Effect of Wearing Personal Protective Equipment (PPE) on CPR Quality in Times of the COVID-19 Pandemic—A Simulation, Randomised Crossover Trial

Cardiopulmonary resuscitation (CPR) is considered an aerosol-generating procedure. Consequently, COVID-19 resuscitation guidelines recommend the use of personal protective equipment (PPE) during resuscitation. In this simulation of randomised crossover trials, we investigated the influence of PPE on the quality of chest compressions (CCs). Thirty-four emergency medical service BLS-providers performed two 20 min CPR sequences (five 2 min cycles alternated by 2 min of rest) on manikins, once with and once without PPE, in a randomised order. The PPE was composed of a filtering facepiece 3 FFP3 mask, safety glasses, gloves and a long-sleeved gown. The primary outcome was defined as the difference between compression depth with and without PPE; secondary outcomes were defined as differences in CC rate, release and the number of effective CCs. The participants graded fatigue and performance, while generalised estimating equations (GEE) were used to analyse data. There was no significant difference in CC quality between sequences without and with PPE regarding depth (mean depth 54 ± 5 vs. 54 ± 6 mm respectively), rate (mean rate 119 ± 9 and 118 ± 6 compressions per minute), release (mean release 2 ± 2 vs. 2 ± 2 mm) and the number of effective CCs (43 ± 18 vs. 45 ± 17). The participants appraised higher fatigue when equipped with PPE in comparison to when equipped without PPE (p < 0.001), and lower performance was appraised when equipped with PPE in comparison to when equipped without PPE (p = 0.031). There is no negative effect of wearing PPE on the quality of CCs during CPR in comparison to not wearing PPE.

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Influence of Personal Protective Equipment on the Quality of Chest Compressions: A Meta-Analysis of Randomized Controlled Trials

Frontiers in Medicine ◽

10.3389/fmed.2021.733724 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ying Cui ◽

Siyi Jiang

Keyword(s):

Personal Protective Equipment ◽

Meta Analysis ◽

Controlled Trials ◽

Protective Equipment ◽

Chest Compressions ◽

Randomized Controlled ◽

Significant Difference ◽

Simulation Based ◽

Reduced Rate

Background: Randomized controlled trials (RCTs) evaluating the influence of personal protective equipment (PPE) on quality of chest compressions during cardiopulmonary resuscitation (CPR) showed inconsistent results. Accordingly, a meta-analysis was performed to provide an overview.Methods: Relevant studies were obtained by search of Medline, Embase, and Cochrane's Library databases. A random-effect model incorporating the potential heterogeneity was used to pool the results.Results: Six simulation-based RCTs were included. Overall, pooled results showed that there was no statistically significant difference between the rate [mean difference (MD): −1.70 time/min, 95% confidence interval (CI): −5.77 to 2.36, P = 0.41, I2 = 80%] or the depth [MD: −1.84 mm, 95% CI: −3.93 to 0.24, P = 0.11, I2 = 73%] of chest compressions performed by medical personnel with and without PPE. Subgroup analyses showed that use of PPE was associated with reduced rate of chest compressions in studies before COVID-19 (MD: −7.02 time/min, 95% CI: −10.46 to −3.57, P < 0.001), but not in studies after COVID-19 (MD: 0.14 time/min, 95% CI: −5.77 to 2.36, P = 0.95). In addition, PPE was not associated with significantly reduced depth of chest compressions in studies before (MD: −3.34 mm, 95% CI: −10.29 to −3.62, P = 0.35) or after (MD: −0.97 mm, 95% CI: −2.62 to 0.68, P = 0.25) COVID-19. No significant difference was found between parallel-group and crossover RCTs (P for subgroup difference both > 0.05).Conclusions: Evidence from simulation-based RCTs showed that use of PPE was not associated with reduced rate or depth of chest compressions in CPR.

