Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY) Study: Secondary Workload and Provider Outcomes in a Simulation-Based Trial.

Autor:	Singer Harel D; Division of Emergency Medicine, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada., Lin Y; KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada., Lo CY; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA., Cheng A; Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Research Program, Alberta Children's Hospital, Calgary, AB, Canada., Davidson J; KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada., Chang TP; Department of Emergency Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA., Matava C; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada., Buyck M; Department of Mother and Child Medicine, Division of Pediatric Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland., Neveu G; Department of Respiratory Therapy, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada., Collia N; Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., Fayyaz J; Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., Manshadi K; Department of Emergency Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA., Levy A; Departments of Pediatrics and Emergency Medicine, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada., Pellerin S; Department of Emergency Medicine, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada., Pirie J; Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2024 Oct 01; Vol. 25 (10), pp. 918-927. Date of Electronic Publication: 2024 Jun 05.
DOI:	10.1097/PCC.0000000000003535
Abstrakt:	Objectives: An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of aerosol box use on patterns of HCP contamination during AGMPs. The objectives of this study are to: 1) evaluate the effect of aerosol box use on HCP workload, 2) identify factors associated with HCP workload when using an aerosol box, and 3) describe the challenges perceived by HCPs of aerosol box use. Design: Simulation-based randomized trial, conducted from May to December 2021. Setting: Four pediatric simulation centers. Subjects: Teams of two HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box). Interventions: Each team performed three scenarios requiring different pediatric airway management (bag-valve-mask [BVM] ventilation, laryngeal mask airway [LMA] insertion, and endotracheal intubation [ETI] with video laryngoscopy) on a simulated COVID-19 patient. National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a standard tool that measures subjective workload with six subscales. Measurements and Main Results: A total of 64 teams (128 participants) were recruited. The use of aerosol box was associated with significantly higher frustration during LMA insertion (28.71 vs. 17.42; mean difference, 11.29; 95% CI, 0.92-21.66; p = 0.033). For ETI, there was a significant increase in most subscales in the intervention group, but there was no significant difference for BMV. Average NASA-TLX scores were all in the "low" range for both groups (range: control BVM 23.06, sd 13.91 to intervention ETI 38.15; sd 20.45). The effect of provider role on workloads was statistically significant only for physical demand ( p = 0.001). As the complexity of procedure increased (BVM → LMA → ETI), the workload increased in all six subscales ( p < 0.05). Conclusions: The use of aerosol box increased workload during ETI but not with BVM and LMA insertion. Overall workload scores remained in the "low" range, and there was no significant difference between airway provider and assistant. Competing Interests: Drs. Cheng’s, Collia’s, Manshadi’s, and Pirie’s institutions received funding from the Canadian Institutes for Health Research. Dr. Cheng’s institution received funding from the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE). The remaining authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
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