Comparison of conventional and powered air-purifying respirators during resuscitation of CBRN victims

Schumacher, Jan; Weidelt, L.; Gray, Stuart A.; Brinker, A.; Stratling, W.

doi:10.1097/00003643-200805001-00605

Cited by 4 publications

(10 citation statements)

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“…The powered respirator ensemble scored significantly better in user rating for heat and vision. The positive ratings of powered respirators for temperature and heat build‐up are consistent with previous reports [10, 21, 22]; as a result, many healthcare workers favour the use of powered respirators over tight fitting masks. In addition, the participants scored the standard respirators significantly higher on visual clarity.…”

Section: Discussionsupporting

confidence: 90%

“…Reports from the current COVID‐19 pandemic in Italy stress the importance of respiratory protective equipment for healthcare workers in anaesthetics and intensive care [16]. Recent studies looking at the impact of PPE on advanced life support and airway management have compared the effect of different standard respirators and powered respirators [8‐11, 17, 18] but this is the first study to compare the use of modern respirators and powered respirators during advanced airway management procedures. Our main finding was that the use of videolaryngoscopy for difficult airway management proved to have certain advantages whilst wearing respiratory protection.…”

Section: Discussionmentioning

confidence: 99%

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The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study

et al. 2020

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The current international COVID-19 health crisis underlines the importance of adequate and suitable personal protective equipment for clinical staff during acute airway management. This study compares the impacts of standard air-purifying respirators and powered air-purifying respirators during simulated difficult airway scenarios. Twenty-five anaesthetists carried out four different standardised difficult intubation drills, either unprotected (control), or wearing a standard or a powered respirator. Treatment times and wearer comfort were determined and compared. In the wearer comfort evaluation form, operators rated mobility, noise, heat, vision and speech intelligibility. All anaesthetists accomplished the treatment objectives of all study arms without adverse events. Total mean (SD) intubation times for the four interventions did not show significant differences between the powered and the standard respirator groups, being 16.4 (8.6) vs. 19.2 (5.2) seconds with the Airtraq TM ; 11.4 (3.4) vs. 10.0 (2.1) seconds with the videolaryngoscope; 39.2 (4.5) vs. 40.1 (4.8) seconds with the fibreoptic bronchoscope scope; and 15.4 (5.7) vs. 15.1 (5.0) seconds for standard tracheal intubation by direct laryngoscopy, respectively. Videolaryngoscopy allowed the shortest intubation times regardless of the respiratory protective device used. Anaesthetists rated heat and vision significantly higher in the powered respirator group; however, noise levels were perceived to be significantly lower than in the standard respirator group. We conclude that standard and powered respirators do not significantly prolong simulated advanced intubation procedures.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study

et al. 2020

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“…Goggles and face shields have the disadvantage of fogging, especially during longer operation times. 21 The results of this study are inconsistent with a survey of health care workers who had used the loose-fitting hood PAPR in clinical practice during the SARS-CoV outbreak in Singapore, when use of a PAPR was mandatory and widespread. 13 They are available as tight-fitting negative pressure masks, known as air-purifying respirators, with the wearer drawing air through a filter.…”

Section: Discussioncontrasting

confidence: 82%

Respiratory Protection During Simulated Emergency Pediatric Life Support: A Randomized, Controlled, Crossover Study

Schumacher

Gray

Michel

et al. 2012

Prehosp. Disaster med.

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“…Recent studies looking at the impact of PPE on advanced life support and airway management have compared the effect of different APR masks [6,7], APR masks against PAPR masks [8], APR masks against PAPR hoods [9], and PAPR suits against controls [10,11]. However, advanced life support, including airway management, may be required before or during the decontamination process, and casualties at this point provide a potential source of dangerous contamination to healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

“…However, advanced life support, including airway management, may be required before or during the decontamination process, and casualties at this point provide a potential source of dangerous contamination to healthcare providers. Recent studies looking at the impact of PPE on advanced life support and airway management have compared the effect of different APR masks [6,7], APR masks against PAPR masks [8], APR masks against PAPR hoods [9], and PAPR suits against controls [10,11]. This is the first study to compare the current NHS issued PRPS suit against a modern, lightweight protective ensemble alternative.…”

Section: Discussionmentioning

confidence: 99%

A randomised crossover simulation study comparing the impact of chemical, biological, radiological or nuclear substance personal protection equipment on the performance of advanced life support interventions

et al. 2017

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Recent incidents involving chemical, biological, radiological and nuclear substances have stressed the importance of sufficient personal protection equipment for medical first-responders. Modern lightweight, battery-independent, suit ensembles may prove superior to the current protective suit used in the UK. This study compared the powered respiratory protective suit (PRPS ensemble) with a lightweight suit consisting of a SARATOGA Multipurpose CBRN Protective Coverall Polyprotect 12 in conjunction with the Avon C50 Respirator/Avon CBRNF12CE filter canister and butyl rubber protective gloves (Polyprotect 12 ensemble). Thirty anaesthetists carried out a standardised resuscitation scenario either unprotected (control) or wearing the PRPS or Polyprotect 12 ensembles in a randomised, crossover simulation study. Treatment times for five simulated advanced life support interventions (application of monitoring; bag/mask ventilation; tracheal intubation; drug and fluid administration; and external pacing) were measured. Wearer comfort was also assessed for the two protective suits by questionnaire. All participants accomplished the treatment objectives of all study arms without adverse events. Total mean (SD) completion time for the five interventions was significantly longer for the PRPS compared with the Polyprotect 12 ensemble (204 (53) s vs. 149 (36) s, respectively; p < 0.0001). Participants rated mobility, noise, heat, vision, dexterity and speech intelligibility significantly better in the Polyprotect 12 ensemble compared with the PRPS ensemble. The combination of a lightweight Polyprotect 12 suit and an Avon C50 air-purifying respirator is preferable to the powered respiratory protective suit during simulated emergency life support, due to a combination of shorter task completion times and improved mobility, communication and dexterity.

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Comparison of conventional and powered air-purifying respirators during resuscitation of CBRN victims

Cited by 4 publications

References 0 publications

The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study

The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study

Respiratory Protection During Simulated Emergency Pediatric Life Support: A Randomized, Controlled, Crossover Study

A randomised crossover simulation study comparing the impact of chemical, biological, radiological or nuclear substance personal protection equipment on the performance of advanced life support interventions

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