Investigating pressure bandaging for snakebite in a simulated setting

Bandage type, training and the effect of transport

E CANALE, Geoffrey Isbister, Bart Currie

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: The clinical evidence base for the use of pressure bandaging in snakebite is limited. We aimed to investigate if pressure bandages (PB) generated and maintained presumptive optimal pressures in a simulated setting. Methods: A total of 96 subjects were recruited, 78 health professionals and 18 from the general public. Participants were asked to apply PB with crepe and with an elasticized bandage without instruction. A paediatric blood pressure cuff attached to a pressure transducer was used to measure the pressure generated. PB application with elasticized bandages was repeated by 36 participants (18 general public and 18 health professionals) with feedback on pressures attained, and reassessment on the sixth subsequent attempt. Pressure was also measured under correctly applied bandages during an ambulance ride. Results: The median pressure generated under crepe bandages was 28 mmHg (interquartile range [IQR]: 17-42 mmHg) compared with 47 mmHg (IQR 26-83 mmHg) with elasticized bandages, with most subgroups applying the elasticized bandage closer to the estimated optimal pressure (55-70 mmHg). Following training, the median pressure for the 36 participants was 65 mmHg (IQR 56-71 mmHg), closer to the optimal range than initial attempts. On initial bandaging, 5/36 (14%) participants achieved optimal pressure range with elasticized bandages, compared with 18/36 (50%) after training (P = 0.002). Crepe bandages initially correctly applied did not maintain desired pressure during ambulance transport on urban roads over 30 min. Elasticized bandages maintained pressure. Conclusions: PB was poorly done by the general public and health professionals. Crepe bandages rarely generated optimal pressures compared with elasticized bandages, but training did improve participants' ability to apply elasticized bandages. PB recommendations should be modified to specify appropriate bandage types. � 2009 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
    Original languageEnglish
    Pages (from-to)184-190
    Number of pages7
    JournalEMA - Emergency Medicine Australasia
    Volume21
    Issue number3
    Publication statusPublished - 2009

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    Snake Bites
    Bandages
    Pressure
    Ambulances
    Emergency Medicine
    Public Health
    Pressure Transducers

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    @article{48e8525308b2469c864c1905d504cdbe,
    title = "Investigating pressure bandaging for snakebite in a simulated setting: Bandage type, training and the effect of transport",
    abstract = "Background: The clinical evidence base for the use of pressure bandaging in snakebite is limited. We aimed to investigate if pressure bandages (PB) generated and maintained presumptive optimal pressures in a simulated setting. Methods: A total of 96 subjects were recruited, 78 health professionals and 18 from the general public. Participants were asked to apply PB with crepe and with an elasticized bandage without instruction. A paediatric blood pressure cuff attached to a pressure transducer was used to measure the pressure generated. PB application with elasticized bandages was repeated by 36 participants (18 general public and 18 health professionals) with feedback on pressures attained, and reassessment on the sixth subsequent attempt. Pressure was also measured under correctly applied bandages during an ambulance ride. Results: The median pressure generated under crepe bandages was 28 mmHg (interquartile range [IQR]: 17-42 mmHg) compared with 47 mmHg (IQR 26-83 mmHg) with elasticized bandages, with most subgroups applying the elasticized bandage closer to the estimated optimal pressure (55-70 mmHg). Following training, the median pressure for the 36 participants was 65 mmHg (IQR 56-71 mmHg), closer to the optimal range than initial attempts. On initial bandaging, 5/36 (14{\%}) participants achieved optimal pressure range with elasticized bandages, compared with 18/36 (50{\%}) after training (P = 0.002). Crepe bandages initially correctly applied did not maintain desired pressure during ambulance transport on urban roads over 30 min. Elasticized bandages maintained pressure. Conclusions: PB was poorly done by the general public and health professionals. Crepe bandages rarely generated optimal pressures compared with elasticized bandages, but training did improve participants' ability to apply elasticized bandages. PB recommendations should be modified to specify appropriate bandage types. � 2009 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.",
    keywords = "ambulance, article, bandage, bandaging technique, blood pressure, controlled study, feedback system, health practitioner, human, major clinical study, pressure, pressure transducer, priority journal, public health, snakebite, Arm, Bandages, Clinical Competence, Constriction, First Aid, Humans, Immobilization, Leg, Manikins, Patient Simulation, Pressure, Snake Bites, Statistics, Nonparametric",
    author = "E CANALE and Geoffrey Isbister and Bart Currie",
    year = "2009",
    language = "English",
    volume = "21",
    pages = "184--190",
    journal = "Emergency Medicine Australasia",
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    Investigating pressure bandaging for snakebite in a simulated setting : Bandage type, training and the effect of transport. / CANALE, E; Isbister, Geoffrey; Currie, Bart.

