The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Ulf Björnstig¹  Peter Naredi¹  Otto Henriksson¹  Peter Lundgren¹ 

[1] Division of Surgery, Department of Surgery and Perioperative Sciences, Umeå University, Sweden

关键词: emergency medical services (EMS);    prehospital trauma care;    passive warming;    active warming;    thermal comfort;    body temperature regulation;    hypothermia;   

Others  :  826931
DOI  :  10.1186/1757-7241-19-59

 received in 2011-07-21, accepted in 2011-10-21,  发布年份 2011

【 摘 要 】

Background

Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientifical 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

【 授权许可】

   
2011 Lundgren et al; licensee BioMed Central Ltd.

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