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Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort - an experimental study
Umeå University, Faculty of Medicine, Department of Nursing. (Arcum)
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing. (Arcum)
2014 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, 43- p.Article in journal (Refereed) Published
Abstract [en]

Background:

Exposure to cold temperatures is, often, a neglected problem in prehospital care. One of the leading influences of the overall sensation of cold discomfort is the cooling of the back. The aim of this study was to evaluate the effect of a heated ambulance mattress-prototype on body temperatures and thermal comfort in an experimental study.

Method: Data were collected during four days in November, 2011 inside and outside of a cold chamber. All participants (n = 23) participated in two trials each. In one trial, they were lying on a stretcher with a supplied heated mattress and in the other trial without a heated mattress. Outcomes were back temperature, finger temperature, core body temperature, Cold Discomfort Scale (CDS), four statements from the state-trait anxiety - inventory (STAI), and short notes of their experiences of the two mattresses. Data were analysed both quantitatively and qualitatively. A repeated measure design was used to evaluate the effect of the two mattresses.

Results:

A statistical difference between the regular mattress and the heated mattress was found in the back temperature. In the heated mattress trial, the statement "I am tense" was fewer whereas the statements "I feel comfortable", "I am relaxed" and "I feel content" were higher in the heated mattress trial. The qualitative analyses of the short notes showed that the heated mattress, when compared to the unheated mattress, was experienced as warm, comfortable, providing security and was easier to relax on.

Conclusions:

Heat supply from underneath the body results in increased comfort and may prevent hypothermia which is important for injured and sick patients in ambulance care.

Place, publisher, year, edition, pages
2014. Vol. 22, 43- p.
Keyword [en]
Thermal comfort, Cold discomfort, Cold exposure
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-93830DOI: 10.1186/s13049-014-0043-5ISI: 000341155300001PubMedID: 25103366OAI: oai:DiVA.org:umu-93830DiVA: diva2:753560
Available from: 2014-10-08 Created: 2014-10-01 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Cold exposure and thermal comfort among patients in prehospital emergency care: innovation research in nursing
Open this publication in new window or tab >>Cold exposure and thermal comfort among patients in prehospital emergency care: innovation research in nursing
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Patients’ cold exposure is a neglected problem in prehospital emergency care. Cold stress increases pain and anxiety and contributes to fear and an overall sense of dissatisfaction. When left untreated, cold stress disturbs vital body functions until ultimately reaches hypothermia.

Aim

The overall aim was to investigate patients’ experiences of thermal comfort and reactions to cold exposure in prehospital emergency care and to evaluate the effects of an intervention using active warming from underneath.

Method

Study I:

Persons (n=20) injured in a cold environment in the north of Sweden were interviewed. Active heat was given to 13 of them.

Study II:

In wintertime, 62 patients were observed during prehospital emergency care. The field study was based on observations, questions about thermal discomfort, vital signs, and temperature measurements.

Study III:

Healthy young persons (n=23) participated in two trials each. Data were collected inside and outside a cold chamber. In one trial, the participants were lying on a regular ambulance stretcher and in a second trial on a stretcher supplied with a heated mattress. Outcomes were the Cold Discomfort Scale (CDS), back, finger, and core body temperature, four statements from the State-TraitAnxiety-Inventory (STAI), vital signs, and short notes about their experiences of the two stretchers.

Study IV:

A quantitative intervention study was conducted in prehospital emergency care in the north of Sweden. The patients (n=30) in the intervention group were transported in an ambulance supplemented with a heated mattress on the stretcher, whereas only a regular stretcher was used in the ambulance for the patients (n=30) in the control group. Outcomes were the CDS, finger, core body, and air temperature, and questions about cold experiences.

Results

Study I:

Patients suffered more because of the cold than from the pain of their injuries. The patients were in a desperate need of heat.

Study II:

Patients are exposed to cold stress due to cold environments. There was a significant decrease from the first measurement in finger temperature of patients who were indoors when the ambulance arrived, compared to the measurement taken in the ambulance. In the patient compartment of the ambulance, 85% of the patients had a finger temperature below the comfort zone and almost half of them experienced the patient compartment in the ambulance to be cold. The regular mattress surface temperature at the ambulance ranged from -22.3 to 8.4 ºC.

Study III:

A statistical increase of the participants’ back temperature was found between those lying on the heated mattress compared to those lying on the regular mattress. The heated mattress was experienced as warm, comfortable, providing security, and easy to relax on.

Study IV:

Thermal comfort increased for the patients in the intervention group and decreased in the control group. A significant higher proportion of the participants rated the stretcher as cold to lie on in the control group compared to the intervention group.

Conclusion

The ambulance milieu is too cold to provide thermal comfort. Heat supply from underneath increased comfort and might prevent cold stress and hypothermia

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2015. 50 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1718
Keyword
thermal comfort, thermal discomfort, cold exposure, cold stress, hypothermia, patients’ experiences, active warming, prehospital emergency care, finger temperature, back temperature
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-102599 (URN)978-91-7601-234-5 (ISBN)
Public defence
2015-05-22, Vårdvetarhuset, Aulan, Institutionen för omvårdnad, Umeå, 09:00 (English)
Opponent
Supervisors
Funder
Swedish National Board of Health and Welfare
Available from: 2015-04-30 Created: 2015-04-28 Last updated: 2016-06-30Bibliographically approved

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Alex, JonasKarlsson, StigSaveman, Britt-Inger

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