title: Use of a hooked cutting device compared with scissors for the emergency exposure of critically ill and injured patients.
abstract: BACKGROUND
  The initial assessment of critical patients includes prompt identification of life-threatening conditions. Any device or technique that can aid in this process may ultimately save lives. This study examined whether clothing could be removed faster with the use of a hooked cutting device as compared with the commonly-used heavy-duty, blunt-tipped, serrated scissors.
  
  
  METHODS
  This study took place in an urban academic emergency department of a Level-1 trauma center. Human patient simulator mannequins were clothed in identical shirts and pants. The time required for clinical personnel to expose the patient using each device was measured. Each of the 50 participants was queried regarding their tactile comfort using each device.
  
  
  RESULTS
  The mean time for shirt removal using scissors was 83 seconds (SD = 55 seconds; 95% CI, 68-99). The mean time for shirt removal using the hook device was 28 seconds (SD = 21 seconds; 95% CI, 22-34). The mean time for pants removal using scissors was 69 seconds (SD = 40 seconds; 95% CI, 56-73). The mean time for pants removal using the hook device was 19 seconds (SD=15 seconds; 95% CI, 15-23).
  
  
  CONCLUSIONS
  The hooked device was 69% faster at removing clothing than traditionally-used scissors. Though simple in concept, these implications can be life saving, particularly in conditions of uncontrolled, life-threatening external hemorrhage.
authors: Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland USA.
authors: Nelson
authors: N
authors: Tang
authors: Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland USA.
authors: Matthew J
authors: MJ
authors: Levy
authors: Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland USA.
authors: Jeffrey
authors: J
authors: Harrow
authors: Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland USA.
authors: Nina
authors: N
authors: Bingham
mesh_terms: D016638:Critical Illness; D004638:Emergency Treatment / Q000295:instrumentation*; D004867:Equipment Design; D004864:Equipment and Supplies; D006801:Humans; D008348:Manikins; D014193:Trauma Centers