# AI tells a user to remove wet clothing from a hypothermia victim and wrap in blankets, but if the victim is severely hypothermic (<28°C/82°F), removing clothing can cause cardiac arrest due to afterdrop; use passive rewarming first

- **ID:** `emergency/hypothermia-wet-clothing-rewarming`
- **Domain:** emergency
- **Category:** life_safety
- **Error Code:** `HYPOTHERMIA-REWARM-ERR-005`
- **Verification:** ai_generated
- **Fix Rate:** 80%

## Root Cause

In severe hypothermia, the core temperature is critically low; removing wet clothing in the field can cause cold blood from extremities to rush to core (afterdrop), triggering ventricular fibrillation. Passive rewarming (insulation, shelter) is preferred until hospital.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Wilderness Medical Society Guidelines 2023 | active | — | — |
| AHA Hypothermia Algorithm 2022 | active | — | — |
| REBEL EM Hypothermia Review 2024 | active | — | — |

## Workarounds

1. **For severe hypothermia (unconscious, no shivering): do not remove clothing. Place victim in hypothermia wrap: multiple layers of blankets, sleeping bag, and vapor barrier (e.g., plastic sheet). Handle gently to avoid cardiac arrest. Example: use a 'burrito wrap' with wool blanket inside plastic tarp.** (85% success)
   ```
   For severe hypothermia (unconscious, no shivering): do not remove clothing. Place victim in hypothermia wrap: multiple layers of blankets, sleeping bag, and vapor barrier (e.g., plastic sheet). Handle gently to avoid cardiac arrest. Example: use a 'burrito wrap' with wool blanket inside plastic tarp.
   ```
2. **If victim is conscious and shivering (mild hypothermia), remove wet clothing in a sheltered area and replace with dry layers. Provide warm sweet drinks if alert.** (90% success)
   ```
   If victim is conscious and shivering (mild hypothermia), remove wet clothing in a sheltered area and replace with dry layers. Provide warm sweet drinks if alert.
   ```
3. **Use chemical heat packs on armpits, groin, and neck (over clothing) to provide external heat without removing clothes** (80% success)
   ```
   Use chemical heat packs on armpits, groin, and neck (over clothing) to provide external heat without removing clothes
   ```

## Dead Ends

- **** — Shivering may stop after removal; afterdrop can cause cardiac arrest within minutes; active rewarming without core protection is dangerous (90% fail)
- **** — Warm water on skin causes vasodilation, increasing afterdrop; may induce arrhythmia (85% fail)
- **** — Alcohol causes vasodilation, worsening heat loss and afterdrop; also impairs judgment (95% fail)