Rauch Simon, van Veelen Michiel Jan, Oberhammer Rosmarie, Dal Cappello Tomas, Roveri Giulia, Gruber Elisabeth, Strapazzon Giacomo
Institute of Mountain Emergency Medicine, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy.
Department of Anaesthesia and Intensive Care, "F. Tappeiner" Hospital, Via Rossini 5, 39012 Merano, Italy.
J Clin Med. 2021 Apr 16;10(8):1728. doi: 10.3390/jcm10081728.
Cardiopulmonary resuscitation (CPR) is considered an aerosol-generating procedure. Consequently, COVID-19 resuscitation guidelines recommend the use of personal protective equipment (PPE) during resuscitation. In this simulation of randomised crossover trials, we investigated the influence of PPE on the quality of chest compressions (CCs). Thirty-four emergency medical service BLS-providers performed two 20 min CPR sequences (five 2 min cycles alternated by 2 min of rest) on manikins, once with and once without PPE, in a randomised order. The PPE was composed of a filtering facepiece 3 FFP3 mask, safety glasses, gloves and a long-sleeved gown. The primary outcome was defined as the difference between compression depth with and without PPE; secondary outcomes were defined as differences in CC rate, release and the number of effective CCs. The participants graded fatigue and performance, while generalised estimating equations (GEE) were used to analyse data. There was no significant difference in CC quality between sequences without and with PPE regarding depth (mean depth 54 ± 5 vs. 54 ± 6 mm respectively), rate (mean rate 119 ± 9 and 118 ± 6 compressions per minute), release (mean release 2 ± 2 vs. 2 ± 2 mm) and the number of effective CCs (43 ± 18 vs. 45 ± 17). The participants appraised higher fatigue when equipped with PPE in comparison to when equipped without PPE ( < 0.001), and lower performance was appraised when equipped with PPE in comparison to when equipped without PPE ( = 0.031). There is no negative effect of wearing PPE on the quality of CCs during CPR in comparison to not wearing PPE.
心肺复苏术（CPR）被视为一种产生气溶胶的操作。因此，新冠病毒复苏指南建议在复苏过程中使用个人防护装备（PPE）。在本次随机交叉试验模拟中，我们研究了个人防护装备对胸外按压（CCs）质量的影响。34名基础生命支持（BLS）急救医疗服务提供者以随机顺序在人体模型上进行了两组20分钟的心肺复苏序列操作（五个2分钟周期，中间间隔2分钟休息），一次佩戴个人防护装备，一次不佩戴。个人防护装备包括一个过滤式面罩3（FFP3）口罩、安全眼镜、手套和一件长袖工作服。主要结局定义为佩戴和不佩戴个人防护装备时按压深度的差异；次要结局定义为胸外按压频率、回弹以及有效胸外按压次数的差异。参与者对疲劳程度和操作表现进行评分，同时使用广义估计方程（GEE）分析数据。在按压深度（平均深度分别为54±5毫米和54±6毫米）、频率（平均频率分别为每分钟119±9次和118±6次按压）、回弹（平均回弹分别为2±2毫米和2±2毫米）以及有效胸外按压次数（43±18次和45±17次）方面，佩戴和不佩戴个人防护装备的序列之间胸外按压质量没有显著差异。与不佩戴个人防护装备相比，参与者认为佩戴个人防护装备时疲劳程度更高（<0.001），且操作表现更低（=0.031）。与不佩戴个人防护装备相比，佩戴个人防护装备在心肺复苏过程中对胸外按压质量没有负面影响。
