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Initial test of emergency procedure performance in temporary negative pressure isolation by using simulation

Mark A Davis¹, Roxanne Landesman, Boaz Tadmor

¹Institute for International Emergency Medicine and Health, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Annals of Emergency Medicine

|August 28, 2007

Summary

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Physicians can perform critical emergency actions inside a simulated bioisolation tent without significant delays. This study found no performance degradation in infectious disease isolation settings, supporting their use for surge capacity.

Area of Science:

Medical Simulation
Infectious Disease Control
Emergency Medicine

Background:

Increased threat of infectious disease spread (e.g., tuberculosis, avian flu) and bioterrorism necessitates enhanced patient isolation surge capacity.
Portable bioisolation tents offer a potential solution for negative pressure isolation.
Healthcare workers' ability to perform emergency procedures within these tents requires evaluation.

Purpose of the Study:

To assess the impact of a simulated bioisolation tent environment on physicians' ability to perform emergency procedures.
To determine if total negative pressure isolation affects the time to complete critical actions during medical emergencies.
To evaluate subjective physician performance within the bioisolation tent setting.

Main Methods:

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Physician teams performed 5 emergency care scenarios in an advanced medical simulation laboratory, both inside and outside a bioisolation tent.

No prior training on negative pressure isolation use was provided to participants.

Time to completion of critical actions was the primary outcome; scenario performance and subjective assessments were secondary variables.

Main Results:

Mean time to complete critical actions was similar whether inside (298 seconds) or outside (284 seconds) the tent (P=.69).
Performing scenarios for the second time (243 seconds) was significantly faster than the first performance (338 seconds) (P=.01).
Physicians' self-assessed performance did not differ between the tent and non-tent settings.

Conclusions:

Physicians unfamiliar with negative pressure isolation environments can perform emergency medical critical actions effectively within a simulated bioisolation tent.
The simulated bioisolation tent environment did not significantly impede the performance of emergency procedures.
These findings support the utility of bioisolation tents for increasing patient isolation surge capacity during public health emergencies.