11 Mar Preventing Skin Injury During Transport
Under military operational (battlefield) conditions, prolonged field care (PFC) occurs under austere conditions outside a fixed medical facility or in a field medical facility. Research indicates the median time for PFC is 10 hours (range 4-120 hours), before evacuation to a higher level of care. In a study of 54 cases of PFC, 36/54 had life-threatening illness or injury placing these casualties at high risk for skin pressure injury. Because of the austere setting, resources to mitigate the risk of pressure injuries are limited as the standard mattress used by the military for aeromedical evacuation and far forward medical care is bulky and cannot be transported to more austere condition. In many cases, the casualty may be on a field stretcher with padding from clothing or a sleeping bag. The litter used by the US military under PFC conditions is the Talon II Model 90C Collapsible Handle Litter. A previous study of strategies to mitigate risk for pressure injuries on the Talon litter found increased risk for pressure injuries compared to a litter with a standard AE mattress (Warrior Evacuation Litter Pad – WELP). The military, which is seeking solutions to mitigate the risk of pressure injuries under austere military conditions, has funded this study to evaluate an innovative solution the AirSupport mattress, which is lightweight and compressible.
This randomized controlled trial, which is military unique, will evaluate the effectiveness of the AirSupport mattress on risk factors for pressure injuries under conditions consistent with prolonged field care and assess the noninferiority of the AirSupport compared to the WELP mattress. 85 healthy subjects will be randomly assigned to one of three groups: Group 1 – Talon litter only; Group 2 – Talon litter + AirSupport Mattress, and Group 3 – Talon litter + WELP. Subjects will be positioned supine for 60 minutes on the designated surface. The outcome variables provide a comprehensive analysis the factors associated with skin pressure injury development including skin interface pressure, skin perfusion/oxygenation, and skin microclimate (skin moisture and temperature) on the three surfaces.
The study comparisons will be Group 1 vs Group 2 (Talon litter without/with AirSupport) and a noninferiority analysis Group 2 (Talon with Air Support) vs Group 3 (Talon with WELP).
Men and women aged 18 to 55 who meet the physical standards for military personnel and weigh less than 250 pounds (maximum allowable weight on the litter). Subjects must be able to remain in the study position (lying supine) for the duration of the study.
Ernie Tolentino (participant screener)
Additional Study Details
Full Study Title
Pressure Injury Mitigation in Prolonged Care
Elizabeth Bridges PI, Professor UW School of Nursing
Joie Whitney Co-I, Professor Emeritus, UW School of Nursing
Accepts Healthy Volunteers?
University of Washington, School of Nursing, Sleep laboratory
1959 NE Pacific, Seattle WA 98195 UW Health Sciences Building
Seattle, Washington 98155