Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Am J Emerg Med. 2021 Jun;44:235-240. doi: 10.1016/j.ajem.2020.03.054. Epub 2020 Mar 31.
The application of appropriate personal protective equipment for respiratory protection to health care workers is a cornerstone for providing safe healthcare in emergency departments. We investigated the protective effect and usefulness of loose-fitting powered air-purifying respirators (PAPRs) during chest compression.
This was a single-center simulation study performed from May 2019 to July 2019 in a tertiary hospital. We measured the concentrations of ambient aerosol and particles inside the loose-fitting PAPR during chest compression, and this ratio was set as the simulated workplace protecting factor (SWPF). According to the National Institute for Occupational Safety and Health regulations, the assigned protection factor (APF) of loose-fitting PAPRs is 25. Thus, the loose-fitting PAPRs were assumed to have a protective effect when the SWPF were ≥ 250 (APF × 10). We measured the SWPF of PAPR in real time during chest compression and also investigated the problems encountered during its use.
Ninety-one participants (median age 29 [interquartile range (IQR): 26-32] years; 74% female) completed the simulation. None of the participants failed with SWPF below 250 during three sessions of chest compression. The median (IQR) values of SWPF at three cycles were 17,063 (10,145-26,373), 15,683 (9477-32,394), and 16,960 (7695-27,279). There was no disconnection of equipment or mechanical failures during chest compression. In addition, most participants (83%) replied that they rarely or never experienced difficulty in verbal communication and felt that the loose-fitting PAPR was comfortable.
The loose-fitting PAPRs provided sufficient respiratory protection without disturbances during chest compression.
为医护人员提供适当的个人防护设备进行呼吸防护，是在急诊部门提供安全医疗服务的基石。我们研究了在胸部按压期间，宽松型动力空气净化呼吸器（PAPR）的防护效果和实用性。
这是 2019 年 5 月至 7 月在一家三级医院进行的单中心模拟研究。我们测量了在胸部按压期间，宽松型 PAPR 内部的环境气溶胶和颗粒浓度，该比值被设定为模拟工作场所保护因子（SWPF）。根据美国国家职业安全与健康研究所的规定，宽松型 PAPR 的指定防护因子（APF）为 25。因此，当 SWPF≥250（APF×10）时，认为宽松型 PAPR 具有防护效果。我们实时测量了 PAPR 在胸部按压过程中的 SWPF，并调查了其使用过程中遇到的问题。
91 名参与者（中位数年龄 29 岁[四分位距：26-32]岁；74%为女性）完成了模拟。在三次胸部按压过程中，没有参与者的 SWPF 低于 250。三次循环的 SWPF 中位数（四分位距）值分别为 17063（10145-26373）、15683（9477-32394）和 16960（7695-27279）。在胸部按压过程中，没有设备断开或机械故障。此外，大多数参与者（83%）表示，他们在言语交流中很少或从未遇到困难，并且认为宽松型 PAPR 很舒适。
在胸部按压过程中，宽松型 PAPR 提供了充足的呼吸防护，且无干扰。
