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The Effect of Different Degrees of Cold Exposure on Medical Laypeople’s Tourniquet Application Time and Quality: A Within-Group Trial

Published online by Cambridge University Press:  13 July 2023

Wilhelm Brodin
Affiliation:
Department of Computer and Information Science, Linköping University, Linköping, Sweden
Marc Friberg
Affiliation:
Department of Computer and Information Science, Linköping University, Linköping, Sweden Center for Disaster Medicine and Traumatology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Carl-Oscar Jonson
Affiliation:
Center for Disaster Medicine and Traumatology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Erik Prytz
Affiliation:
Department of Computer and Information Science, Linköping University, Linköping, Sweden Center for Disaster Medicine and Traumatology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Abstract

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Introduction:

Cold exposure generally has a negative effect on tasks that rely on finger dexterity. It is not known if cold exposure will affect medical laypeople’s ability to perform first aid for life-threatening bleedings, specifically tourniquet application. This study investigates the effect of cold exposure on medical laypeople’s tourniquet application ability.

Method:

Twenty-nine adult medical laypersons received brief tourniquet application training and then completed a tourniquet application test in a baseline condition and three partial cold immersion conditions where their hands were immersed in nearly 0°C water. The three cold immersion conditions were 16°C, 12°C, and 8°C hand-skin temperature. Tourniquet application quality was measured using a procedural checklist. Time until bleeding control was also measured.

Results:

The results show that cold exposure significantly increases the time to bleeding control, F(3, 84) = 5.42, p < .01, η2 = .05. Planned contrasts revealed a significant increase in time between baseline and 8°C hand-skin temperature (M baseline = 65.5s, SD = 17.0; M 8°C = 76.9s, SD = 19.6), t(28) = 3.77, p < .01, r = 0.38. No effect was found on the procedural application quality, F(3, 84) = 2.21, p = .09.

Conclusion:

Cold exposure can decrease the chance of survival for the injured person when a medical layperson provides first aid for life-threatening bleedings due to increased application time. The results can also be used when educating medical laypeople in first aid for life-threatening bleedings as it provides evidence of specific effects from a stressor that is common in regions with cold climate. Future research should be aimed at exploring possible mitigation strategies such as tourniquet design or rewarming procedures and investigating if a similar effect exists for prehospital professionals.

Type
Lightning and Oral Presentations
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine