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Insulated spine boards for prehospital trauma care in a cold environment
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Linköpings universitet, Institutionen för klinisk och experimentell medicin.
Linköpings universitet, Institutionen för klinisk och experimentell medicin.
2004 (English)In: International Journal of Disaster Medicine, ISSN 1503-1438, E-ISSN 1755-4713, Vol. 2, no 1-2, 33-37 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to examine, during field conditions, what impact additional insulation on a spine board would have on thermoregulation.

Method: The study was conducted outdoors, under field conditions in February in the north of Sweden. The subjects, all wearing standardised clothing, were immobilised on uninsulated (n=10) or insulated spine boards (n=9). Tympanic temperature as well as the subjects’ estimated sensation of cold and their estimated level of shivering were measured at five minute intervals during the trial. Statistical analysis of the data gathered for the first 55 minutes was performed.

Results: There were no differences between the two groups regarding reduction in body core temperature or cold discomfort. There was, however, a statistically significant increase in estimated shivering for the subjects placed on uninsulated spine boards.

Conclusion: Additional insulation on a spine board by the means of an insulation mat rendered a significantly reduced need for shivering in a cold environment. This is an effect that could be of great importance during protracted evacuations of injured, ill or otherwise compromised patients. In the light of these results we conclude that spine boards, as well as other materials used for prehospital transportation of patients in cold environments, should be well insulated. This is a measure that could be accomplished by such simple means as using an additional insulation mat.

Place, publisher, year, edition, pages
2004. Vol. 2, no 1-2, 33-37 p.
Keyword [en]
hypothermia
National Category
Surgery
Research subject
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-54367DOI: 10.1080/15031430410023913OAI: oai:DiVA.org:umu-54367DiVA: diva2:523459
Available from: 2012-04-25 Created: 2012-04-24 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Protection against cold in prehospital trauma care
Open this publication in new window or tab >>Protection against cold in prehospital trauma care
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Protection against cold is vitally important in prehospital trauma care to reduce heat loss and prevent body core cooling.

Objectives: Evaluate the effect on cold stress and thermoregulation in volunteer subjects byutilising additional insulation on a spineboard (I). Determine thermal insulation properties of blankets and rescue bags in different wind conditions (II). Establish the utility of wet clothing removal or the addition of a vapour barrier by determining the effect on heat loss within different levels of insulation in cold and warm ambient temperatures (III) and evaluating the effect on cold stress and thermoregulation in volunteer subjects (IV).

Methods: Aural canal temperature, sensation of shivering and cold discomfort was evaluated in volunteer subjects, immobilised on non-insulated (n=10) or insulated (n=9) spineboards in cold outdoor conditions (I). A thermal manikin was setup inside a climatic chamber and total resultant thermal insulation for the selected ensembles was determined in low, moderate and high wind conditions (II). Dry and wet heat loss and the effect of wet clothing removal or the addition of a vapour barrier was determined with the thermal manikin dressed in either dry, wet or no clothing; with or without a vapour barrier; and with three different levels of insulation in warm and cold ambient conditions (III). The effect on metabolic rate, oesophageal temperature, skin temperature, body heat storage, heart rate, and cold discomfort by wet clothing removal or the addition of a vapour barrier was evaluated in volunteer subjects (n=8), wearing wet clothing in a cold climatic chamber during four different insulation protocols in a cross-over design (IV).

Results: Additional insulation on a spine board rendered a significant reduction of estimated shivering but there was no significant difference in aural canal temperature or cold discomfort (I). In low wind conditions, thermal insulation correlated to thickness of the insulation ensemble. In greater air velocities, thermal insulation was better preserved for ensembles that were windproof and resistant to the compressive effect of the wind (II). Wet clothing removal or the use of a vapour barrier reduced total heat loss by about one fourth in the cold environment and about one third in the warm environment (III). In cold stressed wet subjects, with limited insulation applied, wet clothing removal or the addition of a vapour barrier significantly reduced metabolic rate, increased skin rewarming rate, and improved total body heat storage but there was no significant difference in heart rate or oesophageal temperature cooling rate (IV). Similar effects on heat loss and cold stress was also achieved by increasing the insulation. Cold discomfort was significantly reduced with the addition of a vapour barrier and with an increased insulation but not with wet clothing removal.

Conclusions: Additional insulation on a spine board might aid in reducing cold stress inprolonged transportations in a cold environment. In extended on scene durations, the use of a windproof and compression resistant outer cover is crucial to maintain adequate thermal insulation. In a sustained cold environment in which sufficient insulation is not available, wet clothing removal or the use of a vapour barrier might be considerably important reducing heat loss and relieving cold stress.

Place, publisher, year, edition, pages
Umeå universitet, 2012. 52 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1501
Keyword
Hypothermia, prehospital trauma care, emergency medical services, passive warming, thermal insulation, heat loss, body temperature regulation
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-54372 (URN)978-91-7459-422-5 (ISBN)
Public defence
2012-05-16, sal B, 9 tr, Tandläkarhögskolan, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2012-04-25 Created: 2012-04-24 Last updated: 2012-04-25Bibliographically approved

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