scholarly journals Influence of Personal Protective Equipment on Wildland Firefighters’ Physiological Response and Performance during the Pack Test

Author(s):  
Belén Carballo-Leyenda ◽  
Jorge Gutiérrez-Arroyo ◽  
Fabio García-Heras ◽  
Pilar Sánchez-Collado ◽  
José G. Villa-Vicente ◽  
...  

The Pack Test (PT) is a widely used test to establish readiness for work in wildland firefighting. It is common to perform this test dressed in regular exercise clothing. However, wildland firefighters (WFF) have to wear personal protective equipment (PPE) during their deployments, which increases the physiological strain and reduces their work capacity. This study aimed to analyse the impact of full PPE on PT performance. Nine male professional WFF performed in random order a PT walking at the fastest possible self-pace wearing two different clothing configurations: (i) traditional short sports gear (SG) and (ii) the PPE currently used by Spanish WFF. Heart rate (HR), rating of perceived exertion and lap time were recorded during the PT. In addition, oxygen uptake (VO2) was estimated through the individual VO2–HR relationship previously obtained during a graded exercise test. There was a significant decrease in the PT performance (i.e., completion time) (~12%, p < 0.05) in PPE. The physiological demands with this configuration were significantly higher (~10%, p < 0.05). WFF spent ~13 min above the anaerobic threshold in PPE vs. ~4 min in SG. A multiple stepwise regression analysis revealed that PT performance variation might be explained by the maximal aerobic velocity (84.5%) in PPE and the VO2max (75.9%) in SG. In conclusion, wearing complete PPE increases WFF’s physiological strain, which translates into a significant PT performance reduction. Performing the test walking at the fastest possible self-pace wearing the PPE would better reflect the high-intensity effort periods reported in real scenarios.

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.


Work ◽  
2021 ◽  
pp. 1-14
Author(s):  
Mojtaba K. Danesh ◽  
Ehsan Garosi ◽  
Hamedeh Golmohamadpour

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.


2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None


2021 ◽  
Author(s):  
Felicity Hasson ◽  
Paul Slater ◽  
Anne Fee ◽  
Tracey McConnell ◽  
Sheila Payne ◽  
...  

Abstract BackgroundGlobally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.Methods A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19 and data were analysed thematically.ResultsEighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff. Conclusions Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ibrahim Ouergui ◽  
Emerson Franchini ◽  
Hamdi Messaoudi ◽  
Hamdi Chtourou ◽  
Anissa Bouassida ◽  
...  

This study investigated the effect of area sizes (4 × 4, 6 × 6, and 8 × 8 m) and effort-pause ratios (free combat vs. 1:2) variation on the physiological and perceptive responses during taekwondo combats (Study 1). In a second study, the effects on physical performance of 8 weeks of small combat-based training added to regular taekwondo training were investigated (Study 2). In random order, 32 male taekwondo athletes performed six (i.e., two effort-to-pause ratios × three area sizes conditions) different 2-min taekwondo combats (Study 1). Thereafter (Study 2), they were randomly assigned to three experimental groups (4 × 4, 6 × 6, and 8 × 8 m) and an active control group (CG). Regarding Study 1, blood lactate concentration [La] before and after each combat, mean heart rate (HRmean) during each combat, and rating of perceived exertion (CR-10) immediately after each combat were assessed. Regarding Study 2, progressive specific taekwondo (PSTT) to estimate maximum oxygen consumption (VO2max), taekwondo-specific agility, and countermovement jump (CMJ) tests were administered before and after 8 weeks of training. Study 1 results showed that 4 × 4 m elicited lower HRmean values compared with 6 × 6 m (d = −0.42 [small], p = 0.030) and free combat induced higher values compared with the 1:2 ratio (d = 1.71 [large], p &lt; 0.001). For [La]post, 4 × 4 m area size induced higher values than 6 × 6 m (d = 0.99 [moderate], p &lt; 0.001) and 8 × 8 m (d = 0.89 [moderate], p &lt; 0.001) and free combat induced higher values than 1:2 ratio (d = 0.69 [moderate], p &lt; 0.001). Higher CR-10 scores were registered after free combat compared with 1:2 ratio (d = 0.44 [small], p = 0.007). For Study 2, VO2max increased after training [F(1, 56) =30.532, p &lt; 0.001; post-hoc: d = 1.27 [large], p &lt; 0.001] with higher values for 4 × 4 m compared with CG (d = 1.15 [moderate], p = 0.009). Agility performance improved after training [F(1, 56) = 4.419, p = 0.04; post-hoc: d = −0.46 [small], p = 0.04] and 4 × 4 m induced lower values in comparison with 6 × 6 m (d = −1.56 [large], p = 0.001) and CG (d = −0.77 [moderate], p = 0.049). No training type influenced CMJ performance. Smaller area size elicited contrasting results in terms of metabolic demand compared with larger sizes (i.e., lower HRmean but higher [La] and CR-10), whereas free combat induced variables' consistently higher values compared with imposed 1:2 ratio (Study 1). Taekwondo training is effective to improve VO2max and agility (Study 2), but small combat training modality should be investigated further.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanie Ahmadi ◽  
Alireza Ebrahimi ◽  
Farhad Ghorbani

