COVID-19: Masks do not influence neurocognitive performance during a shift at the emergency department

Abstract

The COVID-19 pandemic has led to the widespread mandatory use of personal protective equipment (PPE), including filtering face pieces (FFP). Emergency medical care providers now commonly use this equipment. [1,2] Prior studies indicate that the performance of healthcare providers can be negatively influenced when using such PPE. [3,4] Masks were found to cause headaches, dizziness, and feelings of exhaustion. [5][6][7][8][9] Given these results, FFP class II (FFP2) masks might influence neurocognitive capacity (e.g., attention and concentration) as well as eye-hand coordination and fine motor skills during emergency care. [5,[10][11][12] Recent results support this hypothesis. Using a statewide online questionnaire in Michigan, Arnetz et al [13] reported a direct effect of PPE on cognitive failure in nurses.The majority of previously published studies used surrogates, such as walking on treadmills [14][15][16] or sports [17] to induce stress. Other studies investigated the fit of PPE on functional performance across various occupational domains. [18] Studies investigating healthcare personnel focused on the effects of gloves. [19,20] To our knowledge, no study has investigated the effects of FFP2 masks in real-life emergency medical care settings using standardized psychometric tests. This study aimed to assess the effects of PPE, including FFP2 masks, on neurocognitive performance during patient care at the emergency department (ED). Methods Study design and settingWe conducted this observational study at the ED of a high-volume, tertiary-care academic hospital with approximately 300 patients per day. These include walk-in patients and patients transported by emergency medical services. This study was approved by the local ethics committee and complied with the Declaration of Helsinki.