patients in insulating, vapour-barrier materials – see the burrito-style technique here that can be used for patients who are injured and unable to move. Keep patients dry and covered throughout care, transport, and delays.

✂ Minimise Clothing Removal

emergency blanket in use

Expose only what is clinically necessary. Re-cover patients immediately after examination and avoid full exposure during trauma assessments.

🤲 Handle Gently

Cold patients are physiologically fragile. Avoid unnecessary movement, keep patients horizontal where possible, and handle gently to reduce cardiac risk.

🚑 Continue Warming During Transport & Handover

Maintain insulation throughout ambulance transport and during handover delays. Hypothermia often worsens while waiting outside or inside A&E.

⚠ Recognise High-Risk Patients

Prioritise warming for patients who are elderly, injured, intoxicated, bleeding, or have experienced prolonged immobility or exposure. These patients can deteriorate rapidly in winter conditions.

How THERMARMOUR Passive Warming Can Help

THERMARMOUR Emergency products are trusted by first responders to help mitigate the effects of hypothermia from incident to casualty assessment in hospital.

Developed in collaboration with the NHS and Trusted by the likes of East Midlands Ambulance Service, The THERMARMOUR Emergency Blanket offers a compact and highly effective passive warming solution, providing insulation and protection from the elements, all of which are critical in stabilising patients at the point of first response to assessment in hospital.

Passive Warming is ideal for quick deployment

The Thermarmour emergency blanket is designed to capture and help recirculate the patient’s own body heat, making it very practical in ambulances, where power is limited, as it doesn’t require a heater or power source to start working. Where active heat is needed (in cases of moderate to severe hypothermia), Thermarmour can be used in conjunction with chemical heat blankets or pads. The THERMARMOUR blanket is a multi-layer fabric system: outer waterproof foil, inner foil, a moisture barrier, and a fleece layer, providing necessary protection against wind, conduction and evaporation.

Unlike foil blankets, THERMARMOUR blankets:

Are water and tear-resistant – optimised for strength and durability in the elements.
Provide effective insulation, significantly outperforming foil blankets through the addition of reinforced laminate and fleece layers, which reflect and capture heat.
Help maintain normal body temperature which reduces risk of infection, improves wound healing, and stabilises cardiovascular function.
Act as a vapour barrier, making it ideal for use in the burrito wrap method, reducing evaporative heat loss.
Are lightweight, compact and easy to deploy in situations where there are space and weight constraints, or where active warming is not available.
Are latex-free, to avoid allergy concerns.
Can be cut to size or to accommodate injuries.

Thermarmour products:

Emergency Blanket