Use of a Shear Reduction Surface for Prehospital Transport: A Randomized Crossover Study.

Autor:	Tescher AN; At Mayo Clinic, Rochester, Minnesota, USA, Ann N. Tescher, PhD, APRN, CNS, and Kathleen S. Berns, APRN, CNS, MS, are Advanced Practice RN Clinical Nurse Specialists. Evan Call, MS, CSM (NRM), is Lab Manager, EC Service Corp, Centerville, Utah. Also at Mayo Clinic, Patrick J. Koehler, LRT, RRT-ACCS, and Kip W. Salzwedel, RRT, LRT, are Respiratory Therapists; Heather E. McCormack, DScPT, PT, CWS, is Assistant Professor in Physical Therapy (retired); Lucas A. Myers, BS, is Senior Business Analyst; Clinton E. Hagen, MS, is Principal Data Scientist, and Jay Mandrekar, PhD, is Professor of Biostatistics and Neurology, Department of Quantitative Health Sciences. Marianne Russon, BS, is Project Manager, EC Service Corp. Acknowledgments: Mayo Clinic does not endorse specific products or services included in this article. This paper was presented as a poster at the Minnesota Affiliate National Association of Clinical Nurse Specialists Fall Conference and Annual Meeting, October 28, 2016, Minneapolis, Minnesota; at the National Pressure Ulcer Advisory Panel Research Symposium, November 9, 2016, Las Vegas, Nevada; at the Mayo Clinic Quality Conference, March 15, 2017, Rochester, Minnesota; at the Wound, Ostomy, and Continence Nurses Society's 49th Annual Conference, May 19-23, 2017, Salt Lake City, Utah; at the Wound Care From Innovations to Clinical Trials 2017 Conference, June 20-21, 2017, Manchester, England; and at the National Association of Emergency Medicine Services Physicians Scientific Assembly, January 11-13, 2018, San Diego, California. Portions of this article have been published in abstract form: J Wound Ostomy Continence Nurs 2017;44:R03; Prehosp Emerg Care 2018;22(1):137. The authors thank Scott P. Zietlow, MD, past chair (emeritus), Mayo Clinic Ambulance Board of Directors for support of this study. Kathleen Louden, ELS, senior scientific/medical editor, Mayo Clinic, substantively edited the manuscript. The Scientific Publications staff, Mayo Clinic, provided proofreading, administrative, and clerical support. The authors have disclosed no financial relationships related to this article. Submitted April 7, 2023; accepted in revised form July 26, 2023; published ahead of print August 22, 2023., Berns KS, Call E, Koehler PJ, Salzwedel KW, McCormack HE, Myers LA, Hagen CE, Mandrekar J, Russon M
Jazyk:	angličtina
Zdroj:	Advances in skin & wound care [Adv Skin Wound Care] 2024 Mar 01; Vol. 37 (3), pp. 155-161. Date of Electronic Publication: 2023 Aug 22.
DOI:	10.1097/ASW.0000000000000044
Abstrakt:	Objective: To compare the effectiveness of an antishear mattress overlay (ASMO) with a standard ambulance stretcher surface in reducing pressure and shear and increasing patient comfort. Methods: In this randomized, crossover design, adults in three body mass index categories served as their own controls. Pressure/shear sensors were applied to the sacrum, ischial tuberosity, and heel. The stretcher was placed in sequential 0°, 15°, and 30° head-of-bed elevations with and without an ASMO. The ambulance traveled a closed course, achieving 30 mph, with five stops at each head-of-bed elevation. Participants rated discomfort after each series of five runs. Results: Thirty individuals participated. Each participant had 30 runs (15 with an ASMO, 15 without), for a total of 900 trial runs. The peak-to-peak shear difference between support surfaces was -0.03 N, indicating that after adjustment for elevation, sensor location, and body mass index, peak shear levels at baseline (starting pause) were 0.03 N lower for the ASMO than for the standard surface ( P = .02). The peak-to-peak pressure difference between surfaces was -0.16 mm Hg, indicating that prerun peak-to-peak pressure was 0.16 mm Hg lower with the ASMO versus standard surface ( P = .002). The heel received the most pressure and shear. Discomfort score distributions differed between surfaces at 0° ( P = .004) and 30° ( P = .01); the overall score across all elevations was significantly higher with the standard surface than with the ASMO ( P = .046). Conclusions: The ASMO reduced shear, pressure, and discomfort. During transport, the ambulance team should provide additional heel offloading. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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