From the Departments of Anesthesia and Critical Care Medicine.
Pediatrics, Perelman School of Medicine at the University of Pennsylvania.
Pediatr Emerg Care. 2020 Jun;36(6):267-273. doi: 10.1097/PEC.0000000000002109.
This study aimed to determine whether personal protective equipment (PPE) results in deterioration in chest compression (CC) quality and greater fatigue for administering health care providers (HCPs).
In this multicenter study, HCPs completed 2 sessions. In session 1 (baseline), HCPs wore normal attire; in session 2, HCPs donned full PPE. During each session, they performed 5 minutes of uninterrupted CCs on a child manikin. Chest compression rate, depth, and release velocity were reported in ten 30-second epochs. Change in CC parameters and self-reported fatigue were measured between the start and 2- and 5-minute epochs.
We enrolled 108 HCPs (prehospital and in-hospital providers). The median CC rate did not change significantly between epochs 1 and 10 during baseline sessions. Median CC depth and release velocity decreased for 5 minutes with PPE. There were no significant differences in CC parameters between baseline and PPE sessions in any provider group. Median fatigue scores during baseline sessions were 2 (at start), 4 (at 2 minutes), and 6 (at 5 minutes). There was a significantly higher median fatigue score between 0 and 5 minutes in both study sessions and in all groups. Fatigue scores were significantly higher for providers wearing PPE compared with baseline specifically among prehospital providers.
During a clinically appropriate 2-minute period, neither CC quality nor self-reported fatigue worsened to a significant degree in providers wearing PPE. Our data suggest that Pediatric Basic Life Support recommendations for CC providers to switch every 2 minutes need not be altered with PPE use.
本研究旨在确定个人防护装备(PPE)是否会导致胸部按压(CC)质量恶化和医护人员(HCPs)疲劳加剧。
在这项多中心研究中,HCPs 完成了 2 个会话。在第 1 会话(基线)中,HCPs 穿着正常的服装;在第 2 会话中,HCPs 穿着全套 PPE。在每个会话中,他们在儿童人体模型上进行了 5 分钟不间断的 CC。报告了十个 30 秒时段的胸压率、深度和释放速度。在开始时和 2 分钟和 5 分钟时段测量 CC 参数和自我报告的疲劳变化。
我们招募了 108 名 HCPs(院前和院内提供者)。在基线会话期间,第 1 个和第 10 个时段的 CC 率没有显著变化。使用 PPE 时,CC 深度和释放速度在 5 分钟内下降。在任何提供者组中,基线和 PPE 会话之间的 CC 参数均无显着差异。在基线会话期间,疲劳评分中位数为 2(开始时),4(2 分钟时)和 6(5 分钟时)。在两个研究会话和所有组中,从 0 到 5 分钟的疲劳评分中位数均显着更高。与基线相比,穿着 PPE 的提供者的疲劳评分显着更高,尤其是在院前提供者中。
在临床适当的 2 分钟期间,佩戴 PPE 的提供者的 CC 质量或自我报告的疲劳均未显着恶化。我们的数据表明,小儿基本生命支持建议 CC 提供者每 2 分钟更换一次,无需因使用 PPE 而改变。