Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review
Background: The impact of wearing personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR) on CPR quality and patient outcomes is unclear. This systematic review aimed to examine whether wearing PPE during resuscitation affects patient outcomes, CPR quality and rescuer fatigue....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520423000413 |
| _version_ | 1797820600449761280 |
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| author | Sung Phil Chung Ziad Nehme Nicholas J. Johnson Anthony Lagina Janet Bray |
| author_facet | Sung Phil Chung Ziad Nehme Nicholas J. Johnson Anthony Lagina Janet Bray |
| author_sort | Sung Phil Chung |
| collection | DOAJ |
| description | Background: The impact of wearing personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR) on CPR quality and patient outcomes is unclear. This systematic review aimed to examine whether wearing PPE during resuscitation affects patient outcomes, CPR quality and rescuer fatigue. Methods: In this review registered in PROSPERO (CRD42022347746), we searched Medline, EMBASE and Cochrane library between 2000 and 2022. The inclusion criteria were studies: in actual or simulated cardiac arrest; comparing PPE with no PPE; and randomised controlled trials and observational studies with a English abstract. Risk of bias was assessed using Cochrane's Risk of Bias-2 and ROBINS-I tools and outcomes assessed with GRADE. We conducted a meta-analysis according to the study design. Quantitative data synthesis was done using a random-effect model incorporating the potential heterogeneity. Results: A total of 17 simulation-based studies and 1 clinical study were included. All outcomes were judged to be very low certainty of evidence, subject to high risk of bias. The clinical study showed no difference in survival comparing enhanced and conventional PPE. Meta-analysis of 11 RCTs and 6 observational studies found no difference in CPR quality in rescuers wearing PPE compared with no PPE. Pooled rescuer fatigue was significantly worse in the PPE group (mean difference, 2.7 VAS score out of 10; 95% CI, 1.4–4.0). Conclusions: PPE was not associated with reduced CPR quality or lower cardiac arrest survival. Rescuers wearing PPE may report more fatigue. This finding was mainly derived from simulation studies, additional clinical studies are needed. |
| first_indexed | 2024-03-13T09:40:42Z |
| format | Article |
| id | doaj.art-a3f7c7bb28a8477b817448e4e173850a |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-03-13T09:40:42Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-a3f7c7bb28a8477b817448e4e173850a2023-05-25T04:25:20ZengElsevierResuscitation Plus2666-52042023-06-0114100398Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic reviewSung Phil Chung0Ziad Nehme1Nicholas J. Johnson2Anthony Lagina3Janet Bray4Department of Emergency Medicine, Yonsei University of Medical College, Seoul, Korea; Corresponding author at: Department of Emergency Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, 06723, Seoul, Republic of Korea.Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria, AustraliaDepartment of Emergency Medicine & Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA, USADepartment of Emergency Medicine, Wayne State University, Detroit, MI, USASchool of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit, Curtin University, Perth, Western Australia, AustraliaBackground: The impact of wearing personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR) on CPR quality and patient outcomes is unclear. This systematic review aimed to examine whether wearing PPE during resuscitation affects patient outcomes, CPR quality and rescuer fatigue. Methods: In this review registered in PROSPERO (CRD42022347746), we searched Medline, EMBASE and Cochrane library between 2000 and 2022. The inclusion criteria were studies: in actual or simulated cardiac arrest; comparing PPE with no PPE; and randomised controlled trials and observational studies with a English abstract. Risk of bias was assessed using Cochrane's Risk of Bias-2 and ROBINS-I tools and outcomes assessed with GRADE. We conducted a meta-analysis according to the study design. Quantitative data synthesis was done using a random-effect model incorporating the potential heterogeneity. Results: A total of 17 simulation-based studies and 1 clinical study were included. All outcomes were judged to be very low certainty of evidence, subject to high risk of bias. The clinical study showed no difference in survival comparing enhanced and conventional PPE. Meta-analysis of 11 RCTs and 6 observational studies found no difference in CPR quality in rescuers wearing PPE compared with no PPE. Pooled rescuer fatigue was significantly worse in the PPE group (mean difference, 2.7 VAS score out of 10; 95% CI, 1.4–4.0). Conclusions: PPE was not associated with reduced CPR quality or lower cardiac arrest survival. Rescuers wearing PPE may report more fatigue. This finding was mainly derived from simulation studies, additional clinical studies are needed.http://www.sciencedirect.com/science/article/pii/S2666520423000413Cardiopulmonary resuscitationChest compressionPersonal protective equipment |
| spellingShingle | Sung Phil Chung Ziad Nehme Nicholas J. Johnson Anthony Lagina Janet Bray Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review Resuscitation Plus Cardiopulmonary resuscitation Chest compression Personal protective equipment |
| title | Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review |
| title_full | Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review |
| title_fullStr | Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review |
| title_full_unstemmed | Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review |
| title_short | Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review |
| title_sort | effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes a systematic review |
| topic | Cardiopulmonary resuscitation Chest compression Personal protective equipment |
| url | http://www.sciencedirect.com/science/article/pii/S2666520423000413 |
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