After the victim is successfully dug out, the danger of rapid heat loss plays a critical role, especially in cold and windy conditions.

The patient must be protected from further heat loss during transport.

In Central Europe, thermal packing using hot packs is an established method of insulating a patient before a long transport. No rewarming can be achieved by this method, but further heat loss may be prevented. Required are two or three chemical hot packs, a space blanket, two wool blankets, a bivouac bag and a hat.

An unconscious patient who is not intubated should be treated in the lateral position.

1. Before removing the patient place two wool blankets (one lengthwise, one crosswise) and one space blanket (crosswise) on the stretcher or Akja.
2. Remove the patient while avoiding large movements.
3. Two or three chemical hot packs near the heart on the chest and upper part of abdomen, not directly on the skin.
4. Wrap the patient snugly in the blankets and the space blanket
5. Cap: 50% of the body heat can be lost from the head because of the minimal insulation of the top of the skull and the inability of scalp vessels to vasoconstrict.

During extrication and evacuation large movements of the patient’s body should be strictly avoided in order to prevent mixing of cold blood from the periphery with somewhat warmer blood in the central organs.