Mission Oriented Protective Posture Research Articles

A Neuro-Fuzzy Approach to MOPP Open Time Prediction for Chemical Threats in Low-Intensity Conflicts

Chemical, Biological, Radiological and Nuclear (CBRN) weapon systems hold the potential to cause great damage to a fighting unit. Chemical warfare agents are cheaper and easier to produce and deploy. Mission oriented protective posture (MOPP) equipment is used to isolate soldiers from the toxic environment . Sustained wearing of MOPP overgarments can put soldiers at the risk of dehydration and heat stress. A hierarchal adaptive neuro-fuzzy inference system (HANFIS) model is proposed to predict worst case MOPP open times for surfaces covered with chemical agent resistant coating (CARC) and sand. The model can provide decision support for commanders when determining MOPP open or unmasking time. From HANFIS simulation results it was concluded that the model can accurately predict MOPP open times according to data present in military field manuals, in a manner which is computationally efficient. and easy to interpret based on linguistic rules and most importantly, easy to customize.

Effects of MOPP Gear on SAM Medical Junctional Tourniquet Application: A Prospective, Randomized Control Trial.

Hemorrhage is the leading cause of preventable death on the battlefield, and hemostasis is particularly challenging to achieve at junctional sites such as the axillary or inguinal regions. Mission-oriented protective posture (MOPP) gear, as worn most recently in Syria to guard against chemical weapons, can make the performance of technical skills more challenging still. The objective of this study was to evaluate how wearing MOPP gear affects the application time of the SAM Medical Junctional Tourniquet (SJT) by U.S. Army combat medics. We conducted a prospective, randomized control trial evaluating time for SJT application between participants wearing MOPP versus those not wearing MOPP. Secondary outcomes included SJT application success rate and participant appraisal of SJT application difficulty assessed with five-point Likert items, between groups. Participants placed SJTs on robotic simulation mannequins with a penetrating inguinal injury. In April 2019, we enrolled 49 combat medics. Most participants were male (77.5%), had a median age of 25 (interquartile range 23-28), and in the grade of E4 or less (63.3%). Mean SJT application times in seconds were higher among those wearing MOPP versus those who were not (223.1 versus 167.2; 95% confidence interval for difference in means 5.293, 106.374; P=0.03). Participants wearing MOPP had a less successful application rate overall, but this difference was not statistically significant (64.3% versus 81.0%, P=0.34). Compared to participants not wearing MOPP, those wearing MOPP agreed that SJT application was difficult (4 versus 3, P=0.03), what they were wearing affected SJT application (4 versus 2, P=0.01), and it was difficult to use their hands during SJT application (4 versus 1, P<0.001). Wearing military MOPP gear significantly prolongs the amount of time required for combat medics to apply an SJT on a simulated casualty with a penetrating inguinal injury. This study highlights the importance of incorporating MOPP gear into medical training scenarios to improve skills competency while wearing these protective garments.

Development of Rope Connected Life-Saving Equipment for Transferring Numerous People

BackgroundThis study is focused on a rapid and safe transfer when there are many people who need rescuing in unapproachable location. Generally, a stretcher, a basket or a mesh drawing is used to transfer injured people or survivors in the emergency rescue, however, it turned out that it takes long time to transfer a number of people with a stretcher and it is difficult to transfer injured people safely with a basket or a mesh drawing. It would expect to transfer many people who need rescuing promptly and harmlessly. MethodsIn this article, Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks while wearing chemical protective equipment. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. ResultsAs a result, authors have developed a new life-saving equipment. Numerous people who need rescuing can be quickly and safely rescued and transferred to the hospital with it. From a medical point of view, it reduces the risk of secondary damage from transport and helps avoid missing the golden time for first aid caused by delay in transferring emergency patients as numerous people can be transferred safely and quickly. ConclusionThe article is due to introduce the equipment which can transfer people who need rescuing promptly and effectively in a situation such as when numerous people need rescuing in the mountain. In a rescue situation such as mountain rescue, rope connected life-saving equipment is dropped to the rescue site with a rope from a rescue helicopter and laying down the injured on the life-saving equipment body and equip life-saving equipment to the rope consecutively. In this way, it is expected to transfer the injured rapidly and safely.

Assessment of Deployment-Related Exposures on Risk of Incident Mental Health Diagnoses Among Air Force Critical Care Providers: Nested Case-Control Study.

