Abstract
BackgroundExposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients’ experiences of cold exposure and to identify related factors.MethodDuring January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients’ finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation.ResultsIn the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from −22.3°C to 8.4°C.ConclusionCold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons.
Highlights
IntroductionCold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until reaching hypothermia
Exposure to cold temperatures is often a neglected problem in prehospital care
In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold
Summary
Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until reaching hypothermia. It may impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. People experience a wide range of temperatures between cold and heat. Within this range, skin temperatures over about 43°C and below about 15°C trigger not. Cold exposure increases discomfort and, if untreated, causes incremental disturbances of vital body functions until reaching hypothermia [12]. The initial reaction to cold exposure is peripheral vasoconstriction leading to peripheral blood being shunted to central body regions in order to support vital organs and to retain body heat [13,14]. Tonus of skeletal muscle increases (“shivering”), which can effectively increase heat generation up to four times [13,15]
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