Metabolic fatigue in resuscitators using personal protection equipment against biological hazard

Abstract

Objective. To describe the effects of wearing individual protection equipment against biological hazard when performing a simulated resuscitation.Methods. Uncontrolled quasi-experimental study involving 47 volunteers chosen by random sampling stratified by sex and professional category. We determined vital signs, anthropometric parameters and baseline lactate levels; subsequently, the volunteers put on level D individual protection equipment against biological hazard and performed a simulated resuscitation for 20 minutes. After undressing and 10 minutes of rest, blood was extracted again to determine lactate levels. Metabolic fatigue was defined as a level of lactic acid above 4 mmol/L at the end of the intervention.Results. 25.5% of the participants finished the simulation with an unfavorable metabolic tolerance pattern. The variables that predict metabolic fatigue were the level of physical activity and bone mass -in a protective formand muscle mass. People with a low level of physical activity had ten times the probability of metabolic fatigue compared to those with higher levels of activity (44% versus 4.5%, respectively).Conclusion. Professionals who present a medium or high level of physical activity tolerate resuscitation tasks better with a level D individual biological protection suit in a simulated resuscitation.Descriptors: cardiopulmonary resuscitation; personal protective equipment; anaerobic threshold; containment of biohazards; stress, physiological.How to cite this article: Martín-Rodríguez F. Metabolic fatigue in resuscitators using personal protection equipment against biological hazard. Invest. Educ. Enferm. 2019; 37(2):e04ReferencesBarsuk JH, Cohen ER, Wayne DB, Siddall VJ, McGaghie WC. Developing a Simulation-Based Mastery Learning Curriculum: Lessons from 11 Years of Advanced Cardiac Life Support. Simul. Healthc. 2016; 11(1):52–9. Kwon JH, Burnham CAD, Reske KA, Liang SY, Hink T, Wallace MA, et al. 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The Evaluation of Physiological Index Changes and Safety Work of Female Medical Staff With Different Medical Protection Standards in the Ward of COVID-19

“…Many studies and experts have reported that the use of proper PPE for the medical staff can reduce the risk of infection for medical staff and patients ( 6 , 7 ). However, when medical staff conduct their work with the necessary PPE, these PPE directly affect the physiology of medical staff, since it generates significant metabolic fatigue ( 8 , 9 ). More importantly, this metabolic fatigue can not only impact operational capacity ( 10 ), but also increase the risk of accidents with PPE, increase cross-contamination, and contribute to physiological stress ( 9 ).…”

“…However, when medical staff conduct their work with the necessary PPE, these PPE directly affect the physiology of medical staff, since it generates significant metabolic fatigue ( 8 , 9 ). More importantly, this metabolic fatigue can not only impact operational capacity ( 10 ), but also increase the risk of accidents with PPE, increase cross-contamination, and contribute to physiological stress ( 9 ). N95 masks, as an important PPE, have good filtration efficiency for small particles, but also hinder airflow.…”