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Impact of personal protective equipment on neonatal resuscitation procedures: a randomised, cross-over, simulation study.
Cavallin, Francesco; Lupi, Fiorenzo; Bua, Benedetta; Bellutti, Marion; Staffler, Alex; Trevisanuto, Daniele.
  • Cavallin F; Independent Statistician, Solagna, Italy.
  • Lupi F; Department of Neonatology, Bolzano Hospital, Bolzano, Italy.
  • Bua B; Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy.
  • Bellutti M; Department of Neonatology, Bolzano Hospital, Bolzano, Italy.
  • Staffler A; Department of Neonatology, Bolzano Hospital, Bolzano, Italy.
  • Trevisanuto D; Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy daniele.trevisanuto@unipd.it.
Arch Dis Child Fetal Neonatal Ed ; 107(2): 211-215, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1398607
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Healthcare providers should use personal protective equipment (PPE) when performing aerosol-generating medical procedures during highly infectious respiratory pandemics. We aimed to compare the timing of neonatal resuscitation procedures in a manikin model with or without PPE for prevention of SARS-COVID-19 transmission.

METHODS:

A randomised controlled cross-over (AB/BA) trial of resuscitation with or without PPE in a neonatal resuscitation scenario. Forty-eight participants were divided in 12 consultant-nurse teams and 12 resident-nurse teams. The primary outcome measure was the time of positive pressure ventilation (PPV) initiation. The secondary outcome measures were duration of tracheal intubation procedure, time of initiation of chest compressions, correct use of PPE and discomfort/limitations using PPE.

RESULTS:

There were significant differences in timing of PPV initiation (consultant-nurse teams mean difference (MD) 6.0 s, 95% CI 1.1 to 10.9 s; resident-nurse teams MD 11.0 s, 95% CI 1.9 to 20.0 s), duration of tracheal intubation (consultant-nurse teams MD 22.0 s, 95% CI 7.0 to 36.9 s; resident-nurse teams MD 9.1 s, 95% CI 0.1 to 18.1 s) and chest compressions (consultant-nurse teams MD 32.3 s, 95% CI 14.4 to 50.1 s; resident-nurse teams MD 9.1 s, 95% CI 0.1 to 18.1 s). Twelve participants completed the dressing after entering the delivery room. PPE was associated with visual limitations (43/48 participants), discomfort in movements (42/48), limitations in communication (32/48) and thermal discomfort (29/48).

CONCLUSIONS:

In a manikin model, using PPE delayed neonatal resuscitation procedures with potential clinical impact. Healthcare workers reported limitations and discomfort when wearing PPE. TRIAL REGISTRATION NUMBER NCT04666233.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Resuscitation / Personal Protective Equipment / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans / Infant, Newborn Language: English Journal: Arch Dis Child Fetal Neonatal Ed Journal subject: Pediatrics / Perinatology Year: 2022 Document Type: Article Affiliation country: Archdischild-2021-322216

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Resuscitation / Personal Protective Equipment / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans / Infant, Newborn Language: English Journal: Arch Dis Child Fetal Neonatal Ed Journal subject: Pediatrics / Perinatology Year: 2022 Document Type: Article Affiliation country: Archdischild-2021-322216