Background: High-quality cardiopulmonary resuscitation (CPR) is a key element in the rescue of cardiac arrest patients but is difficult to achieve in circumstances involving aerosol transmission, such as the COVID-19 pandemic.
Methods: This prospective randomized crossover trial included 30 experienced health care providers to evaluate the impact of personal protective equipment (PPE) on CPR quality and rescuer safety. Participants were asked to perform continuous CPR for 5 minutes on a manikin with three types of PPE: level D-PPE, level C-PPE, and PAPR. The primary outcome was effective chest compression per minute. Secondary outcomes were the fit factor by PortaCount, vital signs and fatigue scores before and after CPR, and perceptions related to wearing PPE. Repeated-measures ANOVA was used, and a two-tailed test value of 0.05 was considered statistically significant.
Results: The rates of effective chest compressions for 5 minutes with level D-PPE, level C-PPE, and PAPRs were 82.0 ± 0.2%, 78.4 ± 0.2%, and 78.0 ± 0.2%, respectively ( = 0.584). The fit-factor test values of level C-PPE and PAPRs were 182.9 ± 39.9 vs. 198.9 ± 9.2 ( < 0.001). The differences in vital signs before and after CPR were not significantly different among the groups. In addition, the fatigue and total perception scores of wearing PPE were significantly higher for level C-PPE than PAPRs: 3.8 ± 1.6 vs. 3.0 ± 1.6 ( < 0.001) and 27.9 ± 5.4 vs. 26.0 ± 5.3 ( < 0.001), respectively.
Conclusion: PAPRs are recommended when performing CPR in situations where aerosol transmission is suspected. When PAPRs are in short supply, individual fit-tested N95 masks are an alternative. This trial is registered with NCT04802109.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10703537 | PMC |
| http://dx.doi.org/10.1155/2023/9697442 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of Personal Protective Equipment on Cardiopulmonary Resuscitation and Rescuer Safety.
Emerg Med Int
November 2023
Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan.
Background: High-quality cardiopulmonary resuscitation (CPR) is a key element in the rescue of cardiac arrest patients but is difficult to achieve in circumstances involving aerosol transmission, such as the COVID-19 pandemic.
Methods: This prospective randomized crossover trial included 30 experienced health care providers to evaluate the impact of personal protective equipment (PPE) on CPR quality and rescuer safety. Participants were asked to perform continuous CPR for 5 minutes on a manikin with three types of PPE: level D-PPE, level C-PPE, and PAPR.
Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19.
Kardiol Pol
March 2021
Polish Society of Disaster Medicine, Warsaw, Poland
Background: Obtaining vascular access is one of the key procedures performed in patients in emergency settings.
Aims: The study was conducted as a meta‑analysis and a systematic review and aimed to address the following question: which intravascular access method should be used in patients with COVID‑19 when wearing full personal protective equipment (PPE)?
Methods: We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials that compared intravascular access methods used by operators wearing full level C PPE. We evaluated procedure duration and the success rate of intraosseous and peripheral intravenous accesses.
Comparing Training Techniques in Personal Protective Equipment Use.
Prehosp Disaster Med
August 2020
SUNY Downstate College of Medicine, Brooklyn, New YorkUSA.
Introduction: Physicians' management of hazardous material (HAZMAT) incidents requires personal protective equipment (PPE) utilization to ensure the safety of victims, facilities, and providers; therefore, providing effective and accessible training in its use is crucial. While an emphasis has been placed on the importance of PPE, there is debate about the most effective training methods. Circumstances may not allow for a traditional in-person demonstration; an accessible video training may provide a useful alternative.
View Article and Find Full Text PDFObjective To determine the impact of Level C personal protective equipment (PPE) on the time to perform intravenous (IV) cannulation and endotracheal intubation, both with and without the use of adjuncts. Methods This prospective, case-control study of emergency medicine resident physicians was designed to assess the time taken by each subject to perform endotracheal intubation using both direct laryngoscopy (DL) and video laryngoscopy (VL), as well as peripheral IV cannulation both with and without ultrasound guidance and with and without PPE. Results While median times were higher using VL as compared to DL, there was no significant difference between intubation with either DL or VL in subjects with and without Level C PPE.
View Article and Find Full Text PDFComparison of intubation devices in level C personal protective equipment: A cadaveric study.
Am J Emerg Med
June 2018
Duke Lifepoint Conemaugh Memorial Medical Center, Department of Emergency Medicine, Johnstown, PA, United States. Electronic address:
Background: With the advancement of chemical, biological and nuclear warfare and the reemergence of infectious diseases, the possibility of intubating in personal protective equipment has become increasingly more real to the emergency physician. Human cadaveric models have been found to simulate real world conditions better than mannequins. The aim of the study was to determine the first pass success rate and average time to successful intubation while wearing Personal Protective Equipment (PPE).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!