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RELAÇÃO ENTRE NÍVEIS DE RUÍDO, PRODUTIVIDADE E USO DE EPI EM UMA PEQUENA EMPRESA CALÇADISTA

Colloquium Exactarum ◽

10.5747/ce.2021.v13.n1.e346 ◽

2021 ◽

Vol 13 (1) ◽

pp. 19-29

Author(s):

João Guilherme Marcato ◽

Rafael Zampieri Krambek ◽

Rafael Bellotti Moreno

Keyword(s):

Personal Protective Equipment ◽

Protective Equipment ◽

Small Enterprises ◽

Noise Levels ◽

Protective Devices ◽

Significant Difference ◽

Negative Effect ◽

Micro And Small Enterprises ◽

The Relationship

The effects of noise on health and productivity represent environmental and occupational issues fororganizations, which can be mitigated by awareness of the importance and adoption of personal protective equipment (PPE). However, the analysis of noise levels and the use ofthesaid equipment are neglected in micro and small enterprises (MSE’s). The present study aimed to identify the relationship between noise levels and productivity in a small footwear company, in which two time studies were conducted: with and without the useof hearing protective devices. The result showed that noise levels have a negative effect on productivityand the existence of a real and significant difference in the operator’s productivity with and without the use of PPE.

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Characterizing the Effects of Explosive Ordnance Disposal Operations on the Human Body While Wearing Heavy Personal Protective Equipment

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720821992623 ◽

2021 ◽

pp. 001872082199262

Author(s):

Yi-Ning Wu ◽

Adam Norton ◽

Michael R. Zielinski ◽

Pei-Chun Kao ◽

Andrew Stanwicks ◽

...

Keyword(s):

Human Body ◽

Personal Protective Equipment ◽

Evaluation Methodology ◽

Protective Equipment ◽

Physiological Measurement ◽

Cognitive Stress ◽

Explosive Ordnance Disposal ◽

And Performance ◽

Inspection Tasks ◽

Muscle Activations

Objective To provide a comprehensive characterization of explosive ordnance disposal (EOD) personal protective equipment (PPE) by evaluating its effects on the human body, specifically the poses, tasks, and conditions under which EOD operations are performed. Background EOD PPE is designed to protect technicians from a blast. The required features of protection make EOD PPE heavy, bulky, poorly ventilated, and difficult to maneuver in. It is not clear how the EOD PPE wearer physiologically adapts to maintain physical and cognitive performance during EOD operations. Method Fourteen participants performed EOD operations including mobility and inspection tasks with and without EOD PPE. Physiological measurement and kinematic data recording were used to record human physiological responses and performance. Results All physiological measures were significantly higher during the mobility and the inspection tasks when EOD PPE was worn. Participants spent significantly more time to complete the mobility tasks, whereas mixed results were found in the inspection tasks. Higher back muscle activations were seen in participants who performed object manipulation while wearing EOD PPE. Conclusion EOD operations while wearing EOD PPE pose significant physical stress on the human body. The wearer’s mobility is impacted by EOD PPE, resulting in decreased speed and higher muscle activations. Application The testing and evaluation methodology in this study can be used to benchmark future EOD PPE designs. Identifying hazards posed by EOD PPE lays the groundwork for developing mitigation plans, such as exoskeletons, to reduce physical and cognitive stress caused by EOD PPE on the wearers without compromising their operational performance.

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Safe On-Boat Resuscitation by Lifeguards in COVID-19 Era: A Pilot Study Comparing Three Sets of Personal Protective Equipment

Prehospital and Disaster Medicine ◽

10.1017/s1049023x2100011x ◽

2021 ◽

pp. 1-7

Author(s):

Roberto Barcala-Furelos ◽

Cristian Abelairas-Gómez ◽

Alejandra Alonso-Calvete ◽

Francisco Cano-Noguera ◽

Aida Carballo-Fazanes ◽

...

Keyword(s):

