CPC Medical Considerations Chapter # 13 CPC Medical Considerations Introduction Stress Programs....

CPC Medical CPC Medical ConsiderationsConsiderationsCPC Medical CPC Medical

ConsiderationsConsiderations

Chapter # 13Chapter # 13

CPC Medical CPC Medical ConsiderationsConsiderations

IntroductionIntroduction


IntroductionIntroduction Stress Programs.Stress Programs. Stresses of Encapsulating Garments.Stresses of Encapsulating Garments. Incident Stressors.Incident Stressors. Physiological Factors.Physiological Factors. Work Tolerance.Work Tolerance. Effects of Cold Exposure.Effects of Cold Exposure. Work Mission Duration.Work Mission Duration. Rest Periods.Rest Periods. Field Monitoring.Field Monitoring.

Stress Programs.Stress Programs. Stresses of Encapsulating Garments.Stresses of Encapsulating Garments. Incident Stressors.Incident Stressors. Physiological Factors.Physiological Factors. Work Tolerance.Work Tolerance. Effects of Cold Exposure.Effects of Cold Exposure. Work Mission Duration.Work Mission Duration. Rest Periods.Rest Periods. Field Monitoring.Field Monitoring.


ConsiderationsConsiderations Basic Facts:Basic Facts:

• CPC impacts physiological & psychological stresses to its CPC impacts physiological & psychological stresses to its wearers. Their medical conditions and influential factors wearers. Their medical conditions and influential factors deserve consideration, if a successful hazmat response is deserve consideration, if a successful hazmat response is desired.desired.

Basic Facts:Basic Facts:

• CPC impacts physiological & psychological stresses to its CPC impacts physiological & psychological stresses to its wearers. Their medical conditions and influential factors wearers. Their medical conditions and influential factors deserve consideration, if a successful hazmat response is deserve consideration, if a successful hazmat response is desired.desired.


ConsiderationsConsiderations Basic Facts,Basic Facts, Continued Continued::

• Stress reduction programsStress reduction programsshould have 3 components:should have 3 components:

» pre-incident, on-site,pre-incident, on-site,& post-incident.& post-incident.

• Managers tend toManagers tend tounderestimate the risks ofunderestimate the risks ofstresses adversely affecting CPC wearers stresses adversely affecting CPC wearers because the environment and chemical because the environment and chemical incidents frequently occupy the focus.incidents frequently occupy the focus.

Basic Facts,Basic Facts, Continued Continued::

• Stress reduction programsStress reduction programsshould have 3 components:should have 3 components:

» pre-incident, on-site,pre-incident, on-site,& post-incident.& post-incident.

• Managers tend toManagers tend tounderestimate the risks ofunderestimate the risks ofstresses adversely affecting CPC wearers stresses adversely affecting CPC wearers because the environment and chemical because the environment and chemical incidents frequently occupy the focus.incidents frequently occupy the focus.



Stress Programs:Stress Programs:

• Workers must be periodically examined.Workers must be periodically examined.• Continual practice and training must be Continual practice and training must be

provided in using PPE, especially SCBA and provided in using PPE, especially SCBA and CPC.CPC.

• An effective safety program must be An effective safety program must be implemented, and concerted efforts made, to implemented, and concerted efforts made, to protect the worker.protect the worker.

Stress Programs:Stress Programs:

• Workers must be periodically examined.Workers must be periodically examined.• Continual practice and training must be Continual practice and training must be

provided in using PPE, especially SCBA and provided in using PPE, especially SCBA and CPC.CPC.

• An effective safety program must be An effective safety program must be implemented, and concerted efforts made, to implemented, and concerted efforts made, to protect the worker.protect the worker.

CPC Medical CPC Medical ConsiderationsConsiderationsCPC Medical CPC Medical ConsiderationsConsiderations

Stresses of Encapsulating Garments:Stresses of Encapsulating Garments:

• Do not underestimate risks involved when Do not underestimate risks involved when personnel are working in CPC.personnel are working in CPC.

• Do not loose focus on the workers!Do not loose focus on the workers!• Technological advances.Technological advances.• Must be able to recognize situations which CPC Must be able to recognize situations which CPC

may be breached.may be breached.

Stresses of Encapsulating Garments:Stresses of Encapsulating Garments:

• Do not underestimate risks involved when Do not underestimate risks involved when personnel are working in CPC.personnel are working in CPC.

