Removing Wet Clothing in a Cold Room Does NOT Cause Colds
A patient who is hot and sweating should have wet clothing removed immediately, even in a cold room—this will not cause them to "catch a cold" (viral upper respiratory infection) and is actually essential to prevent hypothermia. The concern about catching cold from removing wet clothing is a medical myth; colds are caused by viruses, not temperature changes.
Why Wet Clothing Must Be Removed
Wet clothing dramatically accelerates heat loss and is a primary risk factor for hypothermia, regardless of the ambient temperature. The American Heart Association guidelines explicitly recommend "removing wet clothing and drying and covering the victim to prevent hypothermia" as a fundamental first aid measure 1. This principle applies universally across trauma, environmental exposure, and heat illness scenarios 1.
The Physiology of Wet Clothing
- Wet garments increase evaporative heat loss, which is one of four mechanisms (along with radiation, conduction, and convection) by which the body loses heat 1
- In trauma patients specifically, wet clothing has been identified as a major risk factor for developing life-threatening hypothermia 1
- Historical military data dating back to the American Revolutionary War demonstrated that wet clothing on injured soldiers led to serious complications, prompting protocols to prohibit wet clothing exposure 1
The Correct Approach: Remove Wet Clothing AND Provide Warmth
The key is to remove wet clothing while simultaneously preventing further heat loss through active warming measures. This is not an either/or situation—both interventions must occur together 1.
Immediate Actions Required
- Remove all wet garments promptly 1
- Immediately wrap the patient in dry blankets, clothing, newspapers, or any available insulating material to cover all exposed body surfaces 1
- Move the patient to a warm environment if possible 1
- For patients with mild hypothermia (>34°C/93.2°F), passive rewarming with dry insulation is generally adequate 1
For Patients Requiring Active Rewarming
- Patients with moderate hypothermia (30-34°C/86-93.2°F) require external warming techniques beyond passive measures 1
- Active warming methods include forced air warming devices, warming blankets, or placing the patient near a heat source 1
- Warm (not hot) water containers can be placed in contact with the skin 1
Common Pitfall: Confusing Viral Illness with Temperature Exposure
The misconception that cold exposure or temperature changes cause "colds" (upper respiratory infections) is medically incorrect. Colds are caused by viral pathogens, not environmental temperature 2. While the patient may feel uncomfortable when wet clothing is removed in a cold room, this temporary discomfort is vastly preferable to the serious morbidity and mortality associated with hypothermia 1.
The Real Risk: Hypothermia, Not Viral Infection
- Hypothermia is associated with significant mortality—studies show 7% mortality in normothermic trauma patients versus 43% in hypothermic patients 1
- Core temperature below 32°C is associated with mortality in a large percentage of trauma cases 1
- Hypothermia causes coagulation disorders, though these completely resolve with aggressive warming 1
Special Consideration: Heat Illness Patients
For patients who are hot and sweating due to heat exhaustion or heat stroke, removing excess clothing is explicitly recommended as a primary intervention. The 2024 American Heart Association guidelines state that first aid providers should "remove excess clothing" when managing exertional hyperthermia or heatstroke 1, 3, 4. This facilitates cooling and is part of standard heat illness management 3, 4.