title: Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion.
abstract: BACKGROUND
  Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity.
  
  
  OBJECTIVE
  To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC.
  
  
  METHODS
  The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05).
  
  
  CONCLUSIONS
  Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.
authors.affiliation: Department of Surgical Nursing, Gulhane Military Medical Academy, School of Nursing, Gulhane Askeri Tip Akademisi, Hemsirelik Yuksek Okulu, 06010 Etlik, Ankara, Turkey. aycosel@gmail.com
authors.forename: Ayla
authors.initials: A
authors.lastname: Yava
authors.forename: Aynur
authors.initials: A
authors.lastname: Koyuncu
authors.forename: Nuran
authors.initials: N
authors.lastname: Tosun
authors.forename: Selim
authors.initials: S
authors.lastname: Kiliç
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D017679:Cryotherapy / Q000379:methods*; D004554:Electric Countershock / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D012307:Risk Factors