• Do not loose focus on the workers!Do not loose focus on the workers!• Technological advances.Technological advances.• Must be able to recognize situations which CPC Must be able to recognize situations which CPC

may be breached.may be breached.



Incident Stressors:Incident Stressors:

• CPC wearers are usually subject to 4 stressors:CPC wearers are usually subject to 4 stressors:

» Environmental.Environmental.» Mechanical.Mechanical.» Physiologic.Physiologic.» Psychological.Psychological.

Incident Stressors:Incident Stressors:

• CPC wearers are usually subject to 4 stressors:CPC wearers are usually subject to 4 stressors:

» Environmental.Environmental.» Mechanical.Mechanical.» Physiologic.Physiologic.» Psychological.Psychological.



Environmental Stressors:Environmental Stressors:

• Temperature.Temperature.• Humidity.Humidity.• Wind speed.Wind speed.• Terrain.Terrain.• Confined spaces.Confined spaces.

Environmental Stressors:Environmental Stressors:

• Temperature.Temperature.• Humidity.Humidity.• Wind speed.Wind speed.• Terrain.Terrain.• Confined spaces.Confined spaces.


Mechanical Stressors:Mechanical Stressors:

• Attributed to disadvantages of Attributed to disadvantages of protective equipment (e.g., objects protective equipment (e.g., objects that damage CPC leading to less that damage CPC leading to less protection, inherent limitations in protection, inherent limitations in mobility, dexterity, and visibility).mobility, dexterity, and visibility).

Mechanical Stressors:Mechanical Stressors:

• Attributed to disadvantages of Attributed to disadvantages of protective equipment (e.g., objects protective equipment (e.g., objects that damage CPC leading to less that damage CPC leading to less protection, inherent limitations in protection, inherent limitations in mobility, dexterity, and visibility).mobility, dexterity, and visibility).


Physiologic Stressors:Physiologic Stressors:

• Fitness.Fitness.• Acclimatization to weather.Acclimatization to weather.• Familiarity w/equipment.Familiarity w/equipment.• Age.Age.• Obesity.Obesity.• Pre-existing medical conditions.Pre-existing medical conditions.

Physiologic Stressors:Physiologic Stressors:

• Fitness.Fitness.• Acclimatization to weather.Acclimatization to weather.• Familiarity w/equipment.Familiarity w/equipment.• Age.Age.• Obesity.Obesity.• Pre-existing medical conditions.Pre-existing medical conditions.


Psychological Stressors:Psychological Stressors:

• Anxiety.Anxiety.• Claustrophobia.Claustrophobia.• Such effects often require Such effects often require

continued care.continued care.

Psychological Stressors:Psychological Stressors:

• Anxiety.Anxiety.• Claustrophobia.Claustrophobia.• Such effects often require Such effects often require

continued care.continued care.



Work Tolerance:Work Tolerance:

• The amount of work or duration an The amount of work or duration an individual can withstand under a set individual can withstand under a set of environmental conditions. As of environmental conditions. As environmental conditions worsen environmental conditions worsen (e.g., (e.g., temperature, temperature, humidity), humidity), work tolerance decreases & CPC work tolerance decreases & CPC wearers work for less time.wearers work for less time. Level A Level A CPC can reduce work tolerance by CPC can reduce work tolerance by 50%.50%.

Work Tolerance:Work Tolerance:

• The amount of work or duration an The amount of work or duration an individual can withstand under a set individual can withstand under a set of environmental conditions. As of environmental conditions. As environmental conditions worsen environmental conditions worsen (e.g., (e.g., temperature, temperature, humidity), humidity), work tolerance decreases & CPC work tolerance decreases & CPC wearers work for less time.wearers work for less time. Level A Level A CPC can reduce work tolerance by CPC can reduce work tolerance by 50%.50%.


Effects of Cold:Effects of Cold:

• Two factors influence a cold exposure injury:Two factors influence a cold exposure injury:» Air temperature.Air temperature.» Wind speed.Wind speed.