Pilot Study ◽

Cardiopulmonary Resuscitation ◽

Severe Acute Respiratory Syndrome ◽

Personal Protective Equipment ◽

High Efficiency ◽

Prehospital Care ◽

Protective Equipment ◽

Preparation Time

Abstract Introduction: On-boat resuscitation can be applied by lifeguards in an inflatable rescue boat (IRB). Due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and recommendations for the use of personal protective equipment (PPE), prehospital care procedures need to be re-evaluated. The objective of this study was to determine how the use of PPE influences the amount of preparation time needed before beginning actual resuscitation and the quality of cardiopulmonary resuscitation (CPR; QCPR) on an IRB. Methods: Three CPR tests were performed by 14 lifeguards, in teams of two, wearing different PPE: (1) Basic PPE (B-PPE): gloves, a mask, and protective glasses; (2) Full PPE (F-PPE): B-PPE + a waterproof apron; and (3) Basic PPE + plastic blanket (B+PPE). On-boat resuscitation using a bag-valve-mask (BVM) and high efficiency particulate air (HEPA) filter was performed sailing at 20km/hour. Results: Using B-PPE takes less time and is significantly faster than F-PPE (B-PPE 17 [SD = 2] seconds versus F-PPE 69 [SD = 17] seconds; P = .001), and the use of B+PPE is slightly higher (B-PPE 17 [SD = 2] seconds versus B+PPE 34 [SD = 6] seconds; P = .002). The QCPR remained similar in all three scenarios (P >.05), reaching values over 79%. Conclusion: The use of PPE during on-board resuscitation is feasible and does not interfere with quality when performed by trained lifeguards. The use of a plastic blanket could be a quick and easy alternative to offer extra protection to lifeguards during CPR on an IRB.

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Students’ satisfaction with hostel accommodations in higher education institutions

Journal of Engineering Design and Technology ◽

10.1108/jedt-04-2017-0036 ◽

2017 ◽

Vol 15 (5) ◽

pp. 652-666 ◽

Cited By ~ 5

Author(s):

Ayodeji Emmanuel Oke ◽

Clinton Ohis Aigbavboa ◽

Marcia M. Raphiri

Keyword(s):

Higher Education ◽

Ethnic Groups ◽

Higher Education Institutions ◽

Item Score ◽

Content Type ◽

Significant Difference ◽

The Difference ◽

Higher Institutions ◽

Students Satisfaction

Purpose There are several types of accommodation available to students of higher education institutions, and it is the responsibility of the institutions to focus on factors that can attract and retain students to their residences. This study aims to investigate satisfaction of higher institutions students with on-campus accommodation with an emphasis on the ethnicity of the students. Design/methodology/approach Using convenience sampling method, questionnaires were administered to students of selected residences in the study area. Mean item score was used to rank identified factors, whereas mean gap and Kruskal–Wallis K-test were adopted to examine the difference in opinion of students from various ethnic groups. Findings Overall, major features that make students dissatisfied with university-owned accommodations are enforcement of rule that compels all students to move out with their belongings during each recess, the effectiveness of the lift system, the size of wardrobe and closet, laundry service in the residence, numbers of electrical sockets and window quality. Considering dwelling unit features, neighbourhood, environmental, building quality and services provided by residence management, this study reveals that there is a significant difference in the satisfaction of students of diverse ethnic groups with their accommodation. Research limitations/implications The study was limited to on-campus residences owned by higher education institutions in South Africa. However, the findings of the study can be adopted for off-campus residences, and such owned by private individuals, agencies and other bodies provided are approved by the institutions. Originality/value The findings of this study will help management of higher education institutions to improve quality of services in their residences for the satisfaction of their students. Developers, contractors and other stakeholders involved in construction of these residences will also find the findings useful in designing and construction of the facilities.

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Association of Blood and Urine Parameter Value Change With the Amount of Consumed Water Regime and Sample Sampling in Healthy Individuals

10.21203/rs.3.rs-258592/v1 ◽

2021 ◽

Author(s):

Snezana M Jovicic

Keyword(s):

