TY - JOUR
T1 - Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks
AU - Adler, Mark D.
AU - Krug, Steven
AU - Eiger, Carmel
AU - Good, Grace L.
AU - Kou, Maybelle
AU - Nash, Mark
AU - Henretig, Fred M.
AU - Hornik, Christoph P.
AU - Gosnell, Leigh
AU - Jia-Yuh, Chen
AU - Debski, Julie
AU - Sharma, Gaurav
AU - Siegel, David
AU - Donoghue, Aaron J.
N1 - Funding Information:
Disclosure: C.P.H. has received funding personally from Sarfez Pharma for consulting, as well as grant money from Purdue Pharma LLP (to Duke Clinical Research Institute) and the National Institutes of Health (NIH) (to Duke Clinical Research Institute) to conduct research. The other authors declare no conflict of interest.
Funding Information:
This work was funded under the National Institute of Child Health and Human Development contract HHSN275201000003I for the Pediatric Trials Network (PI Danny Benjamin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Best Pharmaceuticals for Children Act–Pediatric Trials Network is an alliance of clinical research sites cooperating in the design and conduct of pediatric clinical trials. The Network provided financial and logistical support for the research presented herein under the above contract. The Network is coordinated by the Duke Clinical Research Institute, with data analysis support from the Emmes Company.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - 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.
AB - 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.
KW - Personal protective equipment
KW - Procedural performance
KW - Resuscitation
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UR - http://www.scopus.com/inward/citedby.url?scp=85121260396&partnerID=8YFLogxK
U2 - 10.1097/PEC.0000000000002028
DO - 10.1097/PEC.0000000000002028
M3 - Article
C2 - 32097378
AN - SCOPUS:85121260396
SN - 0749-5161
VL - 37
SP - E1326-E1330
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 12
ER -