• Local injury resulting from cold exposure is generally Local injury resulting from cold exposure is generally known as frostbite. It occurs most frequently on fingers, known as frostbite. It occurs most frequently on fingers, toes, and ears. toes, and ears. There are 3 categories:There are 3 categories:

» Incident Frostbite -Incident Frostbite - Sudden whitening of skin. Sudden whitening of skin.» Superficial Frostbite -Superficial Frostbite - Waxy or white appearance of skin that has Waxy or white appearance of skin that has

hardened topically, but remains resilient at deeper levels.hardened topically, but remains resilient at deeper levels.» Deep Frostbite -Deep Frostbite - Cold, pale skin that is solid to the touch. Cold, pale skin that is solid to the touch.

Effects of Cold:Effects of Cold:

• Two factors influence a cold exposure injury:Two factors influence a cold exposure injury:» Air temperature.Air temperature.» Wind speed.Wind speed.

• Local injury resulting from cold exposure is generally Local injury resulting from cold exposure is generally known as frostbite. It occurs most frequently on fingers, known as frostbite. It occurs most frequently on fingers, toes, and ears. toes, and ears. There are 3 categories:There are 3 categories:

» Incident Frostbite -Incident Frostbite - Sudden whitening of skin. Sudden whitening of skin.» Superficial Frostbite -Superficial Frostbite - Waxy or white appearance of skin that has Waxy or white appearance of skin that has

hardened topically, but remains resilient at deeper levels.hardened topically, but remains resilient at deeper levels.» Deep Frostbite -Deep Frostbite - Cold, pale skin that is solid to the touch. Cold, pale skin that is solid to the touch.

CPC Medical CPC Medical ConsiderationsConsiderationsCPC Medical CPC Medical ConsiderationsConsiderations Effects of Cold, Effects of Cold, ContinuedContinued::

• Systemic Hypothermia:Systemic Hypothermia:

» Caused by exposure to freezing (below 32°F) temperatures or Caused by exposure to freezing (below 32°F) temperatures or those below well below the lower limit of room temperature (65ºF) those below well below the lower limit of room temperature (65ºF) in water.in water.

• 55 stages of Hypothermia symptoms: stages of Hypothermia symptoms:

» Shivering.Shivering.

» Lethargy, apathy, listlessness.Lethargy, apathy, listlessness.

» Unconsciousness, slowed pulse and respiratory rate.Unconsciousness, slowed pulse and respiratory rate.

» Freezing of extremities.Freezing of extremities.

» Death.Death.

Effects of Cold, Effects of Cold, ContinuedContinued::

• Systemic Hypothermia:Systemic Hypothermia:

» Caused by exposure to freezing (below 32°F) temperatures or Caused by exposure to freezing (below 32°F) temperatures or those below well below the lower limit of room temperature (65ºF) those below well below the lower limit of room temperature (65ºF) in water.in water.

• 55 stages of Hypothermia symptoms: stages of Hypothermia symptoms:

» Shivering.Shivering.

» Lethargy, apathy, listlessness.Lethargy, apathy, listlessness.

» Unconsciousness, slowed pulse and respiratory rate.Unconsciousness, slowed pulse and respiratory rate.

» Freezing of extremities.Freezing of extremities.

» Death.Death.


Work Mission Duration:Work Mission Duration:

• Time management tool used to identifyTime management tool used to identifywork-rest cycles based on a task analysis.work-rest cycles based on a task analysis.

• Two important facts to remember:Two important facts to remember:» Wearer w/lowest remaining air supply dictates time Wearer w/lowest remaining air supply dictates time

left for team.left for team.» Return travel time, decontamination time, & safety Return travel time, decontamination time, & safety

margin must be considered.margin must be considered.» See Student Manual, Page 13.78,See Student Manual, Page 13.78,

Work Mission Duration:Work Mission Duration:

• Time management tool used to identifyTime management tool used to identifywork-rest cycles based on a task analysis.work-rest cycles based on a task analysis.

• Two important facts to remember:Two important facts to remember:» Wearer w/lowest remaining air supply dictates time Wearer w/lowest remaining air supply dictates time

left for team.left for team.» Return travel time, decontamination time, & safety Return travel time, decontamination time, & safety

margin must be considered.margin must be considered.» See Student Manual, Page 13.78,See Student Manual, Page 13.78,


Field Monitoring (Pre/Post Assessment):Field Monitoring (Pre/Post Assessment):

• Continuous measuring and evaluation of environmental Continuous measuring and evaluation of environmental and biological parameters to detect dangerous trends, and biological parameters to detect dangerous trends, conditions conducive to adverse health effects, or the onset conditions conducive to adverse health effects, or the onset of injury or illness from exposure to the environment.of injury or illness from exposure to the environment.

