• Critical care nurse · Apr 2018

    Comparative Study

    Reducing the Risk for Pressure Injury During Combat Evacuation.

    • Elizabeth Bridges, JoAnne D Whitney, Robert Burr, and Ernesto Tolentino.
    • Col (Ret) Elizabeth Bridges, USAF, NC, is a professor at the University of Washington School of Nursing and a clinical nurse researcher at the University of Washington Medical Center, Seattle, Washington. ebridges@uw.edu.
    • Crit Care Nurse. 2018 Apr 1; 38 (2): 38-45.

    BackgroundCombat casualties undergoing aeromedical evacuation are at increased risk for pressure injuries. The risk factors pressure and shear are potentially modifiable via solutions appropriate for en route care.ObjectivesTo compare transcutaneous oxygen levels and skin temperatures in healthy participants under offloaded (side lying) and loaded (supine or supine with 30° backrest elevation) under 4 conditions: control (no intervention), Mepilex sacral and heel dressings, LiquiCell pad, and Mepilex plus LiquiCell.MethodsParticipants were randomly assigned to 4 groups according to ideal body weight. Backrest positions were randomized. Transcutaneous oxygen level and temperature were measured on the sacrum and the heel; skin interface pressure was measured with an XSensor pressure imaging system. Measurements were obtained for 5 minutes at baseline (offloaded), 40 minutes with participants supine, and 15 minutes offloaded.ResultsIn the 40 healthy participants, interface pressure, transcutaneous oxygen level, and skin temperature did not differ between the 4 groups. Peak interface pressures were approximately 43 mm Hg for the sacrum and 50 mm Hg for the heel. Sacral transcutaneous oxygen level differed significantly between unloaded (mean, 79 mm Hg; SD, 16.5) and loaded (mean, 57 mm Hg; SD, 25.2) conditions (P < .001) in a flat position (mean, 85.2 mm Hg; SD, 13.6) and with 30° backrest elevation (mean, 66.7 mm Hg; SD, 24.2) conditions (P < .001). Results for the heels and the sacrum were similar. Sacral skin temperature increased significantly across time (approximately 1.0°C).ConclusionsThe intervention strategies did not differ in prevention of pressure injuries.©2018 American Association of Critical-Care Nurses.

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