This study evaluated emergency medical services (EMS) providers’ knowledge of exertional heat stroke (EHS) and assessed current EMS capabilities for recognizing and managing EHS. EMS providers currently practicing in the United States were recruited to complete a 25-item questionnaire. There were 216 questionnaire responses (183 complete) representing 28 states. On average, respondents were 42.0 ± 13.0 years old, male (n = 163, 75.5%), and white (n = 176, 81.5%). Most respondents were Paramedics (n = 110, 50.9%) and had ≥16 years of experience (n = 109/214, 50.9%) working in EMS. Fifty-five percent (n = 99/180) of respondents had previously treated a patient with EHS. The average number of correct answers on the knowledge assessment was 2.6 ± 1.2 out of 7 (~37% correct). Temporal (n = 79), tympanic (n = 76), and oral (n = 68) thermometers were the most prevalent methods of temperature assessment available. Chemical cold packs (n = 164) and air conditioning (n = 134) were the most prevalent cooling methods available. Respondents demonstrated poor knowledge regarding EHS despite years of experience, and over half stating they had previously treated EHS in the field. Few EMS providers reported having access to an appropriate method of assessing or cooling a patient with EHS. Updated, evidence-based training needs to be provided and stakeholders should ensure their EMS providers have access to appropriate equipment.

No abstract

No abstract

Military foot marches account for 17–22% of Army musculoskeletal injuries (MSI), with low back pain (LBP) being a common complaint. Core-exercise and whole-body vibration (WBV) have been shown to decrease LBP in patients with chronic low back MSI. This study investigated if WBV and/or core-exercise influenced LBP or posture associated with a military ruck march. A randomized control trial with three groups: (1) WBV and core-exercise (WBVEx); (2) core-exercise alone (Ex); and (3) control evaluated the effects of core-exercise and WBV on LBP during/after a two 8 K foot marches with a 35 lb rucksack. The intervention groups completed three weeks of core-exercise training with/without WBV. Outcome measurements included visual analog scale (VAS), algometer, posture and electromyography (EMG). LBP, pressure threshold, and posture were elevated throughout the foot march regardless of group. LBP remained elevated for 48 h post foot march (p = 0.044). WBVEx and Ex did not have a significant effect on LBP. WBVEx and Ex both decreased muscle sensitivity and increased trunk flexion (p < 0.001) during the second foot march (FM2). The 8 K foot marches significantly increased LBP. Core-exercise training with/without WBV decreases low back muscle sensitivity. WBV and core-exercise increases trunk flexion which may help improve performance and may influence LBP.

Central vascular function (stiffness, pressure wave energy transmission, hemodynamics) can impact high-flow end-organs such as the myocardium. Police officers, firefighters, emergency medical services personnel, and military personnel ("emergency responders" [ER]) experience more on-duty deaths from cardiac events than other occupational groups. As ER face unique occupational stressors, central vascular stress reactivity (CVSR) may contribute to cardiac risk. PURPOSE: Determine if ER have greater CVSR compared with non-ER (NER). METHODS: 9 ER and 9 age-, sex-, race-, and body fat-matched NER (n = 2 women; Table 1) had central vascular function assessed at rest and during 3 min of mental stress (Stroop). Potential covariates included: fasting cholesterol, lipids, and glucose from a fingerstick sample; physical activity via the International Physical Activity Questionnaire (IPAQ); and depressive symptomology from the Center for Epidemiologic Studies Depression Scale (CESD). Aortic stiffness was assessed using carotid-femoral pulse wave velocity. Doppler ultrasound was used to measure carotid artery β stiffness, while Wave Intensity Analysis provided measures of pressure wave energy transmission. Carotid pressures were measured using applanation tonometry. CVSR was calculated as mental stress -resting. RESULTS: Groups had similar metabolic profiles and IPAQ scores (p ≥ 0.11). CESD score was greater in ER than NER (p = 0.04) and was used as a covariate for analyses. CVSR was similar between groups for all variables (p > 0.05; Table 1). CONCLUSIONS: Despite more depressive symptomology, ER do not have greater central vascular function changes to stress compared with NER, suggesting high resiliency during mental stress in ER.