Trial reportScandinavian journal of trauma, resuscitation and emergency medicine2025
Effect of cold environments on technical performance and perceived workload and stress during advanced medical procedures: a randomized controlled simulation study.
Trial report in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Airway management skills and devices on Italian helicopter emergency medical service: a national survey.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Emergency care for avalanche buried patients - a narrative review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Review
- Impact of ambient temperature on postoperative cognitive dysfunction in elderly patients surgery: A seasonal comparison in tropical regions.World journal of psychiatry · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundAdvanced medical procedures in prehospital settings are often performed in hostile environments, where cold temperatures may impair manual and cognitive performance. Although such procedures are essential in mountain rescue missions, the effects of cold conditions on their execution and associated workload and stress are unknown.
objectiveThis randomized controlled simulation study evaluated differences in performance, perceived workload, and stress during the execution of three advanced emergency medical procedures under cold (- 20 °C) versus control (+ 20 °C) ambient temperatures. Additionally, the study examined the influence of operator experience on these outcomes.
methodsThirty-six members of the International Medical Commission for Alpine Rescue participated in a crossover study conducted at the terraXcube environmental simulator in Bolzano, Italy. Participants performed orotracheal intubation via videolaryngoscopy (OTI-VLS), mini-thoracostomy, and front-of-neck airway (FONA) procedures under both temperature conditions. Time to procedure completion, number of attempts, and perceived workload and stress (using the NASA Task Load Index and Visual Analogue Scale) were measured. Operators were categorized into high or low experience groups based on self-reported prior procedure frequency.
resultsTime to complete the procedures tended to be longer in cold conditions for all procedures, with the largest difference observed for OTI-VLS (14 s, p = 0.076). Success rates exceeded 90% on the first attempt under both conditions. Perceived workload and stress increased significantly in cold environments across all procedures, especially for less experienced participants. Experienced operators completed OTI-VLS and mini-thoracostomy significantly faster and reported lower stress and workload levels compared to their less experienced counterparts.
conclusionsWhile cold environments had low impact on procedural time, they significantly increased perceived workload and stress among rescue personnel. Experience mitigated these effects, emphasizing the importance of tailored training programs to enhance both technical and non-technical skills in challenging conditions. While this study has explored the impact of temperature, it would be valuable to investigate how other environmental factors, such as wind and rain, might affect clinical actions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.