Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Apr 1;134(4):518-525.
doi: 10.1097/ALN.0000000000003684.

COVID-19, Personal Protective Equipment, and Human Performance

Review

COVID-19, Personal Protective Equipment, and Human Performance

Keith J Ruskin et al. Anesthesiology. .

Abstract

Clinicians who care for patients infected with coronavirus disease 2019 (COVID-19) must wear a full suite of personal protective equipment, including an N95 mask or powered air purifying respirator, eye protection, a fluid-impermeable gown, and gloves. This combination of personal protective equipment may cause increased work of breathing, reduced field of vision, muffled speech, difficulty hearing, and heat stress. These effects are not caused by individual weakness; they are normal and expected reactions that any person will have when exposed to an unusual environment. The physiologic and psychologic challenges imposed by personal protective equipment may have multiple causes, but immediate countermeasures and long-term mitigation strategies can help to improve a clinician's ability to provide care. Ultimately, a systematic approach to the design and integration of personal protective equipment is needed to improve the safety of patients and clinicians.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
To accomplish an intubation, a clinician needs cognitive, visual, and motor skills. Wearing personal protective equipment may additively impair all three of these skills. Mitigating impairment in any domain may therefore improve performance. Based on the Task-Taxon-Task (T3) Method.

Comment in

  • Personal Protective Equipment: Comment.
    Johnstone RE. Johnstone RE. Anesthesiology. 2021 Oct 1;135(4):763-764. doi: 10.1097/ALN.0000000000003902. Anesthesiology. 2021. PMID: 34344020 Free PMC article. No abstract available.
  • Personal Protective Equipment: Reply.
    Ruskin KJ, Ruskin AC, Musselman BT, Harvey JR, Nesthus TE, O'Connor M. Ruskin KJ, et al. Anesthesiology. 2021 Oct 1;135(4):764-765. doi: 10.1097/ALN.0000000000003901. Anesthesiology. 2021. PMID: 34370828 Free PMC article. No abstract available.

References

    1. Lee HP, Wang DY: Objective assessment of increase in breathing resistance of N95 respirators on human subjects. Ann Occup Hyg. 2011; 55:917–21 - PubMed
    1. Visentin LM, Bondy SJ, Schwartz B, Morrison LJ: Use of personal protective equipment during infectious disease outbreak and nonoutbreak conditions: A survey of emergency medical technicians. CJEM. 2015; 11:44–56 - PubMed
    1. Castle N, Owen R, Hann M, Clark S, Reeves D, Gurney I: Impact of chemical, biological, radiation, and nuclear personal protective equipment on the performance of low- and high-dexterity airway and vascular access skills. Resuscitation. 2009; 80:1290–5 - PubMed
    1. Loibner M, Hagauer S, Schwantzer G, Berghold A, Zatloukal K: Limiting factors for wearing personal protective equipment (PPE) in a health care environment evaluated in a randomised study. PLoS One. 2019; 14:e0210775. - PMC - PubMed
    1. Yánez Benítez C, Güemes A, Aranda J, Ribeiro M, Ottolino P, Di Saverio S, Alexandrino H, Ponchietti L, Blas JL, Ramos JP, Rangelova E, Muñoz M, Yánez C, Sr; International Cooperation Group on PPE and Emergency Surgery: Impact of personal protective equipment on surgical performance during the COVID-19 pandemic. World J Surg. 2020; 44:2842–7 - PMC - PubMed

Publication types