Abstract Background The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), besides the fact that dental procedures commonly generate blood and saliva droplets that could lead to the contagion have resulted in the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among the Iranian dental practitioners and finding their perspectives on the subject. Methods This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ perceptions and attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients. Results Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n = 170, 70%) did not perform non-emergency procedures during the pandemic. The dental practitioners have suggested several strategies to decrease the risk of contagion, such as reducing treatment sessions (n = 90, 37%), strict triage of patients (n = 156, 64%), and using personal protective equipment (n = 108, 45%). However, most of the dentists (n = 210, 87%) had problems, providing personal protective equipment during the pandemic. Moreover, 97% (n = 234) of the participants reported that they encountered a decrease in their financial income since the eruption of the pandemic. Conclusion Dental health care workers are at the highest risk of contracting COVID-19. Thus, dental practitioners ought to execute the standard protocols more cautiously during the pandemic. They could also lower their work hours and limit dental procedures to emergency treatments to reduce the risk of COVID-19 transmission. Besides, the public organizations should provide proper equipment for the dental practitioners to decrease the risk of contagion.


Author(s):  
José G. B. Derraik ◽  
William A. Anderson ◽  
Elizabeth A. Connelly ◽  
Yvonne C. Anderson

In the COVID-19 pandemic caused by SARS-CoV-2, hospitals are often stretched beyond capacity. There are widespread reports of dwindling supplies of personal protective equipment (PPE), particularly N95-type filtering facepiece respirators (FFRs), which are paramount to protect frontline medical/nursing staff, and to minimize further spread of the virus. We carried out a rapid review to summarize the existing literature on the viability of SARS-CoV-2, the efficacy of key potential disinfection procedures against the virus (specifically ultraviolet light and heat), and the impact of these procedures on FFR performance, material integrity, and/or fit. In light of the recent discovery of SARS-CoV-2 and limited associated research, our review also focused on the closely related SARS-CoV-1. We propose a possible whole-of-PPE disinfection solution for potential reuse that could be rapidly instituted in many health care settings, without significant investments in equipment.


2020 ◽  
pp. postgradmedj-2020-139150 ◽  
Author(s):  
Ramanathan Swaminathan ◽  
Bimantha Perera Mukundadura ◽  
Shashi Prasad

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.


2010 ◽  
Vol 45 (6) ◽  
pp. 560-569 ◽  
Author(s):  
Erik E. Swartz ◽  
Keith Belmore ◽  
Laura C. Decoster ◽  
Charles W. Armstrong

Abstract Context: Football helmet face-mask attachment design changes might affect the effectiveness of face-mask removal. Objective: To compare the efficiency of face-mask removal between newly designed and traditional football helmets. Design: Controlled laboratory study. Setting: Applied biomechanics laboratory. Participants: Twenty-five certified athletic trainers. Intervention(s): The independent variable was face-mask attachment system on 5 levels: (1) Revolution IQ with Quick Release (QR), (2) Revolution IQ with Quick Release hardware altered (QRAlt), (3) traditional (Trad), (4) traditional with hardware altered (TradAlt), and (5) ION 4D (ION). Participants removed face masks using a cordless screwdriver with a back-up cutting tool or only the cutting tool for the ION. Investigators altered face-mask hardware to unexpectedly challenge participants during removal for traditional and Revolution IQ helmets. Participants completed each condition twice in random order and were blinded to hardware alteration. Main Outcome Measure(s): Removal success, removal time, helmet motion, and rating of perceived exertion (RPE). Time and 3-dimensional helmet motion were recorded. If the face mask remained attached at 3 minutes, the trial was categorized as unsuccessful. Participants rated each trial for level of difficulty (RPE). We used repeated-measures analyses of variance (α  =  .05) with follow-up comparisons to test for differences. Results: Removal success was 100% (48 of 48) for QR, Trad, and ION; 97.9% (47 of 48) for TradAlt; and 72.9% (35 of 48) for QRAlt. Differences in time for face-mask removal were detected (F4,20  =  48.87, P  =  .001), with times ranging from 33.96 ± 14.14 seconds for QR to 99.22 ± 20.53 seconds for QRAlt. Differences were found in range of motion during face-mask removal (F4,20  =  16.25, P  =  .001), with range of motion from 10.10° ± 3.07° for QR to 16.91° ± 5.36° for TradAlt. Differences also were detected in RPE during face-mask removal (F4,20  =  43.20, P  =  .001), with participants reporting average perceived difficulty ranging from 1.44 ± 1.19 for QR to 3.68 ± 1.70 for TradAlt. Conclusions: The QR and Trad trials resulted in superior results. When trials required cutting loop straps, results deteriorated.


Sign in / Sign up

Export Citation Format

Share Document