• Minimum environmental parameters:Minimum environmental parameters:» Temperature, relative humidity, & wind speed.Temperature, relative humidity, & wind speed.

• Heat Index -Heat Index - a measure of the body’ ability to cool itself is a measure of the body’ ability to cool itself is determined by a combination of ambient air temperature & determined by a combination of ambient air temperature & relative humidity.relative humidity.

Field Monitoring (Pre/Post Assessment):Field Monitoring (Pre/Post Assessment):

• Continuous measuring and evaluation of environmental Continuous measuring and evaluation of environmental and biological parameters to detect dangerous trends, and biological parameters to detect dangerous trends, conditions conducive to adverse health effects, or the onset conditions conducive to adverse health effects, or the onset of injury or illness from exposure to the environment.of injury or illness from exposure to the environment.

• Minimum environmental parameters:Minimum environmental parameters:» Temperature, relative humidity, & wind speed.Temperature, relative humidity, & wind speed.

• Heat Index -Heat Index - a measure of the body’ ability to cool itself is a measure of the body’ ability to cool itself is determined by a combination of ambient air temperature & determined by a combination of ambient air temperature & relative humidity.relative humidity.



Field MonitoringField Monitoring(Pre/Post Assessment):(Pre/Post Assessment):

• See Activity Sheet #13.2.1, See Activity Sheet #13.2.1, StudentStudentmanual Page 13.23.manual Page 13.23.

Field MonitoringField Monitoring(Pre/Post Assessment):(Pre/Post Assessment):

• See Activity Sheet #13.2.1, See Activity Sheet #13.2.1, StudentStudentmanual Page 13.23.manual Page 13.23.



The Environment, Moisture, & Evaporation:The Environment, Moisture, & Evaporation:• EvaporationEvaporation - - Primary cooling process occurs when your Primary cooling process occurs when your

body releases heat through perspiration.body releases heat through perspiration.

• For evaporation to occur, ambient air must not be For evaporation to occur, ambient air must not be saturated w/moisture. The amount of moisture that air saturated w/moisture. The amount of moisture that air can hold is directly related to ambient air temperature.can hold is directly related to ambient air temperature.

• Evaporation occurs via the lungs & skin. As ambient Evaporation occurs via the lungs & skin. As ambient moisture content moisture content (humidity)(humidity) increases, exhaled gases in increases, exhaled gases in the lungs approach the same humidity & no evaporation the lungs approach the same humidity & no evaporation can occur. When lung humidity increases, waste gases can occur. When lung humidity increases, waste gases are not efficiently removed & the Oare not efficiently removed & the O22 content is decreased. content is decreased.

The Environment, Moisture, & Evaporation:The Environment, Moisture, & Evaporation:• EvaporationEvaporation - - Primary cooling process occurs when your Primary cooling process occurs when your

body releases heat through perspiration.body releases heat through perspiration.

• For evaporation to occur, ambient air must not be For evaporation to occur, ambient air must not be saturated w/moisture. The amount of moisture that air saturated w/moisture. The amount of moisture that air can hold is directly related to ambient air temperature.can hold is directly related to ambient air temperature.

• Evaporation occurs via the lungs & skin. As ambient Evaporation occurs via the lungs & skin. As ambient moisture content moisture content (humidity)(humidity) increases, exhaled gases in increases, exhaled gases in the lungs approach the same humidity & no evaporation the lungs approach the same humidity & no evaporation can occur. When lung humidity increases, waste gases can occur. When lung humidity increases, waste gases are not efficiently removed & the Oare not efficiently removed & the O22 content is decreased. content is decreased.



Heat-Related Injuries:Heat-Related Injuries:

• Heat Rash.Heat Rash.• Heat Cramps.Heat Cramps.• Heat Stress.Heat Stress.• Heat Exhaustion.Heat Exhaustion.• Heat Stroke.Heat Stroke.

Heat-Related Injuries:Heat-Related Injuries:

• Heat Rash.Heat Rash.• Heat Cramps.Heat Cramps.• Heat Stress.Heat Stress.• Heat Exhaustion.Heat Exhaustion.• Heat Stroke.Heat Stroke.


