背景:最少的准备时间是应对突发性灾难的一个特征。虽然设备和用品准备在短时间内部署,对医疗反应者的身体准备知之甚少。由于许多灾害易发地区被列为热带地区,在部署过程中,响应者有可能忍受高环境温度和相对湿度的组合。热适应,定义为对核心体温(Tc)频繁升高的生理和感知适应,是提高医疗反应者对高温条件的耐受性的关键策略。
方法:根据体能训练的持续时间和主观的劳累率(会话RPE)制定了部署前热适应指南。个人训练的目的是将体温感知为温暖至炎热。该准则已针对部署到塔克洛班的澳大利亚医疗援助小组(AusMAT)的Bravo小组(第二轮)实施,菲律宾在2013年11月台风“海燕”之后。准则在部署前五至七天以电子方式分发,随后进行协商。出发前在炎热的条件下进行了集体训练。
结果:使用指南的AusMAT响应者基于寒冷或温和的气候,需要额外的衣服层,在温暖的日子里训练,或温暖的室内条件,以实现会议目标。响应者报告说,这些指南易于使用,适用于他们不同的训练方案,尽管没有完成整个14天的工作,但他们提高了在高温下工作的信心。
结论:部署前热适应指南为AusMAT响应者提供了量化其体育锻炼的能力,并促进了生理适应以最大限度地提高健康水平,安全,和部署期间的性能。虽然保持全年的热量适应环境被认为对医疗反应者至关重要,一旦通知部署,这些指南可能会促进有益的适应。
BACKGROUND: Minimal preparation time is a feature of responding to sudden onset disasters. While equipment and supplies are prepared for deployment at short notice, less is known of the physical preparation of medical responders. With many
disaster-prone areas classified as tropical regions, there is potential for responders to endure a combination of high ambient temperatures and relative humidity during deployment. Heat acclimatization, defined as the physiological and perceptual adaptations to frequent elevations of core body temperature (Tc), is a key strategy to improve tolerance of hot conditions by medical responders.
METHODS: Pre-deployment heat acclimatization
guidelines were developed based upon the duration of physical training and the subjective rate of perceived exertion (session RPE). An objective of individual training sessions was the perception of body temperature as warm to hot. The
guidelines were implemented for Team Bravo (2nd rotation) of the Australian Medical Assistance Team (AusMAT) deployed to Tacloban, Philippines following Typhoon Haiyan in November 2013. The guidelines were distributed electronically five to seven days prior to deployment and were followed by a consultation. A group training session in hot conditions was undertaken prior to departure.
RESULTS: The AusMAT responders to utilize the guidelines were based in cool or temperate climates that required extra layers of clothing, training during warmer parts of the days, or warm indoor conditions to achieve session objectives. Responders reported the
guidelines were simple to use, applicable to their varied training regimens, and had improved their confidence to work in the heat despite not completing the entire 14 day period.
CONCLUSIONS: The pre-deployment heat acclimatization
guidelines provided AusMAT responders the ability to quantify their physical training and promoted physiological adaptations to maximize health, safety, and performance during deployment. While maintaining year-round heat acclimatization is considered essential for medical responders, these guidelines may facilitate beneficial adaptations once notified of deployment.