Articles: emergency-medicine.
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Scand J Trauma Resus · Jan 2025
Randomized Controlled TrialExperimental hypothermia by cold air: a randomized, double-blind, placebo-controlled crossover trial.
Accidental hypothermia is associated with high morbidity and mortality. Research on treatment strategies for accidental hypothermia is complicated by the low incidence and heterogeneous patient population. We have developed a new method for clinical trials of experimental hypothermia, to enable further studies of active rewarming. If cold ambient air is effective as a cooling method, this would mimic the most frequent clinical setting of hypothermic patients and provide a feasible cooling method for field studies. We aimed to induce mild hypothermia in healthy volunteers by exposure to cold ambient air, and tested the hypothesis that drug-induced suppression of endogenous thermoregulation would be required. ⋯ The novel protocol utilizing cold air as a cooling method and drug-induced suppression of endogenous thermoregulation, is effective and enables future research projects. We have provided suggestions for minor alterations.
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Suicide is the 10th leading cause of death in the United States. Prior research suggests that 10% of people who died by suicide received some form of emergency department (ED) treatment in the 2 months preceding death. The risk of attempted suicide is high during transition back to the community after discharge from the ED, so this is an important opportunity to develop effective empirically validated prevention methods. However, the physical layout and crowded nature of most contemporary EDs, resulting in high rates of "hallway bed" assignments, presents some ethical challenges to conducting the requisite behavioral health research in ED settings. ⋯ This example illustrates the ethical considerations when enrolling patients who occupy a hallway bed into research and the value of a collaborative/problem solving focused dialogue between investigators, ethicists, and IRB personnel.