ConsiderationsConsiderations Heat-Related Injuries,Heat-Related Injuries, Continued Continued::

• Heat Rash -Heat Rash - Small blister-like bumps w/pricking sensation Small blister-like bumps w/pricking sensation on affected areas caused by prolonged exposure to humid on affected areas caused by prolonged exposure to humid heat when the skin remains wet w/unevaporated sweat.heat when the skin remains wet w/unevaporated sweat.

• Heat Cramps -Heat Cramps - Painful muscle spasms after prolonged Painful muscle spasms after prolonged exposure to heat while working due to loss of body salt exposure to heat while working due to loss of body salt (electrolytes) in sweat. Usually occurs after drinking large (electrolytes) in sweat. Usually occurs after drinking large volumes of water w/out replacing salt loss.volumes of water w/out replacing salt loss.

Heat-Related Injuries,Heat-Related Injuries, Continued Continued::

• Heat Rash -Heat Rash - Small blister-like bumps w/pricking sensation Small blister-like bumps w/pricking sensation on affected areas caused by prolonged exposure to humid on affected areas caused by prolonged exposure to humid heat when the skin remains wet w/unevaporated sweat.heat when the skin remains wet w/unevaporated sweat.

• Heat Cramps -Heat Cramps - Painful muscle spasms after prolonged Painful muscle spasms after prolonged exposure to heat while working due to loss of body salt exposure to heat while working due to loss of body salt (electrolytes) in sweat. Usually occurs after drinking large (electrolytes) in sweat. Usually occurs after drinking large volumes of water w/out replacing salt loss.volumes of water w/out replacing salt loss.


Heat-Related Injuries, Heat-Related Injuries, ContinuedContinued::

• Heat Stress -Heat Stress - F First sign of thermoregulatory failure. Symptoms irst sign of thermoregulatory failure. Symptoms include fatigue, irritation, altered level of consciousness & include fatigue, irritation, altered level of consciousness & dehydration.dehydration.

• Heat ExhaustionHeat Exhaustion - Second sign of thermoregulatory failure marked - Second sign of thermoregulatory failure marked by Cardiovascular Insufficiency (when total blood volume is by Cardiovascular Insufficiency (when total blood volume is inadequate for vascular system). Symptoms include: shallow inadequate for vascular system). Symptoms include: shallow breathing, profuse sweating, dizziness, lethargy, temperature 99.5ºF - breathing, profuse sweating, dizziness, lethargy, temperature 99.5ºF - 101.3ºF.101.3ºF.

Heat-Related Injuries, Heat-Related Injuries, ContinuedContinued::

• Heat Stress -Heat Stress - F First sign of thermoregulatory failure. Symptoms irst sign of thermoregulatory failure. Symptoms include fatigue, irritation, altered level of consciousness & include fatigue, irritation, altered level of consciousness & dehydration.dehydration.

• Heat ExhaustionHeat Exhaustion - Second sign of thermoregulatory failure marked - Second sign of thermoregulatory failure marked by Cardiovascular Insufficiency (when total blood volume is by Cardiovascular Insufficiency (when total blood volume is inadequate for vascular system). Symptoms include: shallow inadequate for vascular system). Symptoms include: shallow breathing, profuse sweating, dizziness, lethargy, temperature 99.5ºF - breathing, profuse sweating, dizziness, lethargy, temperature 99.5ºF - 101.3ºF.101.3ºF.


Heat-Related Injuries, Heat-Related Injuries, Continued:Continued:

• Heat Stroke:Heat Stroke:

» The last sign of thermoregulatory failureThe last sign of thermoregulatory failureleading to overheating that is potentially fatal.leading to overheating that is potentially fatal.

» Symptoms include:Symptoms include: Hot/dry skin, no perspiration, nauseaHot/dry skin, no perspiration, nausea,, dizziness, rapid dizziness, rapid

pulse, temperature over 104.9ºF.pulse, temperature over 104.9ºF.

Heat-Related Injuries, Heat-Related Injuries, Continued:Continued:

• Heat Stroke:Heat Stroke:

» The last sign of thermoregulatory failureThe last sign of thermoregulatory failureleading to overheating that is potentially fatal.leading to overheating that is potentially fatal.

