Abstract
ObjectivesHot environmental conditions can result in a high core-temperature and dehydration which can impair physical and cognitive performance. This study aimed to assess the effects of a hot operating theatre on various performance, physiological and psychological parameters in staff during a simulated burn surgery.MethodsDue to varying activity levels, surgery staff were allocated to either an Active (n = 9) or Less-Active (n = 8) subgroup, with both subgroups performing two simulated burn surgery trials (CONTROL: ambient conditions; 23±0.2°C, 35.8±1.2% RH and HOT: 34±0°C, 28.3±1.9% RH; 150 min duration for each trial), using a crossover design with four weeks between trials. Manual dexterity, core-temperature, heart-rate, sweat-loss, thermal sensation and alertness were assessed at various time points during surgery.ResultsPre-trials, 13/17 participants were mildly-significantly dehydrated (HOT) while 12/17 participants were mildly-significantly dehydrated (CONTROL). There were no significant differences in manual dexterity scores between trials, however there was a tendency for scores to be lower/impaired during HOT (both subgroups) compared to CONTROL, at various time-points (Cohen’s d = -0.74 to -0.50). Furthermore, alertness scores tended to be higher/better in HOT (Active subgroup only) for most time-points (p = 0.06) compared to CONTROL, while core-temperature and heart-rate were higher in HOT either overall (Active; p<0.05) or at numerous time points (Less-Active; p<0.05). Finally, sweat-loss and thermal sensation were greater/higher in HOT for both subgroups (p<0.05).ConclusionsA hot operating theatre resulted in significantly higher core-temperature, heart-rate, thermal sensation and sweat-loss in staff. There was also a tendency for slight impairment in manual dexterity, while alertness improved. A longer, real-life surgery is likely to further increase physiological variables assessed here and in turn affect optimal performance/outcomes.
Highlights
Over 1.1 million people worldwide each year are affected by burns, with 70% of hospitalisations requiring surgery [1]
There were no significant differences in manual dexterity scores between trials, there was a tendency for scores to be lower/impaired during HOT compared to CONTROL, at various time-points (Cohen’s d = -0.74 to -0.50)
Alertness scores tended to be higher/ better in HOT (Active subgroup only) for most time-points (p = 0.06) compared to CONTROL, while core-temperature and heart-rate were higher in HOT either overall (Active; p
Summary
Over 1.1 million people worldwide each year are affected by burns, with 70% of hospitalisations requiring surgery [1]. Dehydration of 2% of body-mass has been reported to impair: exercise performance [15]; concentration; routine mental work capacity; arithmetic ability; and short-term memory [16,17]; compared to a hydrated state These are important considerations for surgical staff regularly faced with complex scenarios when working in an OR. Clothing worn by staff during burn surgeries typically consists of multiple layers, with minimal skin exposed This combined with minimal air flow, due to fans not being used in a burns OR due to their association with a greater risk of surgical site infection [18], can result in an increase in Tc and greater sweat loss [19]
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