Impact of personal protective equipment on clinical output and perceived exertion.

Abstract:

BACKGROUND AND AIM:Safe clinical care within Ebola Virus Disease Treatment Units (EVDTUs) mandate the use of personal protective equipment (PPE), comprising a fluid impermeable hooded suit, visor, gloves and rubber boots. The aim of this study was to assess the impact of this PPE on clinical personnel's performance in the EVDTU, Kerry Town, Sierra Leone. METHODS:An anonymous questionnaire was administered to healthcare professionals (HCPs) entering the EVDTU ward area (Red Zone (RZ)), during a 2-week period to assess perceived exertion using the Borg Rating of Perceived Exertion Scale. RESULTS:A total of 62 clinical episodes undertaken by 20 HCPs were analysed. There were no episodes of heat illness during the study. HCPs spent a median of 74 (IQR 55-95) minutes within the RZ. Median durations of RZ activity were similar throughout the 24 h period (p=0.22), but Borg scores were significantly higher between 11:00 and 14:59 compared with RZ entry between 15:00 and 10:59, respectively (12 (6-15), n=13; 8 (6-9), n=48; p=0.022). Rates of weight loss per minute spent within the RZ were significantly greater between 11:00 and 14:59 compared with 15:00-10:59, respectively (0.014 (0.009-0.023) kg/min, n=6; 0.007 (0.004-0.013) kg/min, n=37; p=0.037). CONCLUSIONS:Despite acclimatisation and proactive clinical tasking, HCPs in the EVDTU experienced significantly greater rates of weight loss and perceived exertion scores during the hottest times of the day. These findings should be considered by those planning healthcare facilities for future humanitarian missions where HCPs will provide clinical care in full PPE.

journal_name

J R Army Med Corps

authors

Maynard SL,Kao R,Craig DG

doi

10.1136/jramc-2015-000541

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

180-3

issue

3

eissn

0035-8665

issn

2052-0468

pii

jramc-2015-000541

journal_volume

162

pub_type

杂志文章
  • Militaries and the duty of care to enhanced veterans.

    abstract::This article argues that there is a duty of care held by the State to military veterans who have been technologically enhanced as part of their military service. It suggests that enhancements may be permanent, persistent or protracted and demonstrates how enhancements generate additional moral responsibilities from th...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2018-001140

    authors: Henschke A

    更新日期:2019-08-01 00:00:00

  • Hypertonic saline.

    abstract::The optimal fluid for the resuscitation of critically ill and injured patients remains the subject of considerable controversy. Hypertonic crystalloid solutions such as hypertonic saline provide rapid volume expansion, have an acceptable safety profile, and are easy to store and transport. Recent meta-analyses suggest...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章,评审

    doi:10.1136/jramc-150-04-03

    authors: Smith JE,Hall MJ

    更新日期:2004-12-01 00:00:00

  • Incidence of SLAP lesions in a military population.

    abstract:OBJECTIVES:SLAP (superior labrum anterior and posterior) lesions are a recognised cause of shoulder pain and instability. They can occur following a direct blow, biceps traction and compression injuries, and are commonly seen in overhead athletes. Military personnel are physically active and often subjected to trauma. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-151-03-07

    authors: Kampa RJ,Clasper J

    更新日期:2005-09-01 00:00:00

  • Operation Nightingale: the role of BMH Dharan following the 1988. Nepal earthquake, and some observations on Third World earthquake disaster relief missions.

    abstract::Following a large earthquake in Nepal, the experience of a small hospital in dealing with the resulting mass casualties is described. The value of pre-planning and effective triage of the injured is stressed, and aspects of surgical and medical care specific to earthquake victims discussed. Clinical and administrative...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-136-01-02

    authors: Guy PJ,Ineson N,Bailie R,Grimwood A

    更新日期:1990-02-01 00:00:00

  • Ileal conduit for reconstruction of the duodenum following right hemicolectomy and pancreaticoduodenectomy for malignant duodenocolic fistula.

