An exertional heat illness triage tool for a jungle training environment

Smith, Mike; Withnall, R; Boulter, Matthew K

doi:10.1136/jramc-2017-000801

Cited by 4 publications

(3 citation statements)

References 8 publications

(5 reference statements)

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“…Although the burgeoning availability of biological sensing and surveillance technologies presents exciting opportunities to evaluate novel devices in military populations, this should not detract from ongoing efforts to develop, improve and validate practical ‘low-tech’ tools that might optimise performance and improve clinical outcomes 13. Nor should the value of clinical acumen in diagnosis and discerning, individualised management by experienced Medical personnel be diminished.…”

Section: Discussionmentioning

confidence: 99%

“…It may prove possible to close a number of declared capability gaps in diverse areas. This includes managing heat illness in the jungle and other prehospital environments,13 predicting post-traumatic stress disorder in advance of operational deployment14 and optimising rehabilitation following musculoskeletal injury 15. The breadth, depth and accuracy of physiological data capture may be further increased by moving beyond the body surface to use indwelling devices.…”

Section: Implications For Defencementioning

confidence: 99%

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Physiological monitoring for healthy military personnel

2017

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Military employment commonly exposes personnel to strenuous physical exertion. The resulting interaction between occupational stress and individual susceptibility to illness demands careful management. This could extend to prospective identification of high physiological strain in healthy personnel, in addition to recognition and protection of vulnerable individuals. The emergence and ubiquitous uptake of 'wearable' physiological and medical monitoring devices might help to address this challenge, but requires that the right questions are asked in sourcing, developing, validating and applying such technologies. Issues that must be addressed include system requirements, such as the likelihood of end users deploying and using technology as intended; interpretation of data in relation to pretest probability, including the potential for false-positive results; differentiation of pathological states from normal physiology; responsibility for and consequences of acting on abnormal or unexpected results and cost-effectiveness. Ultimately, the performance of a single monitoring system, in isolation or alongside other measures, should be judged by whether any improvement is offered versus existing capabilities and at what cost to mission effectiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For Defencementioning

confidence: 99%

Physiological monitoring for healthy military personnel

2017

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“…Indeed, reducing core temperature below 40°C rapidly after exercise drastically reduces the mortality risk(Casa, Armstrong et al 2012). However, in real-world military contexts, heat stress in often not alleviated and rectal temperature continues to rise even after the cessation of exercise, placing soldiers in danger, even if exercise is stopped(Giesbrecht, Jamieson et al 2007, Smith, Withnall et al 2017). In the humid environment a 40°C rectal temperature would have been seen only 20 min after the average termination time, highlighting the imminent danger of exercise in humid environments.…”

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confidence: 99%

Characterisation of Physiological Performance Measures in Arid and Humid Military Operational Environments

Ashworth¹,

Keaney

Cotter

et al. 2021

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BackgroundMilitary personnel often deploy into hot environments that impose substantial strain on physical and cognitive performance. Hot environments can present as arid or humid and occur in different terrains, requiring different operational approaches. The aim of this study was to characterise the physiological, cognitive and perceptual strain experienced by military personnel during typical operations in arid and humid environments. MethodsNine pack-fit military personnel participated in two heat-stress tests to exhaustion, one in an arid environment (44°C, 21% humidity) and the other in a humid environment (33°C, 78% humidity). Participants walked at 5 km.h-1 while physiological, cognitive and perceptual measures were recorded. Tests were terminated volitionally, or by excessive core temperature or heart rate. Results The operational environments induced similar physiological stress, resulting in no difference in time to exhaustion (p = .155). The humid environment saw a greater elevation in core temperature (+0.3°C, p < .001) and heart rate (+5 b.min-1, p < .001). Skin temperature was greater in the arid environment (+0.4, p < .001) as was sweat evaporation (+0.3 L.h1, p = .045). Baseline performance predictors only provided moderate predictions of performance, whereas changes in perceptual measures provided the best performance predictors during the exercise, specifically perceptions relating to thermal sensation (β = -.65 - -.80) and sleepiness (β = -.79 - -.87). While no differences in cognitive performance were observed, greater cognitive stress was reported by participants over time, regardless of environment (all p < .011). ConclusionsThe humid operational environment elicited a greater thermal strain that may threaten safety, and impair performance, to a greater degree than the arid environment. Perceptual measures of thermal sensation and sleepiness were the best predictors of test termination and could likely be used to monitor thermal tolerance in field settings.

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