Litter Position for Trauma Patients

Overseen By Michelle Horwege, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Disqualifiers: Cardiac, Pulmonary disease

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different stretcher positions for rescuing people from challenging locations like caves or cliffs. Researchers aim to determine if an upright position in a vertical stretcher improves breathing compared to lying flat. Individuals weighing between 130 and 310 pounds without major heart or lung issues may qualify for this trial.

As an unphased trial, it offers participants the opportunity to contribute to innovative rescue techniques that could enhance safety and outcomes in difficult environments.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have significant heart or lung disease, you may not be eligible to participate.

What prior data suggests that this litter position method is safe for trauma patients?

Research shows that different stretcher positions for trauma patients can affect safety and comfort. Studies suggest the flat position might lead to issues like pain and bedsores, but they did not specifically examine safety when the stretcher is upright.

For the upright position, research on patients with ARDS (a lung condition) indicates it might improve breathing. However, concerns exist about the safety of restraints in crash tests, though these tests are quite extreme.

Regarding the forward-leaning position, limited safety data exists, but some studies suggest it might alter breathing without clear safety conclusions.

Overall, the safety of these stretcher positions in real-life rescue situations can vary. While some positions may offer specific benefits, gaps in solid safety data remain. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the "Litter Position for Trauma Patients" trial because it explores different ways to position patients on a litter, potentially impacting recovery outcomes. Unlike traditional methods that typically use a flat position, this trial examines the effects of flat, vertical, and pitched forward positions, along with a baseline comparison. The unique feature of this trial is its focus on how different body orientations can affect trauma patient recovery, especially regarding pulmonary function. Understanding the optimal position could lead to improved trauma care practices and faster recovery times for patients.

What evidence suggests that the vertical litter position is effective for improving pulmonary function in trauma patients?

Research shows that a patient's position on a stretcher can affect their breathing. This trial will compare different litter positions for trauma patients. Participants in the "Flat" arm will be secured in a flat litter, which may make breathing more difficult compared to sitting up. Those in the "Vertical" arm will be secured in a vertical litter; early studies suggest this position could improve lung function, as seen in tests measuring exhaled air in one second. The "Pitched forward" arm will have participants secured in a forward-leaning litter. While evidence is less clear about its benefits, this position might aid breathing similarly to lying on the stomach, such as improving oxygen levels. The "Baseline" arm will involve sitting to establish baseline pulmonary function for comparison. ^{1 2 6 7 8}

Who Is on the Research Team?

Roger B Mortimer, MD

Principal Investigator

UCSF - Fresno

Are You a Good Fit for This Trial?

This trial is for trauma patients who may experience hypothermia and need to be evacuated from challenging environments. It's exploring if being carried in a vertical position on a litter (a type of stretcher) affects lung function differently than the standard horizontal position.

Inclusion Criteria

I weigh between 130 and 310 pounds.

Exclusion Criteria

I do not have serious heart or lung disease.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Baseline Measurement

Participants undergo baseline sitting pulmonary testing to measure FEV1, FVC, and FEV1/FVC.

1 day

1 visit (in-person)

Experimental Testing

Participants are secured in different litter positions (horizontal, vertical, pitched forward) to measure changes in pulmonary function.

1 day

1 visit (in-person)

Follow-up

Participants are monitored for any immediate changes in pulmonary function post-experiment.

1 day

What Are the Treatments Tested in This Trial?

Interventions

• Litter Position

Trial Overview

The study is testing pulmonary function through FEV1, FVC, and FEV1/FVC measurements in simulated patients on litters oriented vertically versus horizontally. The goal is to determine which orientation might be better for breathing during evacuation.

How Is the Trial Designed?

Group I: Flat Active Control 1 Intervention

Secured in a flat litter

Group II: Vertical Active Control 1 Intervention

Secured in a vertical litter

Group III: Pitched forward Active Control 1 Intervention

Secured in a litter leaning forward

Group IV: Baseline Placebo Group 1 Intervention

Sitting baseline pulmonary function

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Citations

1.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S1067991X15000462

Comparison of a Padded Patient Litter and Long Spine ...

This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board.

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11088786/

Traditional Spinal Immobilization versus Spinal Motion ...

This study aimed to compare the cervical range of motion (ROM) and the immobilization time between traditional spinal immobilization (TSI) and spinal motion ...

3.

ahajournals.org

ahajournals.org/doi/10.1161/circ.102.suppl_1.I-22

Part 3: Adult Basic Life Support | Circulation

The lateral technique is ideal for performing 1-rescuer CPR, because the rescuer can maintain the same position for both rescue breathing and chest compressions ...

4.

researchgate.net

researchgate.net/publication/374469730_Effects_of_prone_positioning_on_ARDS_outcomes_of_trauma_and_surgical_patients_A_systematic_review_and_meta-analysis

(PDF) Effects of prone positioning on ARDS outcomes ...

Effects of prone positioning on ARDS outcomes of trauma and surgical patients: A systematic review and meta-analysis ... position in surgical and ...

5.

itrsonline.org

itrsonline.org/papers/tproduct/294801796-145907776381-a-critical-review-of-litter-orientation

A Critical Review of Litter Orientation & Patient Positioning

A Critical Review of Litter Orientation & Patient Positioning. $. $. Presenter: Timothy Durkin Year: 2021. Category: Medical Subcategory: Patient Packaging

6.

academic.oup.com

academic.oup.com/milmed/article-pdf/182/suppl_1/287/21873300/milmed-d-16-00236.pdf

Patient Litter System Response in a Full-Scale CH-46 ...

Acceleration, force, and bending moment data from the instrumented middle ATD were analyzed using available injury criteria. Results indicated that a patient ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC7286246/

The impact of trauma systems on patient outcomes - PMC

The modern comprehensive trauma system optimizes cost-effective and high-quality care of the injured patient starting with injury recognition, ...

8.

bmcpulmmed.biomedcentral.com

bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-023-02805-w

Effects of prone positioning on ARDS outcomes of trauma and ...

The prone position has comparable complications to the supine position. With its benefits of increased oxygenation and decreased mortality, the prone position ...