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Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

  • Maybelle Kou (a1) (a2), Aaron J. Donoghue (a3), Helen Stacks (a2), Adam Kochman (a1), Meghan Semiao (a2), Mark Nash (a4), David Siegel (a5), Lawrence Ku (a6), Julie Debski (a7), Jia-Yuh Chen (a7), Gaurav Sharma (a7), Leigh Gosnell (a6), Steven Krug (a8), Mark D. Adler (a8) (a9) and on behalf of the Best Pharmaceuticals for Children Act – Pediatric Trials Network...

Abstract

Objective:

Personal protective equipment (PPE) is worn by prehospital providers (PHPs) for protection from hazardous exposures. Evidence regarding the ability of PHPs to perform resuscitation procedures has been described in adult but not pediatric models. This study examined the effects of PPE on the ability of PHPs to perform resuscitation procedures on pediatric patients.

Methods:

This prospective study was conducted at a U.S. simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. During each session, they performed timed sets of psychomotor tasks simulating clinical care of a critically ill pediatric patient. The difference in time to completion between baseline and PPE sessions per task was examined using Wilcoxon signed-rank tests.

Results:

A total of 50 paramedics completed both sessions. Median times for task completion at the PPE sessions increased significantly from baseline for several procedures: tracheal intubation (+4.5 seconds, P=0.01), automated external defibrillator (AED) placement (+9.5 seconds, P=0.01), intraosseous line insertion (+7 seconds, P<.0001), tourniquet (+8.5 seconds, P<.0001), intramuscular injection (+21–23 seconds, P<.0001), and pulse oximetry (+4 seconds, P<.0001). There was no significant increase in completion time for bag-mask ventilation or autoinjector use.

Conclusions:

PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.

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Copyright

Corresponding author

Corresponding Author: Maybelle Kou, MD, Inova Fairfax Medical Center/Inova Childrens’ Hospital, 3300 Gallows Road, Falls Church, VA22042. Tel: +703-776-4398; e-mail: Maybelle.Kou@inova.org.

Footnotes

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See Acknowledgments.

This work was funded under National Institute of Child Health and Human Development (NICHD) contract HHSN275201000003I for the Pediatric Trials Network (PI Danny Benjamin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

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References

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* See Acknowledgments.

This work was funded under National Institute of Child Health and Human Development (NICHD) contract HHSN275201000003I for the Pediatric Trials Network (PI Danny Benjamin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

Keywords

Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

  • Maybelle Kou (a1) (a2), Aaron J. Donoghue (a3), Helen Stacks (a2), Adam Kochman (a1), Meghan Semiao (a2), Mark Nash (a4), David Siegel (a5), Lawrence Ku (a6), Julie Debski (a7), Jia-Yuh Chen (a7), Gaurav Sharma (a7), Leigh Gosnell (a6), Steven Krug (a8), Mark D. Adler (a8) (a9) and on behalf of the Best Pharmaceuticals for Children Act – Pediatric Trials Network...

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