» Symptoms include:Symptoms include: Hot/dry skin, no perspiration, nauseaHot/dry skin, no perspiration, nausea,, dizziness, rapid dizziness, rapid

pulse, temperature over 104.9ºF.pulse, temperature over 104.9ºF.



Heat-Related Injury Treatments:Heat-Related Injury Treatments:

• Remove to a cooler location (usually shaded).Remove to a cooler location (usually shaded).

• Re-hydration (cool liquids, not cold liquids).Re-hydration (cool liquids, not cold liquids).

• Cool patient body w/evaporative or active cooling methods Cool patient body w/evaporative or active cooling methods (e.g., cool wraps).(e.g., cool wraps).

• Medical monitoring & vital signs maintenance.Medical monitoring & vital signs maintenance.

• Intravenous therapy (if cardiovascular insufficiency).Intravenous therapy (if cardiovascular insufficiency).

Heat-Related Injury Treatments:Heat-Related Injury Treatments:

• Remove to a cooler location (usually shaded).Remove to a cooler location (usually shaded).

• Re-hydration (cool liquids, not cold liquids).Re-hydration (cool liquids, not cold liquids).

• Cool patient body w/evaporative or active cooling methods Cool patient body w/evaporative or active cooling methods (e.g., cool wraps).(e.g., cool wraps).

• Medical monitoring & vital signs maintenance.Medical monitoring & vital signs maintenance.

• Intravenous therapy (if cardiovascular insufficiency).Intravenous therapy (if cardiovascular insufficiency).


ConsiderationsConsiderations Medical Monitoring Parameters:Medical Monitoring Parameters:

• Body Weight:Body Weight:

» Comparison of pre & post-entry body weights provide the amount Comparison of pre & post-entry body weights provide the amount & rate of water loss.& rate of water loss.

» Water loss cannot be made up quicklyWater loss cannot be made up quickly» Losses can be as great as 3.5 liters/hr.Losses can be as great as 3.5 liters/hr.» Post-entry body weights provide an index of the amount of fluid Post-entry body weights provide an index of the amount of fluid

remaining in body tissues.remaining in body tissues.» Post-entry body weights must be collected immediately upon Post-entry body weights must be collected immediately upon

exiting controlled zones & before re-hydration.exiting controlled zones & before re-hydration.

Medical Monitoring Parameters:Medical Monitoring Parameters:

• Body Weight:Body Weight:

» Comparison of pre & post-entry body weights provide the amount Comparison of pre & post-entry body weights provide the amount & rate of water loss.& rate of water loss.

» Water loss cannot be made up quicklyWater loss cannot be made up quickly» Losses can be as great as 3.5 liters/hr.Losses can be as great as 3.5 liters/hr.» Post-entry body weights provide an index of the amount of fluid Post-entry body weights provide an index of the amount of fluid

remaining in body tissues.remaining in body tissues.» Post-entry body weights must be collected immediately upon Post-entry body weights must be collected immediately upon

exiting controlled zones & before re-hydration.exiting controlled zones & before re-hydration.


Medical Monitoring Parameters, Medical Monitoring Parameters, ContinuedContinued::

• Body Weight, Continued:Body Weight, Continued:

• Suggested water weight loss parameters:Suggested water weight loss parameters:

» Body weight loss should not exceed 1.5%.Body weight loss should not exceed 1.5%.» Stop work & assess @ 3% loss.Stop work & assess @ 3% loss.» Remove personnel for immediate medicalRemove personnel for immediate medical

attention @ 5% lossattention @ 5% loss

Medical Monitoring Parameters, Medical Monitoring Parameters, ContinuedContinued::

• Body Weight, Continued:Body Weight, Continued:

• Suggested water weight loss parameters:Suggested water weight loss parameters:

» Body weight loss should not exceed 1.5%.Body weight loss should not exceed 1.5%.» Stop work & assess @ 3% loss.Stop work & assess @ 3% loss.» Remove personnel for immediate medicalRemove personnel for immediate medical

attention @ 5% lossattention @ 5% loss


Medical Monitoring Parameters, Medical Monitoring Parameters, continuedcontinued::

• Body Core Temperature:Body Core Temperature:

» Tympanic membrane are most feasible means of measurement.Tympanic membrane are most feasible means of measurement.

