![]() The second test was performed after 30 min so as to avoid fatigue bias.įor the analysis of the variables, the statistical package IBM SPSS Statistics version 20 for Windows (Armonk, NY, USA) was used. After five cycles, the roles were changed in order to follow the recommendations regarding changing roles every 2 min. Cycles 11 and 12 were only performed by some participants, depending on the mean compression rate (recommended rate: 100–120 compressions/min). Thus, the complete 20-min test was divided into intervals of five CPR cycles (these five cycles were approximately 2 min each), in such a way that the sample in this study performed the active phase during the odd intervals (intervals 1, 3, 5, 7, 9 and 11) and the support phase during the even intervals (intervals 2, 4, 6, 8, 10 and 12). After these five cycles, there was an exchange of roles, that is, the rescuer passed to the CPR support phase and the instructor carried out the active phase. The resuscitator under study started the test by compressing, so during five cycles of 30 compressions and two ventilations, he performed chest compressions and ventilations with the self-inflating bag (the active phase of CPR), while the supporting instructor attached the mask (the CPR support phase). Therefore, the objective of this study is to analyze the impact of PPE on physiological demands and CPR quality during prolonged CPR. ![]() The reality for emergency departments and pre-hospital emergency departments is that CPR can be prolonged for 30 min or more. Despite that, the resuscitation time in all studies reviewed did not exceed 4 min. While some studies have found no significant change in the CPR quality, a recent systematic review suggests that PPE may affect the rate and depth of cardiac compressions (CC). The effect of PPE on resuscitation is not yet consistent. Scientific evidence also shows that the use of PPE induces changes, both physiologically and in certain technical skills, such as the lack of perspiration which can accelerate dehydration processes and alter thermoregulation mechanisms. It is also known that resuscitation under special circumstances or in extreme situations (altitude, heat or cold) can increase anxiety fatigue in untrained people or anyone who has engaged in physically demanding activity beforehand. Therefore, recommendations for resuscitation indicate relief every two minutes between rescuers. These results suggest that physical preparation should be taken into account when using PPE and protocols for physiological recovery after use should also be established.ĬPR is a procedure that causes physical fatigue. Rescuers were more fatigued, sweated more and their thermal comfort was worse. Performing prolonged resuscitation with PPE did not influence CPR quality, but caused significant physiological demands. CPR_PPE meant an increase in the perceived effort, temperature at the start of the thermal sensation test, thermal comfort and sweating, as opposed to CPR performed with usual clothing. ![]() ![]() The maximum heart rate was higher in the active intervals (compressions + bag-valve-mask) of the test with PPE. The quality of the CPR was similar in both tests. The main variables of interest were: CPR quality, compressions, ventilations, maximum heart rate, body fluid loss, body temperature, perceived exertion index, comfort, thermal sensation and sweating. The other test was carried out using a CPR test with PPE (i.e., CPR_PPE). One of the CPR tests was carried out without using any PPE (CPR_control), i.e., performed with the usual clothing of each rescuer. Two CPR tests were compared with the recommended sequence of 30 chest compressions and 2 ventilations. The study was carried out in a training and simulation emergency box and the total sample consisted of 20 healthcare professionals. A randomized, quasi-experimental, crossover design was used. The aim of this study was to analyze the impact of personal protective equipment on physiological parameters during CPR. The use of personal protective equipment (PPE) is required for the self-protection of healthcare workers during cardiopulmonary resuscitation (CPR) in patients at risk of aerosol transmission of infectious agents.
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