Personal protection equipment for biological hazards: does it affect tracheal intubation performance?

Area of Science:

• Emergency Medicine
• Anesthesiology
• Respiratory Care

Background:

• Personal protective equipment (PPE) is crucial for managing patients with contagious respiratory illnesses.
• Previous research explored PPE's impact on chemical hazards and general airway management, but not specifically on tracheal intubation.
• The effect of PPE on the ability to perform tracheal intubation remains largely uninvestigated.

Purpose of the Study:

• To determine if personal protective equipment (PPE) affects the ability to perform tracheal intubation.
• To assess the impact of different PPE types on tracheal intubation success and time.
• To evaluate the subjective experience of healthcare workers using PPE during intubation.

Main Methods:

• Eighteen participants with varying training levels performed tracheal intubations using direct laryngoscopy, intubating laryngeal mask (Fastrach), and flexible bronchoscopy.
• Three types of PPE were evaluated: eye shield, face shield, and "Dustmaster".
• Intubation time, esophageal intubation incidence, and subjective participant experiences were recorded.

Main Results:

• No significant difference in intubation time was observed across different PPE types and intubation methods.
• Participants reported discomfort, particularly heat, with face shields.
• Fiberoptic bronchoscopic intubation proved difficult with PPE, especially when using an eyepiece without a camera.

Conclusions:

• While PPE may not increase manikin intubation time, certain types can cause discomfort and may pose challenges.
• Further research is necessary to evaluate the clinical implications of PPE use during actual difficult intubations.
• The findings highlight potential usability issues with specific PPE during airway management procedures.