Schumacher J, Gray S A, Weidelt L, Brinker A, Prior K, Stratling W M
GKT School of Medicine, King's College London, St Thomas' Campus, Department of Anaesthetics, London SE1 7EH, UK.
Emerg Med J. 2009 Jul;26(7):501-5. doi: 10.1136/emj.2008.061531.
Advanced life support of patients contaminated with chemical, biological, radiological or nuclear (CBRN) substances requires adequate respiratory protection for medical first responders. Conventional and powered air-purifying respirators may exert a different impact during resuscitation and therefore require evaluation. This will help to improve major incident planning and measures for protecting medical staff.
A randomised crossover study was undertaken to investigate the influence of conventional negative pressure and powered air-purifying respirators on the simulated resuscitation of casualties contaminated with hazardous substances. Fourteen UK paramedics carried out a standardised resuscitation algorithm inside an ambulance vehicle, either unprotected or wearing a conventional or a powered respirator. Treatment times, wearer mobility, ease of communication and ease of breathing were determined and compared.
In the questionnaire, volunteers stated that communication and mobility were similar in both respirator groups while breathing resistance was significantly lower in the powered respirator group. There was no difference in mean (SD) treatment times between the groups wearing respiratory protection and the controls (245 (19) s for controls, 247 (17) s for conventional respirators and 250 (12) s for powered respirators).
Powered air-purifying respirators improve the ease of breathing and do not appear to reduce mobility or delay treatment during a simulated resuscitation scenario inside an ambulance vehicle with a single CBRN casualty.
对受化学、生物、放射性或核（CBRN）物质污染的患者进行高级生命支持时，医疗急救人员需要充分的呼吸防护。传统的和动力送风空气净化呼吸器在复苏过程中可能产生不同的影响，因此需要进行评估。这将有助于改进重大事件的规划和保护医护人员的措施。
进行了一项随机交叉研究，以调查传统负压呼吸器和动力送风空气净化呼吸器对模拟的有害物质污染伤员复苏的影响。14名英国护理人员在救护车内执行标准化的复苏算法，他们要么不戴防护装备，要么佩戴传统呼吸器或动力送风呼吸器。测定并比较了治疗时间、佩戴者的行动能力、沟通便利性和呼吸舒适度。
在调查问卷中，志愿者表示两组呼吸器在沟通和行动能力方面相似，而动力送风呼吸器组的呼吸阻力明显更低。佩戴呼吸防护装备的组与对照组之间的平均（标准差）治疗时间没有差异（对照组为245（19）秒，传统呼吸器组为247（17）秒，动力送风呼吸器组为250（12）秒）。
在救护车内对单一CBRN伤员进行模拟复苏时，动力送风空气净化呼吸器可改善呼吸舒适度，且似乎不会降低行动能力或延误治疗。