    In: EMA - Emergency Medicine Australasia, Vol. 21, No. 3, 2009, p. 184-190.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Investigating pressure bandaging for snakebite in a simulated setting

    T2 - Bandage type, training and the effect of transport

    AU - CANALE, E

    AU - Isbister, Geoffrey

    AU - Currie, Bart

    PY - 2009

    Y1 - 2009

    N2 - Background: The clinical evidence base for the use of pressure bandaging in snakebite is limited. We aimed to investigate if pressure bandages (PB) generated and maintained presumptive optimal pressures in a simulated setting. Methods: A total of 96 subjects were recruited, 78 health professionals and 18 from the general public. Participants were asked to apply PB with crepe and with an elasticized bandage without instruction. A paediatric blood pressure cuff attached to a pressure transducer was used to measure the pressure generated. PB application with elasticized bandages was repeated by 36 participants (18 general public and 18 health professionals) with feedback on pressures attained, and reassessment on the sixth subsequent attempt. Pressure was also measured under correctly applied bandages during an ambulance ride. Results: The median pressure generated under crepe bandages was 28 mmHg (interquartile range [IQR]: 17-42 mmHg) compared with 47 mmHg (IQR 26-83 mmHg) with elasticized bandages, with most subgroups applying the elasticized bandage closer to the estimated optimal pressure (55-70 mmHg). Following training, the median pressure for the 36 participants was 65 mmHg (IQR 56-71 mmHg), closer to the optimal range than initial attempts. On initial bandaging, 5/36 (14%) participants achieved optimal pressure range with elasticized bandages, compared with 18/36 (50%) after training (P = 0.002). Crepe bandages initially correctly applied did not maintain desired pressure during ambulance transport on urban roads over 30 min. Elasticized bandages maintained pressure. Conclusions: PB was poorly done by the general public and health professionals. Crepe bandages rarely generated optimal pressures compared with elasticized bandages, but training did improve participants' ability to apply elasticized bandages. PB recommendations should be modified to specify appropriate bandage types. � 2009 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

    AB - Background: The clinical evidence base for the use of pressure bandaging in snakebite is limited. We aimed to investigate if pressure bandages (PB) generated and maintained presumptive optimal pressures in a simulated setting. Methods: A total of 96 subjects were recruited, 78 health professionals and 18 from the general public. Participants were asked to apply PB with crepe and with an elasticized bandage without instruction. A paediatric blood pressure cuff attached to a pressure transducer was used to measure the pressure generated. PB application with elasticized bandages was repeated by 36 participants (18 general public and 18 health professionals) with feedback on pressures attained, and reassessment on the sixth subsequent attempt. Pressure was also measured under correctly applied bandages during an ambulance ride. Results: The median pressure generated under crepe bandages was 28 mmHg (interquartile range [IQR]: 17-42 mmHg) compared with 47 mmHg (IQR 26-83 mmHg) with elasticized bandages, with most subgroups applying the elasticized bandage closer to the estimated optimal pressure (55-70 mmHg). Following training, the median pressure for the 36 participants was 65 mmHg (IQR 56-71 mmHg), closer to the optimal range than initial attempts. On initial bandaging, 5/36 (14%) participants achieved optimal pressure range with elasticized bandages, compared with 18/36 (50%) after training (P = 0.002). Crepe bandages initially correctly applied did not maintain desired pressure during ambulance transport on urban roads over 30 min. Elasticized bandages maintained pressure. Conclusions: PB was poorly done by the general public and health professionals. Crepe bandages rarely generated optimal pressures compared with elasticized bandages, but training did improve participants' ability to apply elasticized bandages. PB recommendations should be modified to specify appropriate bandage types. � 2009 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

    KW - ambulance

    KW - article

    KW - bandage

    KW - bandaging technique

    KW - blood pressure

    KW - controlled study

    KW - feedback system

    KW - health practitioner

    KW - human

    KW - major clinical study

    KW - pressure

    KW - pressure transducer

    KW - priority journal

    KW - public health

    KW - snakebite

    KW - Arm

    KW - Bandages

    KW - Clinical Competence

    KW - Constriction

    KW - First Aid

    KW - Humans

    KW - Immobilization

    KW - Leg

    KW - Manikins

    KW - Patient Simulation

    KW - Pressure

    KW - Snake Bites

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    M3 - Article

    VL - 21

    SP - 184

    EP - 190

    JO - Emergency Medicine Australasia

    JF - Emergency Medicine Australasia

    SN - 1742-6723

    IS - 3

    ER -