» Determine temperature rise via 2-week baseline.Determine temperature rise via 2-week baseline.

» Max temp rise should not exceed 1.5ºF, upon post-entry exam.Max temp rise should not exceed 1.5ºF, upon post-entry exam.

» Restrict further work until temperature is within 0.5ºF of baseline.Restrict further work until temperature is within 0.5ºF of baseline.

» Obtain temp measurement immediately upon exit.Obtain temp measurement immediately upon exit.

Medical Monitoring Parameters, Medical Monitoring Parameters, continuedcontinued::

• Body Core Temperature:Body Core Temperature:

» Tympanic membrane are most feasible means of measurement.Tympanic membrane are most feasible means of measurement.

» Determine temperature rise via 2-week baseline.Determine temperature rise via 2-week baseline.

» Max temp rise should not exceed 1.5ºF, upon post-entry exam.Max temp rise should not exceed 1.5ºF, upon post-entry exam.

» Restrict further work until temperature is within 0.5ºF of baseline.Restrict further work until temperature is within 0.5ºF of baseline.

» Obtain temp measurement immediately upon exit.Obtain temp measurement immediately upon exit.



Medical Monitoring Parameters , Medical Monitoring Parameters , continuedcontinued::

• Pulse (Age Adjusted Maximum Heart Rate):Pulse (Age Adjusted Maximum Heart Rate):

» 220 - age = Adjusted Heart Rate (beats/min)220 - age = Adjusted Heart Rate (beats/min)

» Best overall indicator.Best overall indicator.» Limit to which worker can maintain aerobic exercise for Limit to which worker can maintain aerobic exercise for

prolonged periods w/out heart damage.prolonged periods w/out heart damage.» Direct measurement of the rate at which the body attempts to Direct measurement of the rate at which the body attempts to

cool itself.cool itself.


• Pulse (Age Adjusted Maximum Heart Rate):Pulse (Age Adjusted Maximum Heart Rate):

» 220 - age = Adjusted Heart Rate (beats/min)220 - age = Adjusted Heart Rate (beats/min)

» Best overall indicator.Best overall indicator.» Limit to which worker can maintain aerobic exercise for Limit to which worker can maintain aerobic exercise for

prolonged periods w/out heart damage.prolonged periods w/out heart damage.» Direct measurement of the rate at which the body attempts to Direct measurement of the rate at which the body attempts to

cool itself.cool itself.


Medical Monitoring Medical Monitoring Parameters , Parameters , continuedcontinued::

• Blood Pressure:Blood Pressure:

» No suspected correlation to heat stress.No suspected correlation to heat stress.

» Reflects the quality of rest for heart muscle in Reflects the quality of rest for heart muscle in between strokes.between strokes.

Medical Monitoring Medical Monitoring Parameters , Parameters , continuedcontinued::

• Blood Pressure:Blood Pressure:

» No suspected correlation to heat stress.No suspected correlation to heat stress.

» Reflects the quality of rest for heart muscle in Reflects the quality of rest for heart muscle in between strokes.between strokes.




• Health Guidelines & RecommendedHealth Guidelines & RecommendedRest/Removal Periods.Rest/Removal Periods.


• Health Guidelines & RecommendedHealth Guidelines & RecommendedRest/Removal Periods.Rest/Removal Periods.


SUMMARYSUMMARY Stress Programs.Stress Programs. Stresses of Encapsulating Garments.Stresses of Encapsulating Garments. Incident Stressors.Incident Stressors. Physiological Factors.Physiological Factors. Work Tolerance.Work Tolerance. Effects of Cold Exposure.Effects of Cold Exposure. Work Mission Duration.Work Mission Duration. Rest Periods.Rest Periods. Field Monitoring.Field Monitoring.

Stress Programs.Stress Programs. Stresses of Encapsulating Garments.Stresses of Encapsulating Garments. Incident Stressors.Incident Stressors. Physiological Factors.Physiological Factors. Work Tolerance.Work Tolerance. Effects of Cold Exposure.Effects of Cold Exposure. Work Mission Duration.Work Mission Duration. Rest Periods.Rest Periods. Field Monitoring.Field Monitoring.

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CPC Medical Considerations Chapter # 13 CPC Medical Considerations Introduction Stress Programs....

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