The purpose of this study was to determine the association between deployment-related occupational/environmental exposures and incident postdeployment mental health (PDMH) conditions in a defined population of military health care professionals working in the deployed critical care environment. A nested case-control study compared cohort members with a PDMH condition (cases, N = 146) with those without a PDMH condition (controls, N = 800) in terms of deployment-related exposures as ascertained using Postdeployment Health Assessment DD 2796 questionnaire data. Multivariable logistic regression models were used to compute odds ratios. Nonphysician career fields (i.e., nurses and medical technicians), exposure to dead bodies or people killed/wounded, history of a vehicular accident/crash, exposure to sand/dust, exposure to lasers, and use of mission-oriented protective posture (MOPP) overgarments were associated with increased likelihood for a PDMH condition. The infrequent exposures (i.e., vehicular accident/crash, lasers, and MOPP overgarments) were the exposures most strongly associated with subsequent PDHM conditions. For military health care providers returning from the deployed environment, several exposures are useful for predicting those at increased risk for a PDMH condition. However, there are likely many other important risk factors beyond those captured on the DD 2796 questionnaire.

The effects of functional limitations on soldier common tasks.

This paper describes the findings associated with the ability of an individual to perform the United States Army's Common Soldier Tasks of: "Maintaining an M16-Series Rifle" , "Protect Yourself from Chemical, Biological, Radiological, and Nuclear (CBRN) Injury or Contamination with Mission-Oriented Protective Posture (MOPP) Gear", and "Protect Yourself from Chemical and Biological (CB) Contamination Using Your Assigned Protective Mask." The analysis was conducted using data compiled from videos of a Soldier performing the given tasks at Walter Reed Army Medical Center. The findings reflect the opinions of researchers in identifying potential elements, which impose abnormal, irregular, and/or extraneous effort when performing the tasks as outlined in STP-21-1-SMCT - Soldier's Manual of Common Tasks: Skill Level I.

Effects of chemical protective equipment on team process performance in small unit rescue operations

In the event of a nuclear, biological, or chemical terrorist attack against civilians, both military and civilian emergency response teams must be able to respond and operate efficiently while wearing protective equipment. Chemical protective equipment protects the user by providing a barrier between the individual and hazardous environment. Unfortunately, the same equipment that is designed to support the user can potentially cause heat stress, reduced task efficiency, and reduced range-of-motion. Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. This article discusses the implications of these results with respect to the study design and the limitations of using an event-based team performance measurement methodology.

Intermittent microclimate cooling during exercise-heat stress in US army chemical protective clothing

The effectiveness of intermittent, microclimate cooling for men who worked in US Army chemical protective clothing (modified mission-oriented protective posture level 3; MOPP 3) was examined. The hypothesis was that intermittent cooling on a 2 min on–off schedule using a liquid cooling garment (LCG) covering 72% of the body surface area would reduce heat strain comparably to constant cooling. Four male subjects completed three experiments at 30°C, 30% relative humidity wearing the LCG under the MOPP 3 during 80 min of treadmill walking at 224 ± 5 W · m−2. Water temperature to the LCG was held constant at 21°C. The experiments were; 1) constant cooling (CC); 2) intermittent cooling at 2-min intervals (IC); 3) no cooling (NC). Core temperature increased (1.6 ± 0.2°C) in NC, which was greater than IC (0.5 ± 0.2°C) and CC (0.5 ± 0.3°C) ( p < 0.05). Mean skin temperature was higher during NC (36.1 ± 0.4°C) than IC (33.7 ± 0.6°C) and CC (32.6 ± 0.6°C) and mean skin temperature was higher during IC than CC ( p < 0.05). Mean heart rate during NC (139 ± 9 b · min−1) was greater than IC (110 ± 10 b · min−1) and CC (107 ± 9 b · min−1) ( p < 0.05). Cooling by conduction (K) during NC (94 ± 4 W · m−2) was lower than IC (142 ± 7 W · m−2) and CC (146 ± 4 W · m−2) ( p < 0.05). These findings suggest that IC provided a favourable skin to LCG gradient for heat dissipation by conduction and reduced heat strain comparable to CC during exercise-heat stress in chemical protective clothing.

Just-in-Time and Continuous Physical Protection for Military Personnel in a Chemical or Biological Environment

This paper presents a capability development framework to define the operational requirements for CB protective clothing. The ultimate goal is to make CB physical protection as transparent as possible to the wearer. Protection is currently provided gradually through MOPP levels (Mission Oriented Protective Posture). Threat/Hazard assessments, actual CB attacks/incidents and location of troops in the battle space dictate the adoption of each level. The intent is to provide Just-In-Time (JIT) protection so as not to create negative effects on the wearer and the fighting force. Synchronized JIT can work if timely and accurate information is available. The donning time of the Individual Protective Equipment (JPE) components also has to be considered, particularly when within range of conventional and asymmetric delivery means. For example, during the Iraq war some of the coalition forces warfighters adopted MOPP 1 (Clothing) for 21 consecutive days. Essentially, their clothing component of IPE became their daily wear uniform. The operational context defines the need for continuous wear of the CB protective clothing, and therefore, the concept of continuous and JIT physical protection.

