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. 2021 Jun:44:235-240.
doi: 10.1016/j.ajem.2020.03.054. Epub 2020 Mar 31.

Are loose-fitting powered air-purifying respirators safe during chest compression? A simulation study

Soo Hyun Park  1 , Sung Yeon Hwang  1 , Guntak Lee  1 , Jong Eun Park  1 , Taerim Kim  1 , Tae Gun Shin  1 , Min Seob Sim  1 , Ik Joon Jo  1 , Seonwoo Kim  2 , Hee Yoon  3
Affiliations

Are loose-fitting powered air-purifying respirators safe during chest compression? A simulation study

Soo Hyun Park et al. Am J Emerg Med. 2021 Jun.

Abstract

Background: The application of appropriate personal protective equipment for respiratory protection to health care workers is a cornerstone for providing safe healthcare in emergency departments. We investigated the protective effect and usefulness of loose-fitting powered air-purifying respirators (PAPRs) during chest compression.

Methods: This was a single-center simulation study performed from May 2019 to July 2019 in a tertiary hospital. We measured the concentrations of ambient aerosol and particles inside the loose-fitting PAPR during chest compression, and this ratio was set as the simulated workplace protecting factor (SWPF). According to the National Institute for Occupational Safety and Health regulations, the assigned protection factor (APF) of loose-fitting PAPRs is 25. Thus, the loose-fitting PAPRs were assumed to have a protective effect when the SWPF were ≥ 250 (APF × 10). We measured the SWPF of PAPR in real time during chest compression and also investigated the problems encountered during its use.

Results: Ninety-one participants (median age 29 [interquartile range (IQR): 26-32] years; 74% female) completed the simulation. None of the participants failed with SWPF below 250 during three sessions of chest compression. The median (IQR) values of SWPF at three cycles were 17,063 (10,145-26,373), 15,683 (9477-32,394), and 16,960 (7695-27,279). There was no disconnection of equipment or mechanical failures during chest compression. In addition, most participants (83%) replied that they rarely or never experienced difficulty in verbal communication and felt that the loose-fitting PAPR was comfortable.

Conclusions: The loose-fitting PAPRs provided sufficient respiratory protection without disturbances during chest compression.

Keywords: Cardiopulmonary resuscitation; Chest; Compression; Infection control; Respiratory protective devices.

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Conflict of interest statement

Declaration of competing interest The authors have no potential conflicts of interest to declare.

Figures

Unlabelled Image
Graphical abstract
Fig. 1
Fig. 1
Flow of simulation. Abbreviations: PPT, power point; PAPR, powered air purifying respirator; SWPF, simulated workplace protection factor.
Fig. 2
Fig. 2
A loose-fitting PAPR. (A) loose-fitting hood (S-433 L-5) (B) breathing tube (BT-20 L) (C) P3 particulate filter (D) 8 h battery (5.2 V, NiMH) (E) Jupiter powered air turbo (3 M, St. Paul, MN). Abbreviations: PAPR, powered air-purifying respirator.
Fig. 3
Fig. 3
Simulation. (A) SWPF real-time monitor (B) SWPF tester (PortaCount Pro+8038) (C) particle generator (TSI model 8026) (D) CPR quality monitor.
Fig. 4
Fig. 4
The SWPF pattern of each participant over time. (A) first chest compression (B) second chest compression (C) third chest compression. Graphs show the pattern of SWPF change over time by using locally estimated scatterplot smoothing method. Abbreviations: SWPF, simulated workplace protection factor.
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References

    1. World World Health Organization . World Health Organization; 2014. Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care.https://apps.who.int/iris/handle/10665/112656 - PubMed
    1. Honda H., Iwata K. Personal protective equipment and improving compliance among healthcare workers in high-risk settings. Curr Opin Infect Dis. 2016;29:400–406. doi: 10.1097/QCO.0000000000000280. - DOI - PubMed
    1. Liang S.Y., Riethman M., Fox J. Infection prevention for the emergency department: out of reach or standard of care? Emerg Med Clin North Am. 2018;36:873–887. doi: 10.1016/j.emc.2018.06.013. - DOI - PMC - PubMed
    1. Cho S.Y., Kang J.M., Ha Y.E., Park G.E., Lee J.Y., Ko J.H., et al. MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. Lancet. 2016;388:994–1001. doi: 10.1016/S0140-6736(16)30623-7. - DOI - PMC - PubMed
    1. Al-Tawfiq J.A., Memish Z.A. Middle East respiratory syndrome coronavirus in the last two years: health care workers still at risk. Am J Infect Control. 2019;47:1167–1170. doi: 10.1016/j.ajic.2019.04.007. - DOI - PMC - PubMed