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Does level D personal protective equipment guard against hazardous biologic agents during cardiopulmonary resuscitation?

Martín Rodríguez F, Fernández Pérez C, Castro Villamor MA, Martín Conty JL, Arnillas Gómez P, Casado Vicente V

Servicio de Emergencias de Castilla y León-SACYL, Unidad Móvil de Emergencias de Valladolid I, Spain. Servicio de Medicina Preventiva. Unidad Transversal de Apoyo a la Investigación. IdIISC. Hospital Clínico San Carlos. Universidad Complutense de Madrid, Spain. Unidad Docente de Medicina Familiar y Comunitaria. Departamento de Medicina, Dermatología y Toxicología. Facultad de Medicina, Valladolid, Spain. Facultad de Terapia Ocupacional, Logopedia y Enfermería. UCLM, Spain.

Objective. Our aim was to determine the usefulness of level D personal protective equipment (PPE) in safeguarding health care staff who perform cardiopulmonary resuscitation (CPR).
Methods. Quasi-experimental, uncontrolled trial in 96 volunteers chosen randomly and stratified by sex, level of training, and professional category. The subjects were selected from a convenience sample of 164 nurses, physicians, and students of nursing and medicine (40 men [41.66%] and 56 women [58.33%]). The mean (SD) age was 31 (11)
years. The Conconi test was used to determine heart rate (HR) at the anaerobic threshold on a cycle ergometer. That HR was then compared to each volunteer’s maximum HR during performance of CPR while wearing PPE.
Results. While the volunteers were performing CPR, 46.9% of them surpassed their maximum recommendable HR recorded during the cycle ergometer test.
Conclusions. We found that performing CPR while wearing level D PPE requires intense physical effort. Special situations should be taken into consideration when developing protocols for situations that require staff to wear PPE. Staff who must perform CPR under these conditions should be given specific training.

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