What is the appropriate first step for hypothermia management in the field?

The appropriate first step for hypothermia management in the field is to remove wet clothing and initiate passive rewarming. This is critical because wet clothing significantly increases heat loss from the body; by removing it, the body can retain more of its heat. Passive rewarming involves using the person’s own body heat to increase their temperature, usually by covering them with dry blankets or clothing after removing wet items, to help minimize further heat loss.

This approach focuses on addressing the immediate environmental factors contributing to hypothermia. While monitoring vitals is important and initiating warming measures (such as warm fluids or blankets) can be part of treatment, removing wet clothing is a foundational step that should be prioritized to facilitate more effective rewarming. Additionally, transporting to a warm facility is essential but should follow the initial management steps to stabilize the patient's condition in the field.