The Effect of Different Degrees of Cold Exposure on Medical Laypeople’s Tourniquet Application Time and Quality: A Within-Group Trial

Introduction: Cold exposure generally has a negative effect on tasks that rely on finger dexterity. It is not known if cold exposure will affect medical laypeople’s ability to perform first aid for life-threatening bleedings, specifically tourniquet application. This study investigates the effect of cold exposure on medical laypeople’s tourniquet application ability. Method: Twenty-nine adult medical laypersons received brief tourniquet application training and then completed a tourniquet application test in a baseline condition and three partial cold immersion conditions where their hands were immersed in nearly 0°C water. The three cold immersion conditions were 16°C, 12°C, and 8°C hand-skin temperature. Tourniquet application quality was measured using a procedural checklist. Time until bleeding control was also measured. Results: The results show that cold exposure significantly increases the time to bleeding control, F (3, 84) = 5.42, p < .01, η 2 = .05. Planned contrasts revealed a significant increase in time between baseline and 8°C hand-skin temperature (M baseline = 65.5s, SD = 17.0; M 8°C = 76.9s, SD = 19.6), t (28) = 3.77, p < .01, r = 0.38. No effect was found on the procedural application quality, F (3, 84) = 2.21, p = .09. Conclusion: Cold exposure can decrease the chance of survival for the injured person when a medical layperson provides first aid for life-threatening bleedings due to increased application time. The results can also be used when educating medical laypeople in first aid for life-threatening bleedings as it provides evidence of specific effects from a stressor that is common in regions with cold climate. Future research should be aimed at exploring possible mitigation strategies such as tourniquet design or rewarming procedures and investigating if a similar effect exists for prehospital professionals.