Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks.

Autor:	Adler MD, Krug S; From the Departments of Pediatrics., Eiger C; Clinical and Organizational Development, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL., Good GL; Center for Simulation, Advanced Education, and Innovation, Children's Hospital of Philadelphia, Philadelphia, PA., Kou M; Department of Emergency Medicine, Inova Fairfax Medical Campus, Falls Church., Nash M; Fairfax County Fire and Rescue Department, Hazardous Materials Response Team, Fairfax, VA., Henretig FM; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA., Hornik CP; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC., Gosnell L; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC., Chen JY; The Emmes Company, Rockville., Debski J; The Emmes Company, Rockville., Sharma G; The Emmes Company, Rockville., Siegel D; Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD., Donoghue AJ
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2021 Dec 01; Vol. 37 (12), pp. e1326-e1330.
DOI:	10.1097/PEC.0000000000002028
Abstrakt:	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. Competing Interests: 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. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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