The Effect of Different Personal Protective Equipment Masks on Health Care Workers’ Cardiopulmonary Resuscitation Performance During the Covid-19 Pandemic

Abstract

Background Personal protective equipment (PPE) are equipment that protect healthcare workers from harmful agents and organisms. The importance of these equipment was noticed again with the Covid-19 pandemic. Objectives In this study, we investigated the effect of different masks used as PPE on resuscitation quality and rescuer fatigue. Methods Participants applied chest compression without a mask, with a surgical mask, a filtering face-piece respirator (FFR) mask, and a half-face mask with active P3 filter. A smart watch was worn on the left wrists of the participants during chest compression in each condition. They were requested to rate their fatigue on the Visual Analogue Scale (VAS). Results Statistically higher average pulse rates were found in the FFR mask and half-face mask conditions. FFR mask and half-face mask resulted in statistically worse results than surgical mask and no-mask conditions in the number of compression per minute, compression depth, and compression effectiveness. Further, half-face mask and FFR mask caused more fatigue in participants. Conclusion Protective masks used as PPE other than surgical masks increase rescuer fatigue in CPR and negatively affect the quality of chest compressions.

The effect of personal protective equipment on cardiac compression quality

“…Chen et al reported that PPE usage reduces the parameters of compression rate, compression depth, and fully released compression rate [4] . In another study, it has been reported that the quality of CPR decreases with improved mask quality [13] . Donoghue et al reported that there was no deterioration in CPR quality relevant to PPE usage in their study involving paediatric manikins [5] .…”

Indoor air quality improvement in COVID-19 pandemic: Review

“… Hospitals and the general public Cost-friendly, single time usage, fluid-resistant, lower adverse health risk, useful while CPR ( Li, Zhao et al, 2021 ) Filtering facepiece respirator(N95) Filter outs 5–50 μm aerosols. Majorly by health care workers Face sealing property, reduced microplastic inhalation risk, increased CO 2 retention and humidity, eye dryness problem, not fit for a longer duration ( Ahmad et al, 2020 ; Boccardo, 2021 ; Serin & Caglar, 2020 ) Half face mask (P3 filter) Filters 80% of aerosols. At the crowded, dusty place Does not slip from the face, durable for 8 hours, increased fatigue during CPR ( Leung et al, 2020 ; Serin & Caglar, 2020 ) Cloth mask Prevents particles of diameter >200 nm.…”

“… Majorly by health care workers Face sealing property, reduced microplastic inhalation risk, increased CO 2 retention and humidity, eye dryness problem, not fit for a longer duration ( Ahmad et al, 2020 ; Boccardo, 2021 ; Serin & Caglar, 2020 ) Half face mask (P3 filter) Filters 80% of aerosols. At the crowded, dusty place Does not slip from the face, durable for 8 hours, increased fatigue during CPR ( Leung et al, 2020 ; Serin & Caglar, 2020 ) Cloth mask Prevents particles of diameter >200 nm. Indoor usage by the general public Affordable, reusable, loose-fitting, less effective against viruses, not fluid resistant ( Davies et al, 2013 ; Leung et al, 2020 ) …”

“…A systematic review and meta-analysis conducted by ( Li et al, 2020 ) concluded that the usage of face masks reduces the infection risk by 70% for health care workers. In a study conducted by ( Serin & Caglar, 2020 ) including 48 participants for determining the CPR while wearing different ranges of masks, it was observed that face masks adversely affect the chest compression quality as wearing masks increases the pulse rate of rescuer leading to fatigue and degrading the quality of CPR. From the 5 rounds each for 2 min for chest compression of mannequins performed wearing different masks, it was found that surgical masks cause lesser rescuer fatigue than N95 and half-face masks.…”

“…Prolonged usage of face masks can cause various discomforts including headache, difficulty in breathing, skin irritation, sweating, fogging on glasses, dryness in the eyes ( Ahmad et al, 2020 ; Boccardo, 2021 ; Li, Zhao, Li, & Song, 2021 ; Scheid, Lupien, Ford, & West, 2020 ; Serin & Caglar, 2020 ). According to an online survey of 3605 conducted by ( Boccardo, 2021 ), the dry eye problem was observed in 18.3% of participants, specifically in women and the ones who wear glasses or use contact lenses.…”