What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers
Abstract Background Accidental hypothermia is a manifest problem during the rescue of entrapped victims and results in different subsequent problems as coagulopathy and wound infection. Different warming methods are available for the preclinicial use. However, their effectiveness has hardly been eva...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-023-00850-6 |
| _version_ | 1797453674568482816 |
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| author | Martin Lier Christopher Jebens Annette Lorey-Tews Tim Heyne Nils Kunze-Szikszay Johannes Wieditz Anselm Bräuer |
| author_facet | Martin Lier Christopher Jebens Annette Lorey-Tews Tim Heyne Nils Kunze-Szikszay Johannes Wieditz Anselm Bräuer |
| author_sort | Martin Lier |
| collection | DOAJ |
| description | Abstract Background Accidental hypothermia is a manifest problem during the rescue of entrapped victims and results in different subsequent problems as coagulopathy and wound infection. Different warming methods are available for the preclinicial use. However, their effectiveness has hardly been evaluated. Methods In a first step a survey among German fire brigades was performed with questions about the most used warming methods. In a second step two crossover studies were conducted. In each study two different warming method were compared with forced air warming – which is the most frequently used and highly effective warming method in operation rooms (Study A: halogen floodlight vs. forced air warming; Study B: forced air warming vs. fleece blanket). In both studies healthy volunteers (Study A: 30 volunteers, Study B: 32 volunteers) were sitting 60 min in a cold store. In the first 21 min there was no subject warming. Afterwards the different warming methods were initiated. Every 3 min parameters like skin temperature, core body temperature and cold perception on a 10-point numeric rating scale were recorded. Linear mixed models were fitted for each parameter to check for differences in temperature trajectories and cold perception with regard to the different warming methods. Results One hundred fifty-one German fire brigades responded to the survey. The most frequently used warming methods were different rescue blankets (gold/silver, wool) and work light (halogen floodlights). Both studies (A and B) showed significantly (p < 0.05) higher values in mean skin temperature, mean body temperature and total body heat for the forced air warming methods compared to halogen floodlight respectively fleece blanket shortly after warming initiation. In contrast, values for the cold perception were significantly lower (less unpleasant cold perception) during the phase the forced air warming methods were used, compared to the fleece blanket or the halogen floodlight was used. Conclusion Forced air warming methods used under the standardised experimental setting are an effective method to keep patients warm during technical rescue. Halogen floodlight has an insufficient effect on the patient’s heat preservation. In healthy subjects, fleece blankets will stop heat loss but will not correct heat that has already been lost. Trial registration The studies were registered retrospectively on 14/02/2022 on the German Clinical Trials registry (DRKS) with the number DRKS00028079. |
| first_indexed | 2024-03-09T15:26:50Z |
| format | Article |
| id | doaj.art-f4f440d2e5e044e2b4f664c79b608956 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-09T15:26:50Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-f4f440d2e5e044e2b4f664c79b6089562023-11-26T12:32:05ZengBMCBMC Emergency Medicine1471-227X2023-08-0123111510.1186/s12873-023-00850-6What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteersMartin Lier0Christopher Jebens1Annette Lorey-Tews2Tim Heyne3Nils Kunze-Szikszay4Johannes Wieditz5Anselm Bräuer6Department of Anesthesiology, University Medical Center GöttingenDepartment of Anesthesiology, Intensive care, Emergency and Pain medicine, Asklepios Clinic AltonaDepartment of Anesthesiology and Intensive care medicine, Buchholz HospitalDepartment of Anesthesiology, University Medical Center GöttingenDepartment of Anesthesiology, University Medical Center GöttingenDepartment of Anesthesiology, University Medical Center GöttingenDepartment of Anesthesiology, University Medical Center GöttingenAbstract Background Accidental hypothermia is a manifest problem during the rescue of entrapped victims and results in different subsequent problems as coagulopathy and wound infection. Different warming methods are available for the preclinicial use. However, their effectiveness has hardly been evaluated. Methods In a first step a survey among German fire brigades was performed with questions about the most used warming methods. In a second step two crossover studies were conducted. In each study two different warming method were compared with forced air warming – which is the most frequently used and highly effective warming method in operation rooms (Study A: halogen floodlight vs. forced air warming; Study B: forced air warming vs. fleece blanket). In both studies healthy volunteers (Study A: 30 volunteers, Study B: 32 volunteers) were sitting 60 min in a cold store. In the first 21 min there was no subject warming. Afterwards the different warming methods were initiated. Every 3 min parameters like skin temperature, core body temperature and cold perception on a 10-point numeric rating scale were recorded. Linear mixed models were fitted for each parameter to check for differences in temperature trajectories and cold perception with regard to the different warming methods. Results One hundred fifty-one German fire brigades responded to the survey. The most frequently used warming methods were different rescue blankets (gold/silver, wool) and work light (halogen floodlights). Both studies (A and B) showed significantly (p < 0.05) higher values in mean skin temperature, mean body temperature and total body heat for the forced air warming methods compared to halogen floodlight respectively fleece blanket shortly after warming initiation. In contrast, values for the cold perception were significantly lower (less unpleasant cold perception) during the phase the forced air warming methods were used, compared to the fleece blanket or the halogen floodlight was used. Conclusion Forced air warming methods used under the standardised experimental setting are an effective method to keep patients warm during technical rescue. Halogen floodlight has an insufficient effect on the patient’s heat preservation. In healthy subjects, fleece blankets will stop heat loss but will not correct heat that has already been lost. Trial registration The studies were registered retrospectively on 14/02/2022 on the German Clinical Trials registry (DRKS) with the number DRKS00028079.https://doi.org/10.1186/s12873-023-00850-6Accidental hypothermiaTechnical rescuePreclinical warmingWarming methodsForced air warmingHalogen floodlight |
| spellingShingle | Martin Lier Christopher Jebens Annette Lorey-Tews Tim Heyne Nils Kunze-Szikszay Johannes Wieditz Anselm Bräuer What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers BMC Emergency Medicine Accidental hypothermia Technical rescue Preclinical warming Warming methods Forced air warming Halogen floodlight |
| title | What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers |
| title_full | What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers |
| title_fullStr | What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers |
| title_full_unstemmed | What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers |
| title_short | What is the best way to keep the patient warm during technical rescue? Results from two prospective randomised controlled studies with healthy volunteers |
| title_sort | what is the best way to keep the patient warm during technical rescue results from two prospective randomised controlled studies with healthy volunteers |
| topic | Accidental hypothermia Technical rescue Preclinical warming Warming methods Forced air warming Halogen floodlight |
| url | https://doi.org/10.1186/s12873-023-00850-6 |
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