Independent Statistician, Solagna, Italy.
Department of Neonatology, Bolzano Hospital, Bolzano, Italy.
Arch Dis Child Fetal Neonatal Ed. 2022 Mar;107(2):211-215. doi: 10.1136/archdischild-2021-322216. Epub 2021 Sep 6.
Healthcare providers should use personal protective equipment (PPE) when performing aerosol-generating medical procedures during highly infectious respiratory pandemics. We aimed to compare the timing of neonatal resuscitation procedures in a manikin model with or without PPE for prevention of SARS-COVID-19 transmission.
A randomised controlled cross-over (AB/BA) trial of resuscitation with or without PPE in a neonatal resuscitation scenario. Forty-eight participants were divided in 12 consultant-nurse teams and 12 resident-nurse teams. The primary outcome measure was the time of positive pressure ventilation (PPV) initiation. The secondary outcome measures were duration of tracheal intubation procedure, time of initiation of chest compressions, correct use of PPE and discomfort/limitations using PPE.
There were significant differences in timing of PPV initiation (consultant-nurse teams: mean difference (MD) 6.0 s, 95% CI 1.1 to 10.9 s; resident-nurse teams: MD 11.0 s, 95% CI 1.9 to 20.0 s), duration of tracheal intubation (consultant-nurse teams: MD 22.0 s, 95% CI 7.0 to 36.9 s; resident-nurse teams: MD 9.1 s, 95% CI 0.1 to 18.1 s) and chest compressions (consultant-nurse teams: MD 32.3 s, 95% CI 14.4 to 50.1 s; resident-nurse teams: MD 9.1 s, 95% CI 0.1 to 18.1 s). Twelve participants completed the dressing after entering the delivery room. PPE was associated with visual limitations (43/48 participants), discomfort in movements (42/48), limitations in communication (32/48) and thermal discomfort (29/48).
In a manikin model, using PPE delayed neonatal resuscitation procedures with potential clinical impact. Healthcare workers reported limitations and discomfort when wearing PPE.
NCT04666233.
在高度传染性呼吸道大流行期间，医疗保健提供者在进行产生气溶胶的医疗操作时应使用个人防护设备（PPE）。我们旨在比较在预防 SARS-COVID-19 传播的情况下，在模型中使用或不使用 PPE 进行新生儿复苏程序的时间。
一项在新生儿复苏场景中使用或不使用 PPE 的随机对照交叉（AB/BA）试验。48 名参与者分为 12 名顾问-护士团队和 12 名居民-护士团队。主要结局测量指标为正压通气（PPV）开始时间。次要结局指标为气管插管程序持续时间、胸外按压开始时间、PPE 的正确使用以及使用 PPE 时的不适/限制。
PPV 开始时间存在显著差异（顾问-护士团队：平均差异（MD）6.0s，95%CI 1.1 至 10.9 s；居民-护士团队：MD 11.0s，95%CI 1.9 至 20.0 s），气管插管持续时间（顾问-护士团队：MD 22.0s，95%CI 7.0 至 36.9 s；居民-护士团队：MD 9.1s，95%CI 0.1 至 18.1 s）和胸外按压（顾问-护士团队：MD 32.3s，95%CI 14.4 至 50.1 s；居民-护士团队：MD 9.1s，95%CI 0.1 至 18.1 s）。12 名参与者在进入产房后完成了着装。PPE 与视觉限制（48 名参与者中的 43 名）、运动不适（48 名参与者中的 42 名）、沟通限制（48 名参与者中的 32 名）和热不适（48 名参与者中的 29 名）有关。
在模型中，使用 PPE 会延迟新生儿复苏程序，可能具有临床影响。医护人员在佩戴 PPE 时报告了限制和不适。
NCT04666233。
