COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial
<i>Background:</i> Guidelines of cardiopulmonary resuscitation (CPR) recommend the use of personal protective equipment (PPE) during the resuscitation of COVID-19 patients. Data on the effects of PPE on rescuers’ stress level and quality of CPR are sparse and conflicting. This trial inve...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/19/5881 |
| _version_ | 1797478526433099776 |
|---|---|
| author | Timur Sellmann Maria Nur Dietmar Wetzchewald Heidrun Schwager Corvin Cleff Serge C. Thal Stephan Marsch |
| author_facet | Timur Sellmann Maria Nur Dietmar Wetzchewald Heidrun Schwager Corvin Cleff Serge C. Thal Stephan Marsch |
| author_sort | Timur Sellmann |
| collection | DOAJ |
| description | <i>Background:</i> Guidelines of cardiopulmonary resuscitation (CPR) recommend the use of personal protective equipment (PPE) during the resuscitation of COVID-19 patients. Data on the effects of PPE on rescuers’ stress level and quality of CPR are sparse and conflicting. This trial investigated the effects of PPE on team performance in simulated cardiac arrests. <i>Methods:</i> During the pandemic period, 198 teams (689 participants) performed CPR with PPE in simulated cardiac arrests (PPE group) and were compared with 423 (1451 participants) performing in identical scenarios in the pre-pandemic period (control group). Video recordings were used for data analysis. The primary endpoint was hands-on time. Secondary endpoints included a further performance of CPR and the perceived task load assessed by the NASA task-load index. <i>Results:</i> Hands-on times were lower in PPE teams than in the control group (86% (83–89) vs. 90% (87–93); difference 3, 95% CI for difference 3–4, <i>p</i> < 0.0001). Moreover, PPE teams made fewer change-overs and delayed defibrillation and administration of drugs. PPE teams perceived higher task loads (57 (44–67) vs. 63 (53–71); difference 6, 95% CI for difference 5–8, <i>p</i> < 0.0001) and scored higher in the domains physical and temporal demand, performance, and effort. Leadership allocation had no effect on primary and secondary endpoints. <i>Conclusions:</i> Having to wear PPE during CPR is an additional burden in an already demanding task. PPE is associated with an increase in perceived task load, lower hands-on times, fewer change-overs, and delays in defibrillation and the administration of drugs. (German study register number DRKS00023184). |
| first_indexed | 2024-03-09T21:33:05Z |
| format | Article |
| id | doaj.art-20f1d33fc2ec47b0933995bd2b4ffa68 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:33:05Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-20f1d33fc2ec47b0933995bd2b4ffa682023-11-23T20:50:24ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011119588110.3390/jcm11195881COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative TrialTimur Sellmann0Maria Nur1Dietmar Wetzchewald2Heidrun Schwager3Corvin Cleff4Serge C. Thal5Stephan Marsch6Department of Anaesthesiology and Intensive Care Medicine, Bethesda Hospital, 47053 Duisburg, GermanyInstitution for Emergency Medicine, 59755 Arnsberg, GermanyInstitution for Emergency Medicine, 59755 Arnsberg, GermanyInstitution for Emergency Medicine, 59755 Arnsberg, GermanyDepartment of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, GermanyDepartment of Anaesthesiology 1, Witten/Herdecke University, 58455 Witten, GermanyDepartment of Intensive Care, University Hospital, 4031 Basel, Switzerland<i>Background:</i> Guidelines of cardiopulmonary resuscitation (CPR) recommend the use of personal protective equipment (PPE) during the resuscitation of COVID-19 patients. Data on the effects of PPE on rescuers’ stress level and quality of CPR are sparse and conflicting. This trial investigated the effects of PPE on team performance in simulated cardiac arrests. <i>Methods:</i> During the pandemic period, 198 teams (689 participants) performed CPR with PPE in simulated cardiac arrests (PPE group) and were compared with 423 (1451 participants) performing in identical scenarios in the pre-pandemic period (control group). Video recordings were used for data analysis. The primary endpoint was hands-on time. Secondary endpoints included a further performance of CPR and the perceived task load assessed by the NASA task-load index. <i>Results:</i> Hands-on times were lower in PPE teams than in the control group (86% (83–89) vs. 90% (87–93); difference 3, 95% CI for difference 3–4, <i>p</i> < 0.0001). Moreover, PPE teams made fewer change-overs and delayed defibrillation and administration of drugs. PPE teams perceived higher task loads (57 (44–67) vs. 63 (53–71); difference 6, 95% CI for difference 5–8, <i>p</i> < 0.0001) and scored higher in the domains physical and temporal demand, performance, and effort. Leadership allocation had no effect on primary and secondary endpoints. <i>Conclusions:</i> Having to wear PPE during CPR is an additional burden in an already demanding task. PPE is associated with an increase in perceived task load, lower hands-on times, fewer change-overs, and delays in defibrillation and the administration of drugs. (German study register number DRKS00023184).https://www.mdpi.com/2077-0383/11/19/5881COVID-19personal protective equipmentcardiopulmonary resuscitationsimulationcontrolled trial |
| spellingShingle | Timur Sellmann Maria Nur Dietmar Wetzchewald Heidrun Schwager Corvin Cleff Serge C. Thal Stephan Marsch COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial Journal of Clinical Medicine COVID-19 personal protective equipment cardiopulmonary resuscitation simulation controlled trial |
| title | COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial |
| title_full | COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial |
| title_fullStr | COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial |
| title_full_unstemmed | COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial |
| title_short | COVID-19 CPR—Impact of Personal Protective Equipment during a Simulated Cardiac Arrest in Times of the COVID-19 Pandemic: A Prospective Comparative Trial |
| title_sort | covid 19 cpr impact of personal protective equipment during a simulated cardiac arrest in times of the covid 19 pandemic a prospective comparative trial |
| topic | COVID-19 personal protective equipment cardiopulmonary resuscitation simulation controlled trial |
| url | https://www.mdpi.com/2077-0383/11/19/5881 |
| work_keys_str_mv | AT timursellmann covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT marianur covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT dietmarwetzchewald covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT heidrunschwager covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT corvincleff covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT sergecthal covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial AT stephanmarsch covid19cprimpactofpersonalprotectiveequipmentduringasimulatedcardiacarrestintimesofthecovid19pandemicaprospectivecomparativetrial |