Exploration of strategies to reduce aerosol-spread during chest compressions: A simulation and cadaver model

Abstract

Objective: To evaluate the effect of strategies to reduce the spread of simulated aerosol during chest compressions on manikin and cadaver experimental models.

Methods: To evaluate aerosol-spread we nebulized ultraviolet sensitive detergents into the artificial airway of a resuscitation dummy and performed CPR. The spread of the visualized aerosol was documented by a camera. In a further approach we applied nebulized detergents into the airways of human cadavers and detected the simulated spread on the same way. Among others we did recordings with undergoing compression-only-CPR, with a surgical mask or an oxygen mask on the patients face and with an inserted supraglottic airway device with and without a connected airway filter.

Results: Most aerosol-spread at the direction of the provider was visualized during compression-only-CPR. The use of a surgical mask and of an oxygen mask on the patient's face deflected the spread. Inserting a supraglottic airway device connected to an airway filter lead to a remarkable reduction of aerosol-spread.

Conclusion: The early insertion of a supraglottic airway device connected to an airway filter before starting chest compression may be beneficial for staff protection during CPR.

Fig. 1

Details of the experimental setup of the simulation model and the cadaver model.

Fig. 2

Aerosol-spread during chest compression at the simulation model.

Fig. 3

Aerosol-spread during chest compression with different devices on the patient's face used in the simulation model (left) and in the cadaver model (right).

Fig. 4

Aerosol-spread during chest compression with a laryngeal tube used in the simulation model (left) and in the cadaver model (right).

Fig. 5

Aerosol-spread during chest compression at the simulation model with different techniques of airway management.