Life-saving Procedures Performed while wearing CBRNe Personal Protective Equipment: A Manikin Randomized Trial (1090-004195)
Start time: Tuesday, January 26, 2021, 8:00 AM End time: Tuesday, January 26, 2021, 9:00 AM Session Type: Research Abstracts (Completed Studies)
Chemical-Biological-Radiological-Nuclear-explosives (CBRNe) are complex events. Decontamination is mandatory to avoid harm and contain hazardous materials, but can delay care. Therefore, the stabilization of patients in the warm zone seems reasonable, but research is limited. Moreover, subjects involved in biological events are considered infectious even after decontamination, and need to be managed while wearing personal protective equipment (PPE), as seen with Ebola and coronavirus disease (COVID-19) pandemic. With this manikin trial we assessed the impact of CBRNe personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR) and combat casualty care procedures.
We compared procedures performed by emergency medicine and anesthesiology senior residents, randomized in two groups (CBRNe PPE versus no PPE). Chest compressions (CCs) depth was defined as the primary outcome. Time to completion was calculated for: tourniquet application; tension pneumothorax needle decompression; peripheral venous access (PVA) and intraosseous access (IO) positioning; drug preparation and administration. A questionnaire was delivered to evaluate participants’ perception.
36 residents participated. No significant difference between the groups in CCs depth (mean difference: 0.26 cm [95% CI: -0.26, 0.77 cm; p = 0.318]), as well as for CCs rate, CCs complete release, and time for drugs preparation and administration was detected. PPE contributed to significantly higher times for tourniquet application, tension pneumothorax decompression, PVA and IO positioning. The residents found simulation relevant to the residencies’ core curriculum.
This study suggests that CPR can be performed while wearing PPE without impacting quality, while other tasks requiring higher dexterity can be significantly impaired by PPE.