Ambulance deceleration causes increased intra cranial pressure in supine position: a prospective observational prove of principle study
| العنوان: | Ambulance deceleration causes increased intra cranial pressure in supine position: a prospective observational prove of principle study |
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| المؤلفون: | Sanne E. Hoeks, Iscander M. Maissan, Robert Jan Stolker, Jan Bosch, Boris Vlottes, Dennis den Hartog |
| المساهمون: | Anesthesiology, Surgery |
| المصدر: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 29, Iss 1, Pp 1-5 (2021) Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1):87. BioMed Central Ltd. |
| بيانات النشر: | BioMed Central, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Intra cranial pressure, Supine position, Transportation, Nerve sheath, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Fluid shift, Ambulance, ONSD, 03 medical and health sciences, 0302 clinical medicine, Cerebro spinal fluid, Traumatic brain injury, TBI, Ultrasound, Medicine, 030212 general & internal medicine, Original Research, Optical nerve sheath diameter, POCUS, business.industry, RC86-88.9, EMS, Medical emergencies. Critical care. Intensive care. First aid, ICP, Anesthesia, Emergency Medicine, business |
| الوصف: | Background Ambulance drivers in the Netherlands are trained to drive as fluent as possible when transporting a head injured patient to the hospital. Acceleration and deceleration have the potential to create pressure changes in the head that may worsen outcome. Although the idea of fluid shift during braking causing intra cranial pressure (ICP) to rise is widely accepted, it lacks any scientific evidence. In this study we evaluated the effects of driving and deceleration during ambulance transportation on the intra cranial pressure in supine position and 30° upright position. Methods Participants were placed on the ambulance gurney in supine position. During driving and braking the optical nerve sheath diameter (ONSD) was measured with ultrasound. Because cerebro spinal fluid percolates in the optical nerve sheath when ICP rises, the diameter of this sheath will distend if ICP rises during braking of the ambulance. The same measurements were taken with the headrest in 30° upright position. Results Mean ONSD in 20 subjects in supine position increased from 4.80 (IQR 4.80–5.00) mm during normal transportation to 6.00 (IQR 5.75–6.40) mm (p After raising the headrest of the gurney 30° mean ONSD increased from 4.80 (IQR 4.67–5.02) mm during normal transportation to 4.90 (IQR 4.80–5.02) mm (p = 0.022) during braking. In 15 subjects (75%) there was no change in ONSD at all. Conclusions ONSD and thereby ICP increases during deceleration of a transporting vehicle in participants in supine position. Raising the headrest of the gurney to 30 degrees reduces the effect of breaking on ICP. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1757-7241 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5514fac4715fbd4d47bbe1bb4d68ad3cTest http://europepmc.org/articles/PMC8246666Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....5514fac4715fbd4d47bbe1bb4d68ad3c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17577241 |
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