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热暴露和冰浆摄入对医护人员冒险行为的影响。

Effects of Heat Exposure and Ice Slurry Ingestion on Risk-Taking Behavior in Healthcare Workers.

机构信息

Department of Emergency Medicine, Singapore General Hospital, SINGAPORE.

出版信息

Med Sci Sports Exerc. 2024 Oct 1;56(10):2016-2025. doi: 10.1249/MSS.0000000000003486. Epub 2024 May 15.

Abstract

PURPOSE

Healthcare workers (HCWs) wearing personal protective equipment (PPE) experience physiological strain that can impair motor and psychological functions, potentially affecting patient care. We assessed the effects of heat exposure on maximal strength and risk-taking behavior among PPE-wearing HCWs and the efficacy of ice slurry to alleviate adverse effects.

METHODS

Seventeen HCWS completed two experimental trials in a crossover design, consuming 5 g·kg -1 of body mass of ambient drink (AMB) or ice slurry (ICE) before donning PPE and undergoing 2 h of simulated decontamination exercise (wet-bulb globe temperature (WBGT): 25.9°C ± 0.8°C, PPE microenvironment WBGT: 29.1°C ± 2.1°C). Body core temperature ( Tc ), heart rate (HR), chest skin temperature ( Tsk ), ratings of perceived exertion (RPE), thermal sensation (RTS), maximal voluntary contraction (MVC), risk-taking behavior (balloon analogue risk-taking task (BART)), and salivary cortisol were assessed.

RESULTS

Predrinking to postdrinking ∆ Tc was greater in ICE (-0.2°C ± 0.1°C) than AMB (-0.0°C ± 0.1°C, P = 0.003). Post-drinking RTS was lower in ICE (2.7 ± 1.2) than AMB (4.1 ± 0.4, P < 0.001). ICE and AMB had similar Tc and HR (both P > 0.05), but Tsk was lower in ICE than AMB ( P = 0.049). A lower MVC (30.3 ± 6.7 vs 27.4 ± 4.9 kg, P = 0.001) and higher BART-adjusted total pump count (472 ± 170 vs 615 ± 174 pumps, P = 0.017) was observed pretrial to posttrial in AMB but absent in ICE (both P > 0.05). Salivary cortisol was similar between trials ( P = 0.42).

CONCLUSIONS

Heat-exposed PPE-wearing HCWs had impaired maximal strength and elevated risk-taking behavior. This may increase the risk of avoidable workplace accidents that can jeopardize HCWs and patient care. Ice slurry ingestion alleviated these heat-related impairments, suggesting its potential as an ergogenic aid.

摘要

目的

穿着个人防护装备(PPE)的医护人员会经历生理压力,这可能会损害他们的运动和心理功能,从而影响患者护理。我们评估了热暴露对穿戴 PPE 的医护人员最大力量和冒险行为的影响,以及冰浆缓解不良影响的效果。

方法

17 名医护人员以交叉设计完成了两项实验性试验,在穿戴 PPE 之前分别摄入 5 g·kg -1 的体质量环境饮料(AMB)或冰浆(ICE),并进行 2 小时的模拟去污练习(湿球黑球温度(WBGT):25.9°C ± 0.8°C,PPE 微环境 WBGT:29.1°C ± 2.1°C)。评估核心体温(Tc)、心率(HR)、胸部皮肤温度(Tsk)、感知用力程度(RPE)、热感觉(RTS)、最大自主收缩(MVC)、冒险行为(气球模拟风险任务(BART))和唾液皮质醇。

结果

与 AMB(-0.0°C ± 0.1°C)相比,ICE 中的预饮后体温差(-0.2°C ± 0.1°C)更大(P = 0.003)。ICE 的 RTS (2.7 ± 1.2)低于 AMB(4.1 ± 0.4,P < 0.001)。ICE 和 AMB 的 Tc 和 HR 相似(均 P > 0.05),但 Tsk 低于 ICE(P = 0.049)。与 AMB 相比,MVC 较低(30.3 ± 6.7 与 27.4 ± 4.9 kg,P = 0.001),BART 调整后的总泵计数较高(472 ± 170 与 615 ± 174 泵,P = 0.017)。在 AMB 中观察到预试验到试验后,但 ICE 中未见(均 P > 0.05)。试验之间的唾液皮质醇相似(P = 0.42)。

结论

暴露于热环境中的穿戴 PPE 的医护人员的最大力量受损,冒险行为增加。这可能会增加可避免的工作场所事故风险,从而危及医护人员和患者护理。冰浆摄入缓解了这些与热相关的损伤,表明其作为一种运动补剂的潜力。

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