{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:22:19Z","timestamp":1771658539290,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J R Army Med Corps"],"accepted":{"date-parts":[[2015,9,23]]},"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background and aim<\/jats:title>\n                  <jats:p>Safe clinical care within Ebola Virus Disease Treatment Units (EVDTUs) mandate the use of personal protective equipment (PPE), comprising a fluid impermeable hooded suit, visor, gloves and rubber boots. The aim of this study was to assess the impact of this PPE on clinical personnel's performance in the EVDTU, Kerry Town, Sierra Leone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An anonymous questionnaire was administered to healthcare professionals (HCPs) entering the EVDTU ward area (Red Zone (RZ)), during a 2-week period to assess perceived exertion using the Borg Rating of Perceived Exertion Scale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 62 clinical episodes undertaken by 20 HCPs were analysed. There were no episodes of heat illness during the study. HCPs spent a median of 74 (IQR 55\u201395) minutes within the RZ. Median durations of RZ activity were similar throughout the 24\u2005h period (p=0.22), but Borg scores were significantly higher between 11:00 and 14:59 compared with RZ entry between 15:00 and 10:59, respectively (12 (6\u201315), n=13; 8 (6\u20139), n=48; p=0.022). Rates of weight loss per minute spent within the RZ were significantly greater between 11:00 and 14:59 compared with 15:00\u201310:59, respectively (0.014 (0.009\u20130.023) kg\/min, n=6; 0.007 (0.004\u20130.013) kg\/min, n=37; p=0.037).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite acclimatisation and proactive clinical tasking, HCPs in the EVDTU experienced significantly greater rates of weight loss and perceived exertion scores during the hottest times of the day. These findings should be considered by those planning healthcare facilities for future humanitarian missions where HCPs will provide clinical care in full PPE.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jramc-2015-000541","type":"journal-article","created":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T22:20:53Z","timestamp":1446070853000},"page":"180-183","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Impact of personal protective equipment on clinical output and perceived exertion"],"prefix":"10.1136","volume":"162","author":[{"given":"Shelly Lyn","family":"Maynard","sequence":"first","affiliation":[{"name":"High Readiness Detachment Halifax, 1 Canadian Field Hospital, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Kao","sequence":"additional","affiliation":[{"name":"Royal Canadian Medical Services, 1 Canadian Field Hospital, London, Ontario, Canada"},{"name":"Division of Critical Care, Department of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DG","family":"Craig","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, James Cook University Hospital, Middlesbrough, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,28]]},"reference":[{"key":"2025081308125624000_162.3.180.1","unstructured":"http:\/\/apps.who.int\/ebola\/en\/current-situation\/ebola-situation-report (accessed 13 Sep 2015)."},{"key":"2025081308125624000_162.3.180.2","first-page":"1172","article-title":"Rapid assessment of Ebola infection prevention and control needs\u2014six districts, Sierra Leone, October 2014","volume":"63","author":"Pathmanathan","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025081308125624000_162.3.180.3","doi-asserted-by":"crossref","unstructured":"Clay KA , O'Shea MK , Fletcher T , et al . Use of an ultraviolet tracer in simulation training for the clinical management of Ebola virus disease. J Hosp Infect 2015 Aug 10. pii: S0195-6701(15)00298-4. doi: 10.1016\/j.jhin.2015.07.006. [Epub ahead of print]. doi:10.1016\/j.jhin.2015.07.006","DOI":"10.1016\/j.jhin.2015.07.006"},{"key":"2025081308125624000_162.3.180.4","unstructured":"Kitamura M . Inside an Ebola suit at 115 degrees, where skipping a step can mean death. 2014. http:\/\/www.bloomberg.com\/news\/2014-09-23\/inside-an-ebola-protective-suit-that-feels-115-degrees.html (accessed 30 Jun 2015)."},{"key":"2025081308125624000_162.3.180.5","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc"},{"key":"2025081308125624000_162.3.180.6","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv153"},{"key":"2025081308125624000_162.3.180.7","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/mev003"},{"key":"2025081308125624000_162.3.180.8","unstructured":"Joint Service Publication 539. Climatic illness and injury in the armed forces: force protection and initial medical treatment. Ministry of Defence, 2014."}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2015-000541","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T15:13:05Z","timestamp":1755097985000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2015-000541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,28]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,5,26]]},"published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1136\/jramc-2015-000541"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2015-000541","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,28]]}}}