Evaluation of a Virtual Reality Simulator in Sustainment Training

Is there a better way to train and prepare our health care personnel to function in a chemical biological environment while continuing to provide for patient care in a variety of healthcare settings? The purpose of this pilot work was to compare the effectiveness and user satisfaction of the Cath-Sim Intravenous Training System to the traditional IV arm model for teaching and achieving competence at IV insertion while in Mission-Oriented Protective Posture level 4 for Army medical personnel. Grounded in adult psychomotor learning principles and in an established evaluation model, participants were tested on both the traditional IV arm and Cath-Sim models and then allowed to practice on each model while at Mission-Oriented Protective Posture level 4. One week later, participants were again tested on both models. Outcome measures included (1) a computer-generated score sheet measuring time to success and criterion success/nonsuccess on the Cath-Sim; (2) time and success rating for IV insertion on the IV arm model; and (3) satisfaction evaluations completed by the participants. There were conflicting evaluation scores for recommending one model over the other. Participants felt that there was some benefit to each model depending on user, setting, and purpose.

Physiological Effects of Thermal Stress on Aviators Flying a UH-60 Helicopter Simulator

An evaluation of the physiological effects on aviators of heat stress (90 degrees F wet bulb globe temperature [WBGT]) versus a cooler condition (70 degrees F WBGT) when wearing either a MOPP0 (Mission-Oriented Protective Posture 0) uniform or a MOPP4 ensemble encumbered with a ballistic chest plate and overwater survival gear was performed at the United States Army Aeromedical Research Laboratory. The study used a repeated-measures design with 14 aviators flying 4-hour missions in a UH-60 helicopter simulator. Average crew endurance in the MOPP4-hot condition was reduced to one-third of the fully completed mission time of 309 minutes. For the hot condition, core temperature in the simulator rose 1.4 degrees F/hour when aviators wore the encumbered MOPP4 ensemble versus 0.27 degree F/hour when they wore the MOPP0 uniform. Sweating rate in the MOPP4-hot condition was 1,523 ml/hour, resulting in 2.5% dehydration, in contrast to 183 ml/hour and 0.9% dehydration in the MOPP4-cool condition. In this study, pilots flying realistic UH-60 simulator sorties rapidly incurred significant physiological heat strain when wearing an encumbered MOPP4 flight ensemble in hot cockpit conditions.

Effects of Chemical Protective Clothing, Exercise, and Diphenhydramine on Cognitive Performance During Sleep Deprivation

The cognitive performance effects of some stressors experienced in military training and combat were determined in a field experiment. The effects of wearing chemical protective clothing (CPC) at Mission-Oriented Protective Posture Level IV, walking 18 to 24 miles (29–39 km) while carrying a heavy backpack, and taking 50-mg oral doses every 6 hr of diphenhydramine (an antihistamine) were investigated on 72 Marines during a 36-hr sleep deprivation double-blind, placebo-controlled experiment. We administered tests that measured reaction time, spatial ability, memory, and logical reasoning. The results suggest that wearing CPC for an 11-hr period or prolonged engagement in moderate exercise produces general cognitive impairment in sleep-deprived participants. However, after repeated dosing, taking diphenhydramine has little cognitive effect. These results suggest that, if a job is near the limit of a person's cognitive abilities, performance may suffer if the person is sleep deprived and required to wear CPC or engage in prolonged, moderate exercise.

Chemical and Biological Weapons

To the Editor. —War in the Middle East has increased fears that chemical or biological weapons (CBW) might be used in battle. Iraq's "supposed use" (Marwick's term 1 ) of mustard gas and tabun, a nerve gas, has been well documented by medical teams from the United Nations 2 and portrayed vividly in a recent Public Broadcasting Service documentary ("NOVA," The Poison Winds of War , 1990). The CBW battlefield is not as safe as we were led to believe by Marwick. 1 Unfortunately, misconceptions concerning the hazards of CBW agents and the ability to defend against them could affect decisions concerning their use. Although there are defensive measures that can protect combatants on a CBW battlefield, they are associated with significant risks and are likely to affect decision making and impair performance. 3,4 The use of mission-oriented protective posture gear, designed to isolate the wearer from the environment, induces severe psychological

Carbohydrate-Electrolyte Solutions during Field Training: An Overview

The rationale and methods of evaluating two carbohydrate-electrolyte solutions at a field training exercise in hot weather are presented in this overview. The carbohydrate-electrolyte solutions were formulated to produce a multipurpose replacement beverage which could satisfy diverse requirements of troops working in hot climates. Several uses of these beverages include replacement of electrolytes and fluid while in Mission Oriented Protective Posture IV, fluid replacement for mild heat casualties, and oral rehydration therapy for treatment of diarrheal losses.