Mark D Adler, Steven Krug1, Carmel Eiger2, Grace L Good3, Maybelle Kou4, Mark Nash5, Fred M Henretig6, Christoph P Hornik7, Leigh Gosnell7, Jia-Yuh Chen8, Julie Debski8, Gaurav Sharma8, David Siegel9, Aaron J Donoghue. 1. From the Departments of Pediatrics. 2. Clinical and Organizational Development, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. 3. Center for Simulation, Advanced Education, and Innovation, Children's Hospital of Philadelphia, Philadelphia, PA. 4. Department of Emergency Medicine, Inova Fairfax Medical Campus, Falls Church. 5. Fairfax County Fire and Rescue Department, Hazardous Materials Response Team, Fairfax, VA. 6. Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA. 7. Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. 8. The Emmes Company, Rockville. 9. Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Abstract
OBJECTIVES: Personal protective equipment (PPE) is worn by health care providers (HCPs) to protect against hazardous exposures. Studies of HCPs performing critical resuscitation tasks in PPE have yielded mixed results and have not evaluated performance in care of children. We evaluated the impacts of PPE on timeliness or success of emergency procedures performed by pediatric HCPs. METHODS: This prospective study was conducted at 2 tertiary children's hospitals. For session 1, HCPs (medical doctors and registered nurses) wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Differences in completion time per task were compared. RESULTS: There were no significant differences in medical doctor completion time across sessions. For registered nurses, there was a significant difference between baseline and PPE sessions for both defibrillation and IV placement tasks. Registered nurses were faster to defibrillate in Ebola PPE and slower when wearing chemical PPE (median difference, -3.5 vs 2 seconds, respectively; P < 0.01). Registered nurse IV placement took longer in Ebola and chemical PPE (5.5 vs 42 seconds, respectively; P < 0.01). After the PPE session, participants were significantly less likely to indicate that full-body PPE interfered with procedures, was claustrophobic, or slowed them down. CONCLUSIONS: Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE's impact on procedures performed in a clinical care context.
OBJECTIVES: Personal protective equipment (PPE) is worn by health care providers (HCPs) to protect against hazardous exposures. Studies of HCPs performing critical resuscitation tasks in PPE have yielded mixed results and have not evaluated performance in care of children. We evaluated the impacts of PPE on timeliness or success of emergency procedures performed by pediatric HCPs. METHODS: This prospective study was conducted at 2 tertiary children's hospitals. For session 1, HCPs (medical doctors and registered nurses) wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Differences in completion time per task were compared. RESULTS: There were no significant differences in medical doctor completion time across sessions. For registered nurses, there was a significant difference between baseline and PPE sessions for both defibrillation and IV placement tasks. Registered nurses were faster to defibrillate in Ebola PPE and slower when wearing chemical PPE (median difference, -3.5 vs 2 seconds, respectively; P < 0.01). Registered nurse IV placement took longer in Ebola and chemical PPE (5.5 vs 42 seconds, respectively; P < 0.01). After the PPE session, participants were significantly less likely to indicate that full-body PPE interfered with procedures, was claustrophobic, or slowed them down. CONCLUSIONS: Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE's impact on procedures performed in a clinical care context.
Authors: William J Brady; Summer Chavez; Michael Gottlieb; Stephen Y Liang; Brandon Carius; Alex Koyfman; Brit Long Journal: Am J Emerg Med Date: 2022-04-27 Impact factor: 4.093
Authors: Marek Malysz; Marek Dabrowski; Bernd W Böttiger; Jacek Smereka; Klaudia Kulak; Agnieszka Szarpak; Milosz Jaguszewski; Krzysztof J Filipiak; Jerzy R Ladny; Kurt Ruetzler; Lukasz Szarpak Journal: Cardiol J Date: 2020-05-18 Impact factor: 2.737
Authors: Aaron J Donoghue; Maybelle Kou; Grace L Good; Carmel Eiger; Mark Nash; Fred M Henretig; Helen Stacks; Adam Kochman; Julie Debski; Jia-Yuh Chen; Gaurav Sharma; Christoph P Hornik; Leigh Gosnell; David Siegel; Steven Krug; Mark D Adler Journal: Pediatr Emerg Care Date: 2020-06 Impact factor: 1.602
Authors: Torrey A Laack; Franziska Pollok; Benjamin J Sandefur; Aidan F Mullan; Christopher S Russi; Suraj M Yalamuri Journal: West J Emerg Med Date: 2020-08-17