title: Pre-deployment Heat Acclimatization Guidelines for Disaster Responders.
abstract: BACKGROUND
  Minimal preparation time is a feature of responding to sudden onset disasters. While equipment and supplies are prepared for deployment at short notice, less is known of the physical preparation of medical responders. With many disaster-prone areas classified as tropical regions, there is potential for responders to endure a combination of high ambient temperatures and relative humidity during deployment. Heat acclimatization, defined as the physiological and perceptual adaptations to frequent elevations of core body temperature (Tc), is a key strategy to improve tolerance of hot conditions by medical responders.
  
  
  METHODS
  Pre-deployment heat acclimatization guidelines were developed based upon the duration of physical training and the subjective rate of perceived exertion (session RPE). An objective of individual training sessions was the perception of body temperature as warm to hot. The guidelines were implemented for Team Bravo (2nd rotation) of the Australian Medical Assistance Team (AusMAT) deployed to Tacloban, Philippines following Typhoon Haiyan in November 2013. The guidelines were distributed electronically five to seven days prior to deployment and were followed by a consultation. A group training session in hot conditions was undertaken prior to departure.
  
  
  RESULTS
  The AusMAT responders to utilize the guidelines were based in cool or temperate climates that required extra layers of clothing, training during warmer parts of the days, or warm indoor conditions to achieve session objectives. Responders reported the guidelines were simple to use, applicable to their varied training regimens, and had improved their confidence to work in the heat despite not completing the entire 14 day period.
  
  
  CONCLUSIONS
  The pre-deployment heat acclimatization guidelines provided AusMAT responders the ability to quantify their physical training and promoted physiological adaptations to maximize health, safety, and performance during deployment. While maintaining year-round heat acclimatization is considered essential for medical responders, these guidelines may facilitate beneficial adaptations once notified of deployment.
authors.affiliation: Disaster Medicine Research,National Critical Care and Trauma Response Centre,Darwin,Northern Territory,Australia.
authors.forename: Matt B
authors.initials: MB
authors.lastname: Brearley
mesh_terms: D000064:Acclimatization; D001315:Australia; D004189:Disaster Planning; D060731:Emergency Responders; D017408:Guidelines as Topic; D006358:Hot Temperature; D006801:Humans
keywords: AusMAT Australian Medical Assistance Team; RPE rate of perceived exertion; Tc
                  core body temperature; deployment; disaster; guidelines; heat acclimatization; thermal