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Treatment of Motionsickness in Prehospital Trauma Victims: Oxyarm™ Is More Effective Than a Venturi Mask

Roman Fleischhackl, B.S.; Thomas Scheck, M.D.; Alexander Kober, M.D.; Sabine Fleischhackl, B.S.; Klaus Hoerauf, M.D.

Department of Anesthesia and Intensive Care Medicine, University of Vienna, Vienna Red Cross "Van Swieten", "Bertha von Suttner" and the Research Insitute of the Vienna Red Cross, Vienna, Austria

Background: Supplemental oxygen given in the PACU and on emergency transport reduces PONV and motion sickness. Unfortunately, patient's satisfaction is impaired by the discomfort of the convential face mask. Oxyarm™ is a new oxygen delivery system without direct contact to the patient´s face. We therefore tested the hypothesis that oxygen administration with Oxyarm™ is more effective and better tolerated in treating motion sickness on emergency transport than a face mask.

Methods: Forty victims of minor trauma were randomly assigned to either Oxyarm™ (n=20) or face mask (n=20) for oxygen inhalation (8l/min) during transport. A paramedic measured vital signs before and after transport. Patients rated their levels of nausea, negative smell of the device, feeling of restriction by the device and satisfaction with their care on 100-mm-long visual analog scales. Results in the two groups were compared with Chi Square or unpaired, two-tailed t tests; data are presented as means ± SDs.

Results: Before randomisation, patients did not differ significantly in morphometrics, demographics and SpO2 or in their scales of nausea. Oxygen saturation upon arrival at the hospital was comparable in both groups (Oxyarm™, 99 ± 1 vs. face mask, 99 ± 1%, P = 0.8). However, the patients using Oxyarm™ had significantly less nausea (4.4 ± 2.1 vs. 27.5 ± 5 mm, P = 0.03) and vomiting (0 vs. 7  episodes, P < 0.01). The Oxyarm™ group also had significantly lower scales for negative smell (4.5 ± 2 vs. 27.0 ± 13 mm, P < 0.01), restriction by the device (86 ± 12 vs. 94 ± 13 mm, P < 0.01), and greater overall satisfaction (4.2 ± 2.3 vs. 28.0 ± 9 mm, P < 0.01). Six patients removed the face mask on  transport, none rejected Oxyarm™.

Conclusion: Our results indicate that supplemental oxygen during hospital transport applicated by Oxyarm™ is more effective in treatment of motion sickness than a face mask and increases patient's comfort and compliance significantly. We therefore can recommend the use of Oxyarm™ in prehospital trauma care.

Literature: Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Goll V et al., Anesth Analg 2001 Jan;92(1):112-7

A randomized controlled trial of oxygen for reducing nausea and vomiting during emergency transport of patients older than 60 years with minor trauma. Kober A et al., Mayo Clin Proc 2002 Jan;77(1):35-8

Anesthesiology 2002; 96: A347

Source: Copyright © 2006, American Society of Anesthesiologists. All rights  reserved.