OBJECTIVE: We sought to determine whether the use of currently issued gowns delays initiation of chest compressions and ventilations during cardiopulmonary resuscitation and whether simple gown modifications can reduce this delay. METHODS: Firefighter defibrillation instructors were allocated into pairs and videotaped while performing standardized cardiac arrest scenarios. Three scenarios were compared: "no gown," "standard gown" and "modified gown." Key time intervals were extracted from videotaped data. RESULTS: Ninety-five scenarios were analyzed. Mean time interval to chest compression was 39 seconds (95% confidence interval [CI] 34-43) for "no gown" scenarios, 71 seconds (95% CI 66-77) for "standard gown" scenarios and 59 seconds (95% CI 54-63) for "modified gown" scenarios (p < 0.001). Time to first ventilation was 146 seconds (95% CI 134-158), 238 seconds (95% CI 224-253) and 210 seconds (95% CI 198-223) in the 3 groups, respectively (p < 0.001). Post hoc testing showed that the time differences between all groups were statistically significant. CONCLUSION: Standard gowns protect front-line care providers but cause significant delays to chest compressions and ventilations, potentially increasing patient morbidity and mortality. Minor gown modifications, including pre-tied neck straps and longer waist ties that tie in front, allow for easier use and shorter delays to time-critical interventions. Future research is required to reduce care delays while maintaining adequate protection of emergency medical service providers from infectious disease.
RCT Entities:
OBJECTIVE: We sought to determine whether the use of currently issued gowns delays initiation of chest compressions and ventilations during cardiopulmonary resuscitation and whether simple gown modifications can reduce this delay. METHODS: Firefighter defibrillation instructors were allocated into pairs and videotaped while performing standardized cardiac arrest scenarios. Three scenarios were compared: "no gown," "standard gown" and "modified gown." Key time intervals were extracted from videotaped data. RESULTS: Ninety-five scenarios were analyzed. Mean time interval to chest compression was 39 seconds (95% confidence interval [CI] 34-43) for "no gown" scenarios, 71 seconds (95% CI 66-77) for "standard gown" scenarios and 59 seconds (95% CI 54-63) for "modified gown" scenarios (p < 0.001). Time to first ventilation was 146 seconds (95% CI 134-158), 238 seconds (95% CI 224-253) and 210 seconds (95% CI 198-223) in the 3 groups, respectively (p < 0.001). Post hoc testing showed that the time differences between all groups were statistically significant. CONCLUSION: Standard gowns protect front-line care providers but cause significant delays to chest compressions and ventilations, potentially increasing patient morbidity and mortality. Minor gown modifications, including pre-tied neck straps and longer waist ties that tie in front, allow for easier use and shorter delays to time-critical interventions. Future research is required to reduce care delays while maintaining adequate protection of emergency medical service providers from infectious disease.
Authors: Myra H Wyckoff; Eunice M Singletary; Jasmeet Soar; Theresa M Olasveengen; Robert Greif; Helen G Liley; David Zideman; Farhan Bhanji; Lars W Andersen; Suzanne R Avis; Khalid Aziz; Jason C Bendall; David C Berry; Vere Borra; Bernd W Böttiger; Richard Bradley; Janet E Bray; Jan Breckwoldt; Jestin N Carlson; Pascal Cassan; Maaret Castrén; Wei-Tien Chang; Nathan P Charlton; Adam Cheng; Sung Phil Chung; Julie Considine; Daniela T Costa-Nobre; Keith Couper; Katie N Dainty; Peter G Davis; Maria Fernanda de Almeida; Allan R de Caen; Edison F de Paiva; Charles D Deakin; Therese Djärv; Matthew J Douma; Ian R Drennan; Jonathan P Duff; Kathryn J Eastwood; Walid El-Naggar; Jonathan L Epstein; Raffo Escalante; Jorge G Fabres; Joe Fawke; Judith C Finn; Elizabeth E Foglia; Fredrik Folke; Karoline Freeman; Elaine Gilfoyle; Craig A Goolsby; Amy Grove; Ruth Guinsburg; Tetsuo Hatanaka; Mary Fran Hazinski; George S Heriot; Karen G Hirsch; Mathias J Holmberg; Shigeharu Hosono; Ming-Ju Hsieh; Kevin K C Hung; Cindy H Hsu; Takanari Ikeyama; Tetsuya Isayama; Vishal S Kapadia; Mandira Daripa Kawakami; Han-Suk Kim; David A Kloeck; Peter J Kudenchuk; Anthony T Lagina; Kasper G Lauridsen; Eric J Lavonas; Andrew S Lockey; Carolina Malta Hansen; David Markenson; Tasuku Matsuyama; Christopher J D McKinlay; Amin Mehrabian; Raina M Merchant; Daniel Meyran; Peter T Morley; Laurie J Morrison; Kevin J Nation; Michael Nemeth; Robert W Neumar; Tonia Nicholson; Susan Niermeyer; Nikolaos Nikolaou; Chika Nishiyama; Brian J O'Neil; Aaron M Orkin; Osokogu Osemeke; Michael J Parr; Catherine Patocka; Jeffrey L Pellegrino; Gavin D Perkins; Jeffrey M Perlman; Yacov Rabi; Joshua C Reynolds; Giuseppe Ristagno; Charles C Roehr; Tetsuya Sakamoto; Claudio Sandroni; Taylor Sawyer; Georg M Schmölzer; Sebastian Schnaubelt; Federico Semeraro; Markus B Skrifvars; Christopher M Smith; Michael A Smyth; Roger F Soll; Takahiro Sugiura; Sian Taylor-Phillips; Daniele Trevisanuto; Christian Vaillancourt; Tzong-Luen Wang; Gary M Weiner; Michelle Welsford; Jane Wigginton; Jonathan P Wyllie; Joyce Yeung; Jerry P Nolan; Katherine M Berg Journal: Resuscitation Date: 2021-11-11 Impact factor: 5.262
Authors: Christopher M Watson; Jordan M Duval-Arnould; Michael C McCrory; Stephan Froz; Cheryl Connors; Trish M Perl; Elizabeth A Hunt Journal: Jt Comm J Qual Patient Saf Date: 2011-11
Authors: Ryan W Morgan; Martha Kienzle; Anita I Sen; Todd J Kilbaugh; Maya Dewan; Tia T Raymond; Adam S Himebauch; Robert A Berg; Ken Tegtmeyer; Vinay M Nadkarni; Alexis A Topjian; Robert M Sutton; Heather A Wolfe Journal: Pediatr Crit Care Med Date: 2020-09 Impact factor: 3.971