Reactions to cold exposure emphasize the need for weather protection in prehospital care: an experimental study.

INTRODUCTION: Exposure to cold temperature is a serious but often neglected problem in prehospital care. It not only is an uncomfortable, subjective experience, but it also can cause severe disturbances in vital functions, gradually leading to hypothermia. OBJECTIVE: The aim of this study was to examine healthy subjects' physiological and subjective reactions to cold exposure (30 minutes at -5 degrees C in the a climatic chamber) while they were lying in a protective covering. METHODS: Healthy volunteers (n = 20) participated in the experiment, which consisted of a 10-minute stabilization period of vital functions at room temperature (23 degrees C), 30 minutes of cold exposure (-5 degrees C), and a 30-minute recovery period at room temperature. Subjects lay supinely in protective covering during the entire experiment. Skin temperatures, oxygen saturation, pulse rates, pulse wave amplitude in the middle finger, and surface electromyography (EMG) activity of the major pectoral muscle were recorded continuously during the test. Before and immediately after the cold exposure, tympanic membrane temperatures were measured. In addition, subjects were asked to estimate cold using a standard scale. RESULTS: During the cold exposure, the decrease in tympanic membrane temperature was not significant. The pulse wave amplitude in the finger decreased sharply upon entering the cold chamber. Skin temperatures, especially of the fingers and toes, decreased during the cold exposure. There were no clear signs of shivering in electromyographic recordings. Subjective cold feelings followed decreasing skin temperatures. Skin temperatures did not return quickly. Even 30 minutes after the exposure, all the skin temperatures still had not returned to normal levels. However, subjective cold feeling was relieved immediately. CONCLUSIONS: Cold exposure provoked immediate protective vasoconstriction in the peripheral compartment, which caused linear decreases of local skin temperatures. This probably was triggered from the unprotected face and upper respiratory areas.

Electronic communication channel within the patient data management system improves internal communication in the ICU.

The aim of this study was to improve the internal communication within the intensive care unit of the Kuopio University Hospital. We developed an intranet based internal communication channel within the patient data management system and studied the effectiveness of this system in improving communication in the ICU. The hypothesis was that the communication difficulties caused by the structure of the unit, large personnel and work schedule (three separate shifts) could be reduced by supplementing oral communication by this intranet based system. The results clearly indicate that this type of system can significantly improve communication within our unit.

Reducing the physical work load and strain of personal helpers through clothing redesign.

This study assessed the effects of redesigning clients' clothing on the physical work load and strain of personal helpers. Five women, aged 18-54 years, who helped persons with physical disabilities were measured at their worksites before and after development of the clothes worn by clients. The physical work load and strain of the helpers' dressing/undressing of clients were determined from their hand and back movements, work time, muscular activity, heart rate (HR), percentage of heart rate range (%HRR), and rating of perceived exertion (RPE). The muscular activity of the right (p=0.05) and left (p=0.02) trapezius muscles, HR (p=0.03), and %HRR (p=0.03) of the helpers were lower when the new outerwear was used in place of traditional outerwear. Four helpers reported lower perceived exertion, and three had shorter work time with the new outerwear. This study showed that redesigning clients' clothing can help reduce the physical work load and strain of personal helpers.