Water Intake ◽

Freezing Point ◽

Freezing Point Depression ◽

Sodium Potassium ◽

Significant Difference ◽

Urine Biomarker ◽

Concentration Changes ◽

The Difference ◽

And Gender

Abstract Background: Understanding the effect of pre-analytical factors is important for data quality of bio-specimens and health status. The study examines the effect of 9-days fluid intake and 2-time sampling on concentration changes of 7-Urine and 17-Blood variables. Material and Method: SPSS software v23.0 applies to data processing. The group of 23 healthy subjects divide based on water intake and gender. Results: A statistically significant difference(p<0.01) between 1st/2nd sampling is confirmed for Freezing point depression, Sodium, Potassium, Creatinine Urea and Urate in Urine and Urea, Urate, Glucose, Hematocrit, Thrombocyte in Blood. The difference between water intake after 1st sampling is confirmed (p<0.01) for Freezing point depression, Sodium, Urate and(p<0.05) for Potassium(p<0.05), Chloride(p<0.05), Creatinine(p<0.05), Urate, Urea in Urine and Potassium(p<0.01) and Chloride(p<0.05) in Blood. Difference between gender exists for Urea(p<0.05) in Urine after 2nd sampling and Urate(P<0.01), Glucose(p<0.01/0.05), Ht(p<0.01/0.05) after 1st and 2nd sampling and MCHC(p<0.01) after 2nd sampling in Blood samples.Conclusion: Water intake increases blood and urine biomarker range after sampling.

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PERBANDINGAN KUALITAS PRODUK DAN MINAT MENABUNG PADA LPD DESA ADAT TAJUN DENGAN DESA ADAT TEGAL

Agrisocionomics Jurnal Sosial Ekonomi Pertanian ◽

10.14710/agrisocionomics.v4i1.5373 ◽

2020 ◽

Vol 4 (1) ◽

pp. 59-67

Author(s):

Eka Swarnadi Luh ◽

Ketut Budi Susrusa ◽

Ida Ayu Listia Dewi

Keyword(s):

Product Quality ◽

Financial Institutions ◽

Rapid Development ◽

Research Data ◽

The Other ◽

Physical Evidence ◽

Significant Difference ◽

The Difference ◽

Better Than

LPDs are non-bank financial institutions that are regulated and approved by the Regional Regulations of the Province of Bali. The management of LPD is fully handed over to the relevant Pakraman village. In line with the rapid development of LPDs, it turns out that on the other hand it shows diverse performance, so that LPDs need to pay attention to the level of product quality and customer interest in the products offered. The purpose of the study was to determine the comparison of product quality and interest in saving at the Tajun Traditional Village LPD with the Traditional Village of Tegal. The number of samples from Tajun Adat Village LPD was 98 people and the LPD of Tegal Traditional Village was 84 people. The research data were analyzed by the Mann-Whitney Test. The results showed that there was a significant difference between the quality of the products of the Adat Village of Tajun LPD and the Traditional Village of Tegal. This difference is indicated by indicators of physical evidence, reliability, responsiveness and empathy. The product quality of Tajun Adat Village's LPD is better than the traditional village of Tegal. There is a significant difference between the interest in saving the traditional village of Tajun LPD and the traditional village of Tegal. The difference is in the indicator of confidence. Interest in Saving Tajun Indigenous Village LPD is higher than the Traditional Village of Tegal.

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The effect of continuous care model-based intervention on the quality of sleep in menopausal women: A clinical trial study

10.21203/rs.2.14033/v1 ◽

2019 ◽

Author(s):

Farzaneh AKBARI ◽

sousan Heydarpour ◽

Nader Salari

Keyword(s):

Clinical Trial ◽

Intervention Group ◽

Control Group ◽

Quality Of Sleep ◽

Care Model ◽

Continuous Care ◽

Menopausal Women ◽

Significant Difference ◽

The Difference

Abstract BACKGROUND Sleep disorder, brings in many physical, behavioral, and mental problems. Applying continuous care model leads to proper recognition of the patient’s problems and involves the patient in solving health problems. This study aimed to determine the effect of continuous care model on the quality of sleep in menopausal women. METHODS AND MATERIALS A random clinical trial study was carried out with participation of 110 menopausal women visiting Kermanshah-based clinics (the west of Iran) in 2017. The participants were randomly assigned to intervention (n=55) and control (n=55) groups. The control group received the routine cares and in addition to the routine cares the intervention group attended four weekly group consultation sessions (60-90min). The quality of sleep in the two groups was assessed using Pittsburg Sleep Quality Index before, immediately after, and one month after the intervention. Data analyses were done using independent t-test, ANOVA with frequent measures, Friedman’s test, Wilcoxon’s post hoc test, and X2 test in SPSS (24). RESULTS The mean scores of quality of sleep before and after the intervention were significantly different in the intervention group (p=0.001). There was no significant difference between the two groups in terms of quality of sleep before (p=0.140) and immediately after the intervention (p=0.168). However, one month after, the difference between the two groups was significant (P<0.001). CONCLUSION Implementation of the continuous care model led to an improvement of quality of sleep in the menopausal women.

