PMID- 32307296
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1532-8171 (Electronic)
IS  - 0735-6757 (Print)
IS  - 0735-6757 (Linking)
VI  - 44
DP  - 2021 Jun
TI  - Are loose-fitting powered air-purifying respirators safe during chest 
      compression? A simulation study.
PG  - 235-240
LID - S0735-6757(20)30196-0 [pii]
LID - 10.1016/j.ajem.2020.03.054 [doi]
AB  - BACKGROUND: The application of appropriate personal protective equipment for 
      respiratory protection to health care workers is a cornerstone for providing safe 
      healthcare in emergency departments. We investigated the protective effect and 
      usefulness of loose-fitting powered air-purifying respirators (PAPRs) during 
      chest compression. METHODS: This was a single-center simulation study performed 
      from May 2019 to July 2019 in a tertiary hospital. We measured the concentrations 
      of ambient aerosol and particles inside the loose-fitting PAPR during chest 
      compression, and this ratio was set as the simulated workplace protecting factor 
      (SWPF). According to the National Institute for Occupational Safety and Health 
      regulations, the assigned protection factor (APF) of loose-fitting PAPRs is 25. 
      Thus, the loose-fitting PAPRs were assumed to have a protective effect when the 
      SWPF were >/= 250 (APF x 10). We measured the SWPF of PAPR in real time during 
      chest compression and also investigated the problems encountered during its use. 
      RESULTS: Ninety-one participants (median age 29 [interquartile range (IQR): 
      26-32] years; 74% female) completed the simulation. None of the participants 
      failed with SWPF below 250 during three sessions of chest compression. The median 
      (IQR) values of SWPF at three cycles were 17,063 (10,145-26,373), 15,683 
      (9477-32,394), and 16,960 (7695-27,279). There was no disconnection of equipment 
      or mechanical failures during chest compression. In addition, most participants 
      (83%) replied that they rarely or never experienced difficulty in verbal 
      communication and felt that the loose-fitting PAPR was comfortable. CONCLUSIONS: 
      The loose-fitting PAPRs provided sufficient respiratory protection without 
      disturbances during chest compression.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Park, Soo Hyun
AU  - Park SH
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Hwang, Sung Yeon
AU  - Hwang SY
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Lee, Guntak
AU  - Lee G
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Park, Jong Eun
AU  - Park JE
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Kim, Taerim
AU  - Kim T
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Shin, Tae Gun
AU  - Shin TG
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Sim, Min Seob
AU  - Sim MS
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Jo, Ik Joon
AU  - Jo IJ
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Kim, Seonwoo
AU  - Kim S
AD  - Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea.
FAU - Yoon, Hee
AU  - Yoon H
AD  - Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea. Electronic address: 
      wildhi.yoon@samsung.com.
LA  - eng
PT  - Journal Article
DEP - 20200331
PL  - United States
TA  - Am J Emerg Med
JT  - The American journal of emergency medicine
JID - 8309942
RN  - 0 (Aerosols)
RN  - 0 (Air Pollutants, Occupational)
SB  - IM
MH  - Adult
MH  - Aerosols/analysis
MH  - Air Pollutants, Occupational/analysis
MH  - *Chest Wall Oscillation
MH  - Emergency Medicine/*education
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Humans
MH  - Infection Control/*methods
MH  - Male
MH  - National Institute for Occupational Safety and Health, U.S.
MH  - Occupational Exposure/*prevention & control
MH  - Respiratory Protective Devices/*standards
MH  - United States
PMC - PMC7163180
OTO - NOTNLM
OT  - Cardiopulmonary resuscitation
OT  - Chest
OT  - Compression
OT  - Infection control
OT  - Respiratory protective devices
COIS- Declaration of competing interest The authors have no potential conflicts of 
      interest to declare.
EDAT- 2020/04/21 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/03/31
CRDT- 2020/04/21 06:00
PHST- 2020/01/06 00:00 [received]
PHST- 2020/03/08 00:00 [revised]
PHST- 2020/03/26 00:00 [accepted]
PHST- 2020/04/21 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/04/21 06:00 [entrez]
PHST- 2020/03/31 00:00 [pmc-release]
AID - S0735-6757(20)30196-0 [pii]
AID - 10.1016/j.ajem.2020.03.054 [doi]
PST - ppublish
SO  - Am J Emerg Med. 2021 Jun;44:235-240. doi: 10.1016/j.ajem.2020.03.054. Epub 2020 
      Mar 31.