    abstract::We describe a case of malignant duodenocolic fistula in which after a radical resection of right hemicolectomy and pancreaticoduodenectomy, the duodenal defect was reconstructed using a conduit of transposed ileum. This technique, not previously described, offers an alternative to 'duodenal patching', which allows onl...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-139-02-08

    authors: Ohri AK,Ohri SK

    更新日期:1993-06-01 00:00:00

  • Acute salivary gland enlargement following instrumentation of the upper airway.

    abstract::A case of sudden enlargement of the submandibular and parotid salivary glands following endotracheal intubation is described. The literature concerning this condition is reviewed, and the possible causes are discussed. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-133-03-11

    authors: Strowbridge NF

    更新日期:1987-10-01 00:00:00

  • Acute tibial compartment syndrome secondary to psychosomatic disorder.

    abstract::A case of a 28 years old Caucasian woman is presented with acute tibial compartment of her left leg secondary to repeated self inflicted soft tissue injuries, together with literature review on Dermatitis Artefacta. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章,评审

    doi:10.1136/jramc-140-02-11

    authors: Eskander MB,MacDonald R

    更新日期:1994-06-01 00:00:00

  • British Military Hospital Dharan: surgical experience 1985-86.

    abstract::The clinical experience of an army surgeon in a military hospital in East Nepal is discussed. The truly general nature of the work load is highlighted and the need for a broad based general training in surgery for such a task is well illustrated. A high degree of interdisciplinary cooperation was experienced and was i...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-134-01-02

    authors: Ryan JM

    更新日期:1988-02-01 00:00:00

  • Tattoo removal by surgery in a bloodless field.

    abstract::Tattoo removal from the forearm often requires excision and split skin grafting. The authors propose the use of a bloodless field to facilitate accurate dermal peeling, to ensure complete removal of the pigment, and to reduce operative time. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-137-01-02

    authors: Hull JB,Corner NB,Roberts P,Attwood AI

    更新日期:1991-02-01 00:00:00

  • Informal caregiving and intimate relationships: the experiences of spouses of UK military personnel.

    abstract:AIM:Currently, there is no research available on the experiences of spouses providing informal care to wounded, injured or sick (WIS) UK military personnel. The aim of this study was to fill this gap by investigating the relationship experiences of non-military partners caring for WIS UK military personnel. METHODS:Sp...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2016-000679

    authors: Thandi G,Oram S,Verey A,Greenberg N,Fear NT

    更新日期:2017-08-01 00:00:00

  • Trauma related symptoms in British soldiers 36 months following a tour in the former Yugoslavia.

    abstract::This paper measures the prevalence of psychological symptoms in two British Infantry battalions, 36 months after being involved in peace keeping operations in the former Yugoslavia during November 1992-April 1993. Those deployed had a high level of post traumatic stress disorder (16%) compared to (9%) in the control g...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-145-01-03

    authors: Baggaley MR,Piper ME,Cumming P,Murphy G

    更新日期:1999-02-01 00:00:00

  • A 2-year review of the general internal medicine admissions to the British Role 3 Hospital in Camp Bastion, Afghanistan.

    abstract:BACKGROUND:Detailed knowledge of the likely volume and nature of the diseases presenting to deployed secondary care facilities aids operational planning. Now the British operation in Afghanistan has ended and a record of the experience is useful to preserve the lessons learned. METHODS:Over a 2-year period from April ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2014-000385

    authors: Cox AT,Lentaigne J,White S,Burns DS,Parsons I,O'Shea M,Stacey M,Sharma S,Wilson D

    更新日期:2016-02-01 00:00:00

  • Delay in treatment of testicular tumours in the Army.

    abstract::Modern drug treatment, added to our previous experience of surgery and radiotherapy, is currently producing nearly 90% cure of all patients with testicular tumours. Most of the failures of treatment today occur in patients with a large mass of diseased tissue which has accumulated due to delayed diagnosis. A retrospec...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-131-03-04

    authors: Attard GJ

    更新日期:1985-10-01 00:00:00

  • Historical origins and current concepts of wound debridement.

