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The effect of active warming in prehospital trauma care during road and air ambulance transportation: a clinical randomized trial
Division of Surgery, Department of Surgery and Perioperative Sciences, Umeå University, Sweden .
2011 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 19, 59- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientific evidence of its effectiveness in a clinical setting is scarce. The objective of this study was to evaluate the effect of additional active warming during road or air ambulance transportation of trauma patients.

METHODS:

Patients were assigned to either passive warming with blankets or passive warming with blankets with the addition of an active warming intervention using a large chemical heat pad applied to the upper torso. Ear canal temperature, subjective sensation of cold discomfort and vital signs were monitored.

RESULTS:

Mean core temperatures increased from 35.1°C (95% CI; 34.7-35.5°C) to 36.0°C (95% CI; 35.7-36.3°C) (p < 0.05) in patients assigned to passive warming only (n = 22) and from 35.6°C (95% CI; 35.2-36.0°C) to 36.4°C (95% CI; 36.1-36.7°C) (p < 0.05) in patients assigned to additional active warming (n = 26) with no significant differences between the groups. Cold discomfort decreased in 2/3 of patients assigned to passive warming only and in all patients assigned to additional active warming, the difference in cold discomfort change being statistically significant (p < 0.05). Patients assigned to additional active warming also presented a statistically significant decrease in heart rate and respiratory frequency (p < 0.05).

CONCLUSIONS:

In mildly hypothermic trauma patients, with preserved shivering capacity, adequate passive warming is an effective treatment to establish a slow rewarming rate and to reduce cold discomfort during prehospital transportation. However, the addition of active warming using a chemical heat pad applied to the torso will significantly improve thermal comfort even further and might also reduce the cold induced stress response.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT01400152.

Place, publisher, year, edition, pages
2011. Vol. 19, 59- p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-197730DOI: 10.1186/1757-7241-19-59PubMedID: 22017799OAI: oai:DiVA.org:uu-197730DiVA: diva2:613963
Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2017-12-06Bibliographically approved

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