ABSTRACT
Introduction: During the recent COVID-19 pandemics, hospital staff often used personal protective equipment (PPE) beyond the standards recommended by the public health authorities. The aim of the study is to investigate the impact of the additional PPE compared to the standard PPE onto team performance when dealing with a medical emergency. Method(s): Single centre, prospective, randomized, controlled, openlabel, study compared 22 teams, consisting of a doctor and 2 nurses, randomized in a 1:1 ratio to use standard PPE or Super-Safe Setup in a simulated medical crisis. Before randomisation, all teams underwent a standardised mock scenario without the use of PPE was used to assess the performance at baseline. The primary outcome was Team Emergency Assessment Measure (TEAM), secondary outcomes included the timing and quality parameters of CPR and physiological changes the rescuers. Result(s): As compared to standard PPE recommended by WHO [1], the use of additional PPE that included hooded coverall, significantly reduced non-technical skills of teams (TEAM score 30.6 +/- 5.7 vs. 36.2 +/- 5.0, p = 0.015) (Table 1), mainly due to reducing performance in complex tasks such as planning of future actions, prioritisation, and following the guidelines. This was also reflected in participants self-assessment score (Table 1). Nonetheless, there was no significant difference in the quality parameters and timing of milestones during a simulated CPR. There were no differences in rescuers physiological responses. Conclusion(s): During a simulated crisis, extended PPE compared to the PPE recommended by the World Health Organisation degraded nontechnical team skills. This did not translate into measurable deterioration of patient-centred outcomes, such as quality or timing of CPR.