    abstract::In the late 18th Century wound debridement consisted of incision of skin and deep fascia to release the swelling associated with ballistic injury, however extremity war wounds were more usually managed non-operatively or by amputation. During the First World War debridement was redefined to include excision of all non...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 社论,历史文章

    doi:10.1136/jramc-157-02-01

    authors: Guthrie HC,Clasper JC

    更新日期:2011-06-01 00:00:00

  • Social characteristics and their importance in reducing inequalities in health in the Armed Forces.

    abstract:OBJECTIVES:To investigate whether there was a difference in social characteristics in different garrison towns of the British Forces Germany and to ascertain whether the health visitor workload was different in these towns. DESIGN:Self completed questionnaires administered to mothers by health visitors on first contac...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-144-02-07

    authors: Ross DA,Clayton TC

    更新日期:1998-06-01 00:00:00

  • Psychological briefing, prevention or priming? or, How many psychiatrists does it take to change a mind?

    abstract::This paper is a corollary of the recent Class Action against the MoD 2003 and should be read in conjunction with Palmer 2003. As fear is a prerequisite for the diagnosis of Post Traumatic Stress Disorder (PTSD) it was examined in some detail during this case. This paper serves to amplify those deliberations. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章,评审

    doi:10.1136/jramc-150-02-03

    authors: Palmer I

    更新日期:2004-06-01 00:00:00

  • The prevalence of causative organisms of community-acquired urethritis in an age group at high risk for sexually transmitted infections in Korean Soldiers.

    abstract:OBJECTIVES:This study was designed to evaluate the causative organisms in young male soldiers with clinical signs and symptoms after sexual contact that suggests a diagnosis of urethritis. METHODS:Between June 2012 and January 2015, male patients with urethritis symptoms that had resulted from sexual contact within 3 ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2015-000488

    authors: Kim HJ,Park JK,Park SC,Kim YG,Choi H,Ko JI,Kim MK,Jeong YB,Shin YS

    更新日期:2017-02-01 00:00:00

  • The general practice 'management of otitis externa'.

    abstract::Clinical confusion, treatment failure and recurrence commonly plague the Management of Otitis Externa. The aim of this study was to investigate the clinical attitudes and habits of army general practitioners and to review the recent literature. The results of a questionnaire survey showed that although all the respond...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章,评审

    doi:10.1136/jramc-138-01-07

    authors: Robertson DG,Bennett JD

    更新日期:1992-02-01 00:00:00

  • Sports injuries in British troops deployed on Operation Resolute (Bosnia)

    abstract::This study presents epidemiological data on sports injuries in deployed British troops in Bosnia, during the first five months of Operation Resolute. A retrospective analysis was carried out of sports injuries seen in one practice in the divisional rear area during April 1996. They account for a significant morbidity ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-143-01-07

    authors: Adams MS,Croft AM

    更新日期:1997-02-01 00:00:00

  • Selective non-operative management of ballistic abdominal solid organ injury in the deployed military setting.

    abstract::This article describes the non-operative management of five patients with ballistic abdominal solid organ injuries in a role 2E medical treatment facility. The selective non-operative management of ballistic abdominal solid organ injury is an accepted management strategy in high-volume civilian trauma centres, and app...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-156-01-04

    authors: Wood AM,Trimble K,Louden MA,Jansen J

    更新日期:2010-03-01 00:00:00

  • The effectiveness of a military pre-hospital fluid infusion strategy.

    abstract::We performed a study to assess the effectiveness of a fluid infusion strategy currently used in the military pre-hospital environment using the patient's own body weight as an infusion device. Thirteen healthy volunteers were cannulated and 0.9% sodium chloride infused over a period of ten minutes. The volumes infused...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-153-03-06

    authors: O'Meara M,Wood P,Thurgood A,Porter K

    更新日期:2007-09-01 00:00:00

  • Teaching medical students to recognise their strengths and limitations in leadership, teamwork and communication by military led tutorials.

