Use of a Shear Reduction Surface for Prehospital Transport: A Randomized Crossover Study.
Adv Skin Wound Care
; 37(3): 155-161, 2024 Mar 01.
Article
in En
| MEDLINE
| ID: mdl-37590441
ABSTRACT
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pressure Ulcer
/
Emergency Medical Services
Type of study:
Clinical_trials
Limits:
Adult
/
Humans
Language:
En
Journal:
Adv Skin Wound Care
Year:
2024
Document type:
Article