Scand J Trauma Resus
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Scand J Trauma Resus · Jan 2025
Randomized Controlled TrialExperimental hypothermia by cold air: a randomized, double-blind, placebo-controlled crossover trial.
Accidental hypothermia is associated with high morbidity and mortality. Research on treatment strategies for accidental hypothermia is complicated by the low incidence and heterogeneous patient population. We have developed a new method for clinical trials of experimental hypothermia, to enable further studies of active rewarming. If cold ambient air is effective as a cooling method, this would mimic the most frequent clinical setting of hypothermic patients and provide a feasible cooling method for field studies. We aimed to induce mild hypothermia in healthy volunteers by exposure to cold ambient air, and tested the hypothesis that drug-induced suppression of endogenous thermoregulation would be required. ⋯ The novel protocol utilizing cold air as a cooling method and drug-induced suppression of endogenous thermoregulation, is effective and enables future research projects. We have provided suggestions for minor alterations.
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Scand J Trauma Resus · Nov 2024
Randomized Controlled TrialA randomized clinical trial of intranasal dexmedetomidine versus inhaled nitrous oxide for procedural sedation and analgesia in children.
Procedural sedation and analgesia is an important part of pediatric emergency care, safe and clinically useful alternatives for adequate management are necessary. The objective of this clinical trial was to evaluate the non-inferiority of intranasal dexmedetomidine to nitrous oxide with respect to analgesia for a painful procedure in children 3-15 years of age. ⋯ The results of this trial support that intranasal dexmedetomidine is not inferior to 50% nitrous oxide in providing analgesia for a painful procedure in children 3-15 years of age and can be considered as an alternative to 50% nitrous oxide for procedural sedation and analgesia.
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Scand J Trauma Resus · Jul 2024
Randomized Controlled TrialEffect of oxygen supplementation on cognitive performance among HEMS providers after acute exposure to altitude: the HEMS II randomized clinical trial.
Emergency medical services (EMS) providers transiently ascend to high altitude for primary missions and secondary transports in mountainous areas in helicopters that are unpressurised and do not have facilities for oxygen supplementation. The decrease in cerebral oxygen saturation can lead to impairment in attention and reaction time as well as in quality of care during acute exposure to altitude. ⋯ This randomized clinical trial found that oxygen supplementation improves cognitive performance among HEMS providers during acute exposure to 4000 m altitude. The use of oxygen supplementation may allow to maintain attention and timely reaction in HEMS providers. The impact of repeated altitude ascents on the same day, sleep-deprivation, and additional stressors should be investigated. Trial registration NCT05073406, ClinicalTrials.gov trial registration.
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Scand J Trauma Resus · Jun 2024
Randomized Controlled TrialOnline training to improve BLS performance with dispatcher assistance? Results of a cluster-randomised controlled simulation trial.
The prognosis for patients improves significantly with effective cardiopulmonary resuscitation (CPR) performed by bystanders. Current research indicates that individuals who receive CPR from trained bystanders have a greater likelihood of survival compared to those who receive dispatcher-assisted CPR from untrained laypersons. This cluster-randomised controlled trial assessed the impact of a 30-min online training session prior to a simulated cardiac arrest situation with dispatcher-assisted CPR (DA-CPR) on enhancing Basic Life Support (BLS) performance. ⋯ Prior online training exhibits beneficial impacts on the BLS performance of bystanders during DA-CPR. To maximise the effect size, online training should be incorporated into a set of interventions that are mutually complementary and specifically designed for the target participants.
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Scand J Trauma Resus · Apr 2024
Randomized Controlled TrialEffect of a vapor barrier in combination with active external rewarming for cold-stressed patients in a prehospital setting: a randomized, crossover field study.
Use of a vapor barrier in the prehospital care of cold-stressed or hypothermic patients aims to reduce evaporative heat loss and accelerate rewarming. The application of a vapor barrier is recommended in various guidelines, along with both insulating and wind/waterproof layers and an active external rewarming device; however, evidence of its effect is limited. This study aimed to investigate the effect of using a vapor barrier as the inner layer in the recommended "burrito" model for wrapping hypothermic patients in the field. ⋯ The use of a vapor barrier as the innermost layer in combination with an active external heat source leads to higher mean skin rewarming rates in patients wearing wet clothing who are at risk of accidental hypothermia.