Subject classification: this is a medicine resource.

Victims of severe hypothermia sometimes worsen their condition by removing their clothes, this is a sad but well known fact. That bizarre behaviour greatly increases heat loss and makes it less likely that rescuers will find the victim while that person’s life can still be saved.

Research has been done about what type of person is most likely to undress in this way [1] [2] but as far as this author knows no research has been done over what types of clothing are most likely to be removed.

A great many modern clothes are easy to take off, trousers and skirts are sometimes only held up by elastic, pullovers and short sleeved tops frequently have no fastenings at all. By contrast during the 19th century and before undressing was likely to involve untying straps and laces, unbuckling belts, undoing braces. Anyone with the presence of mind to do all the above probably understood that removing clothes in very cold conditions is a bad idea. Antarctic explorer, Scott wrote that one of his team, Atkinson got lost in bad weather and became confused through hypothermia, despite confusion Atkinson did not undress. Also doctors have written detailed descriptions of the behaviour of Napolion's soldiers succumbing to cold during the retreat from Moscow in 1812. These desctiptions do not include undressing. [3]

It certainly would not be reasonable to suggest that removing clothes in general should be made less convenient. Only a small proportion of us are likely face problems through extreme hypothermia. In any case when people are confused through heat stroke or any heat related condition is would be better if they can undress easily.

Despite this when clothes are intended to be worn in very cold conditions there is a case for designing garments so some presence of mind is needed to remove them. This author hopes researchers in the field will investigate what types of clothes are removed during paradoxical undressing as this could possibly provide useful advice for manucfacturers of clothes worn in extreme cold.

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