Respiratory protection during simulated emergency pediatric life support: a randomized, controlled, crossover study

Area of Science:

• Emergency Medicine
• Respiratory Protection
• Pediatric Resuscitation

Background:

• Effective respiratory protection is crucial for medical first responders during emergency pediatric life support (EPLS) for children with transmissible respiratory diseases.
• Conventional air-purifying respirators (APRs) and powered air-purifying respirator-hoods (PAPRs) may impact pediatric resuscitation differently, necessitating evaluation.

Purpose of the Study:

• To investigate the influence of APRs versus PAPR-hoods during simulated pediatric cardiopulmonary resuscitation scenarios.
• To compare treatment times and wearer comfort between different respiratory protection methods.

Main Methods:

• A randomized, controlled, crossover study design was employed.
• Sixteen paramedics performed a standardized EPLS scenario in an ambulance, either unprotected, with a conventional APR, or with a PAPR-hood.
• Treatment times and wearer comfort were recorded and compared across conditions.

Main Results:

• All participants completed the simulated treatments without adverse events.
• Communication, dexterity, and mobility were rated significantly better with APRs.
• Heat buildup was significantly less with PAPR-hoods.
• Treatment times did not significantly differ from the control for APRs, but were significantly longer for PAPR-hoods.

Conclusions:

• Conventional APRs demonstrated a trend towards better treatment times compared to PAPR-hoods in simulated pediatric resuscitation.
• Participants found mobility, communication, and dexterity superior with the tight-fitting APR system over the loose-fitting PAPR-hood.