    abstract:OBJECTIVES:The General Medical Council has stipulated that greater importance must be placed on undergraduate students developing their ability to lead and work effectively as part of a team. Wales Universities' Officer Training Corps have attempted to meet this requirement through a third year interactive tutorial whi...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2013-000052

    authors: Clark J,Hall TF,O'Mahony K

    更新日期:2013-12-01 00:00:00

  • Anaesthetic and other treatments of shell shock: World War I and beyond.

    abstract::Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general an...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 历史文章,杂志文章

    doi:10.1136/jramc-158-01-07

    authors: McKenzie AG

    更新日期:2012-03-01 00:00:00

  • "Bomb explosion on the Nis express" - lessons from a major incident, Kosovo 16 Feb 2001.

    abstract::On Friday 16 February 2001, terrorists detonated a bomb under a civilian coach travelling from Nis in Serbia to Gracanica in Kosovo. 10 people were killed at the scene. 13 casualties were treated in the British KFOR hospital (Reynolds Hospital) in Pristina. Another 8 casualties were evacuated to the American KFOR hosp...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-151-01-04

    authors: Vassallo DJ,Graham PJ,Gupta G,Alempijevic Dj

    更新日期:2005-03-01 00:00:00

  • Sandhurst: preparation for life as a GDMO.

    abstract::The ten-week Professionally Qualified Officers (PQO) course has been running successfully for a number of years and focuses on the values of officership, leadership and command. This article compares the principals embodied in the "Sandhurst Ethos" and the General Medical Council's "Duties of a Doctor" and examines ho...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-158-04-21

    authors: Moss AS

    更新日期:2012-12-01 00:00:00

  • Renal function after trauma.

    abstract:OBJECTIVE:The lack of need for immediate renal replacement treatment for military trauma victims suggests that the current policy of restricting operational deployment of those Service personnel with active inflammatory renal disease and significantly impaired renal function, combined with good prehospital care for all...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-2013-000042

    authors: World MJ

    更新日期:2013-06-01 00:00:00

  • Limb complications following pre-hospital tourniquet use.

    abstract::It has been stated that the application of a pre-hospital tourniquet could prevent 7% of combat deaths, however their widespread use has been questioned due to the potential risk from prolonged ischaemia. We reviewed members of the UK Armed Forces who sustained severe limb-threatening injuries in Iraq and Afghanistan,...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-155-03-06

    authors: Clasper JC,Brown KV,Hill P

    更新日期:2009-09-01 00:00:00

  • BATLS/BARTS training in Lithuania.

    abstract:OBJECTIVE:In order to train medical personnel properly for future international missions the Lithuanian Armed Forces decided to adopt BATLS/BARTS as a basic course for military pre-hospital trauma care. This decision was based upon the increasing Lithuanian participation in international missions as a part of multinati...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-152-04-04

    authors: Molde A,Milasius S,Lundberg L

    更新日期:2006-12-01 00:00:00

  • Nutrition of the critically ill patient in field hospitals on operations.

    abstract::Although much of the evidence is inconclusive, most of it is based on small patient groups it is generally supportive of early, enteral feeding of critically ill patients. It has become a standard of care in the UK and as such should be encouraged in deployed operational ITUs. ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:10.1136/jramc-154-04-17

    authors: Henning J,Scott T,Price S

    更新日期:2008-12-01 00:00:00

  • Hoffman II external fixator techniques--a work-around to use small pins in large clamps.

    abstract::We describe a novel technique to allow use of small pins in medium pin size clamps. Slipping a second 3 mm pin into the same clamp hole as the first allows the 5 mm clamp to bite securely on a 3 mm pin. This enables construction of an external fixator frame utilising 3 mm and 5 mm pins, as required to span the elbow, ...

    journal_title:Journal of the Royal Army Medical Corps

    pub_type: 杂志文章

    doi:

    authors: Rodger MP,Standley D,Kazel M

    更新日期:2010-09-01 00:00:00