Laser speckle contrast imaging and laser Doppler flowmetry reproducibly assess reflex cutaneous vasoconstriction.

OBJECTIVE: Reproducibility of the reflex cutaneous vasoconstriction response is currently unknown. Our aim was to determine the test-retest reproducibility of laser speckle contrast imaging (LSCI) and varying sampling depths of laser Doppler flowmetry (LDF) in response to whole-body cooling. METHODS: Over two studies, nine and fourteen healthy, young adults underwent a 40-min cooling bout over two separate experiments. Participants were cooled from 34.0 °C to 30.5 °C and held at a 30.5 °C plateau for 10-min prior to rewarming. Throughout the cooling bout, changes in blood flow were measured as LSCI flux and LDF flux for Study 1 and LDF flux by three different LDF sampling depths in Study 2. Test-retest reproducibility and reliability were evaluated by the coefficient of variation (CV) and intraclass correlation coefficients (ICC), respectively. Vasoconstriction was presented as cutaneous vascular conductance (CVC = flux / mean arterial pressure) and expressed as a percent change from baseline (%ΔCVCBASELINE). RESULTS: For Study 1, test-retest reproducibility displayed good reproducibility for LSCI (CV: <9.0%) and good-to-moderate for LDF (CV: <17.0%) throughout the cooling bout and at plateau (LSCI CV: 1.0%; LDF CV: 1.9%). For Study 2, all Doppler depths displayed good reproducibility during the cooling bout (CV: <9.0%) and at plateau (CV: 0.9-2.0%). Only LSCI demonstrated reliability across both studies (ICC: 0.58-0.88). A reduced vasoconstriction response was measured with the shallowest penetration in the skin (LSCI: 26 ± 0.9%ΔCVCBASELINE) compared to the Doppler with the deepest penetration (35 ± 0.6%ΔCVCBASELINE, p < 0.001). CONCLUSIONS: Although Dopplers better discriminate the reflex cutaneous vasoconstriction response, LSCI exhibits greater test-retest reproducibility and reliability, and thus may be more suitable for longitudinal assessments.

Emergency Medication Access and Administration in Schools: A Focus on Epinephrine, Albuterol Inhalers, and Glucagon.

Access to emergency medications is a growing concern, particularly regarding the availability, safety, and use of these medications in schools. The purpose of this article is to report results not previously published from a national survey, specifically regarding the emergency use of epinephrine, albuterol inhalers, and glucagon. A nonexperimental, cross-sectional design was utilized for this descriptive study. An online survey was distributed to school nurses in 2015, and data from 6,298 school nurse respondents are presented in the analysis. Findings related to stock and student-specific emergency medication use and storage, epinephrine usage data, and delegation of emergency medication administration to unlicensed assistive personnel are presented in this article. Further development of policies and procedures regarding emergency medication administration in schools is needed. School nurses are a valuable resource for obtaining knowledge in this area and keeping students safe at school.