Document Type: Original Article

Authors

1 Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 2 Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Tehran Emergency Medical Service Center, Tehran, Iran

5 Reconstruction Research Center, Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

6 Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Objective: This study aimed to compare the efficacy of rescue blankets with conventional blankets in terms of preventing hypothermia in the pre-hospital setting. Methods: In this randomized clinical trial, patients older than 18 years old with Cold Discomfort Scale (CDS) > 2, and those who were transferred to the emergency department (ED) by emergency medical service entered the study. Patients were randomly divided into two groups based on the type of transfer. In this regard, one group was transferred with rescue blankets and the other group was transferred with conventional blankets. The tympanic temperature in patients and CDS were recorded before the use of blanket (primary) and at the time of arrival in the ED (secondary). Results: Finally, 161 patients with the mean age of 45.31±19.8 years were included (63.4% were male). Totally, 88 cases (54.7%) were transferred with rescue blankets and 73 cases (45.3%) with conventional blankets. The mean of the primary tympanic temperatures in the rescue and conventional blanket groups were 36.20±0.84°C and 36.34±0.65°C, respectively (P=0.23). The mean of the primary CDS in rescue and conventional blanket groups were 6.55±1.95 and 5.89±2.29, respectively (P=0.05). Also, the mean of the secondary tympanic temperatures in the rescue and conventional blanket groups were 36.59±0.47°C and 36.76±0.48 °C, respectively (P=0.03). Besides, the mean of the secondary CDS in the rescue and conventional blanket groups were 2.64±2.80 and 2.41±1.29, respectively (P=0.48). Conclusion: According to the results, there is no significant difference in the tympanic temperature and CDS of the patients transferred with the rescue blanket compared with the conventional blanket

Keywords

Main Subjects

1. Ireland S, Endacott R, Cameron P, Fitzgerald M, Paul E. The incidence and significance of accidental hypothermia in major trauma--a prospective observational study. Resuscitation 2011; 82(3): 300-6. doi: 10.1016/j. resuscitation.2010.10.016.

2. Beilman GJ, Blondet JJ, Nelson TR, Nathens AB, Moore FA, Rhee P, et al. Early hypothermia in severely injured trauma patients is a significant risk factor for multiple organ dysfunction syndrome but not mortality. Ann Surg 2009; 249(5): 845-50. doi: 10.1097/ SLA.0b013e3181a41f6f.

3. Martin RS, Kilgo PD, Miller PR, Hoth JJ, Meredith JW, Chang MC. Injury-associated hypothermia: an analysis of the 2004 National Trauma Data Bank. Shock 2005; 24(2): 114-8. doi: 10.1097/01.shk.0000169726.25189.b1.

4. Aléx J, Karlsson S, Saveman BI. Patients’ experiences of cold exposure during ambulance care. Scand J Trauma Resusc Emerg Med 2013; 21: 44. doi: 10.1186/1757-7241- 21-44.

5. Lintu NS, Mattila MA, Holopainen JA, Koivunen M, Hanninen OO. Reactions to cold exposure emphasize the need for weather protection in prehospital care: an experimental study. Prehosp Disaster Med 2006; 21(5): 316-20. doi: 10.1017/s1049023x00003940.

6. Giesbrecht GG. Prehospital treatment of hypothermia. Wilderness Environ Med 2001; 12(1): 24-31. doi: 10.1580/1080-6032(2001)012[0024:ptoh]2.0.co;2.

7. Henriksson O, Lundgren JP, Kuklane K, Holmer I, Bjornstig U. Protection against cold in prehospital carethermal insulation properties of blankets and rescue bags in different wind conditions. Prehosp Disaster Med 2009; 24(5): 408-15. doi: 10.1017/s1049023x00007238.

8. Light IM, Norman JN. The thermal properties of a survival bag incorporating metallised plastic sheeting. Aviat Space Environ Med 1980; 51(4): 367-70.

9. Henriksson O, Bjornstig U, Saveman BI, Lundgren PJ. Protection against cold - a survey of available equipment in Swedish pre-hospital services. Acta Anaesthesiol Scand 2017; 61(10): 1354-60. doi: 10.1111/aas.13002.

10. Jussila K, Rissanen S, Parkkola K, Anttonen H. Evaluating cold, wind, and moisture protection of different coverings for prehospital maritime transportation-a thermal manikin and human study. Prehosp Disaster Med 2014; 29(6): 580-8. doi: 10.1017/s1049023x14001125.

11. Cohen S, Hayes JS, Tordella T, Puente I. Thermal efficiency of prewarmed cotton, reflective, and forced-warm-air inflatable blankets in trauma patients. Int J Trauma Nurs 2002; 8(1): 4-8. doi: 10.1067/mtn.2002.121312.

12. Haverkamp FJC, Giesbrecht GG, Tan E. The prehospital management of hypothermia - An up-to-date overview. Injury 2018;49(2):149-64. doi: 10.1016/j. injury.2017.11.001.

13. Thomassen Ø, Færevik H, Østerås Ø, Sunde GA, Zakariassen E, Sandsund M, et al. Comparison of three different prehospital wrapping methods for preventing hypothermia--a crossover study in humans. Scand J Trauma Resusc Emerg Med 2011; 19: 41. doi: 10.1186/1757-7241-19-41.