Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia.
Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Front Public Health. 2021 Sep 1;9:712481. doi: 10.3389/fpubh.2021.712481. eCollection 2021.
Personal protective equipment (PPE) is an essential component of safely treating suspected or confirmed SARS-CoV-2 patients. PPE acts as a barrier to heat loss, therefore increasing the risk of thermal strain which may impact on cognitive function. Healthcare workers (HCWs) need to be able to prioritize and execute complex tasks effectively to ensure patient safety. This study evaluated pre-cooling and per-cooling methods on thermal strain, thermal comfort and cognitive function during simulated emergency management of an acutely unwell patient. This randomized controlled crossover trial was run at the Clinical Services Department of the Medical Research Unit The Gambia. Each participant attended two sessions (Cool and Control) in standard PPE. Cool involved pre-cooling with an ice slurry ingestion and per-cooling by wearing an ice-vest external to PPE. Twelve participants completed both sessions. There was a significant increase in tympanic temperature in Control sessions at both 1 and 2 h in PPE ( = 0.01). No significant increase was seen during Cool. Effect estimate of Cool was -0.2°C (95% CI -0.43; 0.01, = 0.06) post 1 h and -0.28°C (95% CI -0.57; 0.02, = 0.06) post 2 h on tympanic temperature. Cool improved thermal comfort ( < 0.001), thermal sensation ( < 0.001), and thirst ( = 0.04). No difference on cognitive function was demonstrated using multilevel modeling. Thermal strain in HCWs wearing PPE can be safely reduced using pre- and per-cooling methods external to PPE.
个人防护设备 (PPE) 是安全治疗疑似或确诊 SARS-CoV-2 患者的重要组成部分。PPE 起到防止热量散失的作用，因此会增加热应激的风险，从而可能影响认知功能。医护人员需要能够有效地优先处理和执行复杂任务，以确保患者安全。本研究评估了在模拟急性不适患者紧急管理期间，预冷和持续冷却对热应激、热舒适度和认知功能的影响。 该随机对照交叉试验在冈比亚医学研究单位临床服务部进行。每位参与者在标准 PPE 下参加两次会议（Cool 和 Control）。Cool 涉及通过摄入冰浆进行预冷和在 PPE 外部穿冰背心进行持续冷却。 12 名参与者完成了这两个会议。在 PPE 中，Control 会议在 1 小时和 2 小时时鼓膜温度均显著升高（= 0.01）。Cool 期间未见明显升高。Cool 的效应估计值在 1 小时后为 -0.2°C（95%CI -0.43；0.01，= 0.06），在 2 小时后为 -0.28°C（95%CI -0.57；0.02，= 0.06）。Cool 改善了热舒适度（<0.001）、热感觉（<0.001）和口渴感（= 0.04）。使用多层次建模未显示认知功能有差异。 使用 PPE 外部的预冷和持续冷却方法可以安全地降低穿戴 PPE 的医护人员的热应激。