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Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.128 ◽

2020 ◽

pp. 1-8

Author(s):

Maybelle Kou ◽

Aaron J. Donoghue ◽

Helen Stacks ◽

Adam Kochman ◽

Meghan Semião ◽

...

Keyword(s):

Pediatric Patient ◽

Personal Protective Equipment ◽

Clinical Care ◽

Chemical Exposure ◽

Task Completion ◽

Protective Equipment ◽

Signed Rank ◽

The Difference ◽

Simulation Center ◽

Bag Mask Ventilation

ABSTRACT Background: Personal protective equipment (PPE) is worn by prehospital providers (PHPs) for protection from hazardous exposures. Evidence regarding the ability of PHPs to perform resuscitation procedures has been described in adult but not pediatric models. This study examined the effects of PPE on the ability of PHPs to perform resuscitation procedures on pediatric patients. Methods: This prospective study was conducted at a US simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. During each session, they performed timed sets of psychomotor tasks simulating clinical care of a critically ill pediatric patient. The difference in time to completion between baseline and PPE sessions per task was examined using Wilcoxon signed-rank tests. Results: A total of 50 paramedics completed both sessions. Median times for task completion at the PPE sessions increased significantly from baseline for several procedures: tracheal intubation (+4.5 s; P = 0.01), automated external defibrillator (AED) placement (+9.5 s; P = 0.01), intraosseous line insertion (+7 s; P < 0.0001), tourniquet (+8.5 s; P < 0.0001), intramuscular injection (+21-23 s, P < 0.0001), and pulse oximetry (+4 s; P < 0.0001). There was no significant increase in completion time for bag-mask ventilation or autoinjector use. Conclusions: PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.

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Comparing Training Techniques in Personal Protective Equipment Use

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000564 ◽

2020 ◽

Vol 35 (4) ◽

pp. 364-371 ◽

Cited By ~ 1

Author(s):

Richard J. Salway ◽

Trenika Williams ◽

Camilo Londono ◽

Patricia Roblin ◽

Kristi Koenig ◽

...

Keyword(s):

Sample Size ◽

Personal Protective Equipment ◽

Emergency Preparedness ◽

Null Hypothesis ◽

Small Sample ◽

Protective Equipment ◽

Video Training ◽

Significant Difference ◽

Demonstration Video ◽

Training Modalities

AbstractIntroduction:Physicians’ management of hazardous material (HAZMAT) incidents requires personal protective equipment (PPE) utilization to ensure the safety of victims, facilities, and providers; therefore, providing effective and accessible training in its use is crucial. While an emphasis has been placed on the importance of PPE, there is debate about the most effective training methods. Circumstances may not allow for a traditional in-person demonstration; an accessible video training may provide a useful alternative.Hypothesis:Video training of Emergency Medicine (EM) residents in the donning and doffing of Level C PPE is more effective than in-person training.Null Hypothesis:Video training of EM residents in the donning and doffing of Level C PPE is equally effective compared with in-person training.Methods:A randomized, controlled pilot trial was performed with 20 EM residents as part of their annual Emergency Preparedness training. Residents were divided into four groups, with Group 1 and Group 2 viewing a demonstration video developed by the Emergency Preparedness Team (EPT) and Group 3 and Group 4 receiving the standard in-person demonstration training by an EPT member. The groups then separately performed a donning and doffing simulation while blinded evaluators assessed critical tasks utilizing a prepared evaluation tool. At the drill’s conclusion, all participants also completed a self-evaluation survey about their subjective interpretations of their respective trainings.Results:Both video and in-person training modalities showed significant overall improvement in participants’ confidence in doffing and donning PPE equipment (P <.05). However, no statistically significant difference was found in the number of failed critical tasks in donning or doffing between the training modalities (P >.05). Based on these results, the null hypothesis cannot be rejected. However, these results were limited by the small sample size and the study was not sufficiently powered to show a difference between training modalities.Conclusion:In this pilot study, video and in-person training were equally effective in training for donning and doffing Level C PPE, with similar error rates in both modalities. Further research into this subject with an appropriately powered study is warranted to determine whether this equivalence persists using a larger sample size.

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