Active Warming in Prehospital Trauma Care

NCT01400152 | Completed DMC

• 1 other identifier: jpl1
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

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. 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. 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). 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 reduce the cold induced stress response.

Conditions

Body Core Temperature; Thermal Comfort

Keywords

Hypothermia, body temperature regulation,thermal comfort, active warming, passive warming, prehospital trauma care

Outcome Measures

Primary Outcomes (2)

• Body core temperature

  From initial assessment upon arrival of EMS crew until second assessment about 30 minutes later.

• Cold discomfort

  From initial assessment upon arrival of EMS crew until second assessment about 30 minutes later.

Study Arms (2)

Passive warming with additional active warming

ACTIVE COMPARATOR

Device: Additional active warming

Passive warming

NO INTERVENTION

Interventions

Additional active warming DEVICE

Chemical heat pad applied to the upper torso

Passive warming with additional active warming

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Subjects were sequential trauma patients, age ≥ 18 years, who had sustained an injury outdoors and were transported by one of the participating EMS units.

You may not qualify if:

• Patients were excluded if initial level of consciousness was affected, (Glasgow Coma Scale \< 15), if they required prehospital CPR or if duration of transportation was expected to be shorter than 10 minutes.
• As the aim of the study was to investigate the effect of active warming intervention in cold stressed patients, those patients who had already received active warming or had been taken indoors for more than 10 minutes before EMS unit arrival or had an initial cold discomfort rating ≤ 2 were also excluded.

Sponsors & Collaborators

• Umeå University: lead
• Ministry of Health and Social Affairs, Sweden: collaborator

Study Sites (1)

Department of Surgery and Perioperative Sciences, Umeå University

Umeå, 901 85, Sweden

Location

Related Publications (1)

• Lundgren P, Henriksson O, Naredi P, Bjornstig U. The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial. Scand J Trauma Resusc Emerg Med. 2011 Oct 21;19:59. doi: 10.1186/1757-7241-19-59.

  PMID: 22017799 DERIVED

MeSH Terms

Conditions

Hypothermia

Condition Hierarchy (Ancestors)

Body Temperature Changes; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ulf Björnstig, MD, PhD

  Umeå University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: July 18, 2011
• First Posted: July 22, 2011
• Study Start: December 1, 2007
• Primary Completion: May 1, 2010
• Study Completion: May 1, 2010
• Last Updated: July 22, 2011

Record last verified: 2011-07

Locations

SE (1)