Journal
PREHOSPITAL AND DISASTER MEDICINE
Volume 28, Issue 1, Pages 33-38Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1049023X12001525
Keywords
APR; biological warfare; deliberate release; EPLS; medical simulation; pandemic flu; PAPR; pediatric resuscitation; respiratory protection; SARS
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Introduction: Emergency pediatric life support (EPLS) of children infected with transmissible respiratory diseases requires adequate respiratory protection for medical first responders. Conventional air-purifying respirators (APR) and modern loose-fitting powered air-purifying respirator-hoods (PAPR-hood) may have a different impact during pediatric resuscitation and therefore require evaluation. Objective: This study investigated the influence of APRs and PAPR-hoods during simulated pediatric cardiopulmonary resuscitation. Methods: Study design was a randomized, controlled, crossover study. Sixteen paramedics carried out a standardized EPLS scenario inside an ambulance, either unprotected (control) or wearing a conventional APR or a PAPR-hood. Treatment times and wearer comfort were determined and compared. Results: All paramedics completed the treatment objectives of the study arms without adverse events. Study subjects reported that communication, dexterity and mobility were significantly better in the APR group, whereas the heat-build-up was significantly less in the PAPR-hood group. Treatment times compared to the control group did not significantly differ for the APR group but did with the PAPR-hood group (261 +/- 12 seconds for the controls, 275 +/- 9 seconds for the conventional APR and 286 +/- 13 seconds for the PAPR-hood group, P < .05. Conclusions: APRs showed a trend to better treatment times compared to PAPR-hoods during simulated pediatric cardiopulmonary resuscitation. Study participants rated mobility, ease of communication and dexterity with the tight-fitting APR system significantly better compared to the loose-fitting PAPR-hood.
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