Effects of personal protective equipment on cardiopulmonary resuscitation quality and outcomes: A systematic review.

Content Provider	Europe PMC
Author	Chung, Sung Phil Nehme, Ziad Johnson, Nicholas J. Lagina, Anthony Bray, Janet
Copyright Year	2023
Abstract	BackgroundThe impact of wearing personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR) on CPR quality and patient outcomes is unclear. This systematic review aimed to examine whether wearing PPE during resuscitation affects patient outcomes, CPR quality and rescuer fatigue.MethodsIn this review registered in PROSPERO (CRD42022347746), we searched Medline, EMBASE and Cochrane library between 2000 and 2022. The inclusion criteria were studies: in actual or simulated cardiac arrest; comparing PPE with no PPE; and randomised controlled trials and observational studies with a English abstract. Risk of bias was assessed using Cochrane's Risk of Bias-2 and ROBINS-I tools and outcomes assessed with GRADE. We conducted a meta-analysis according to the study design. Quantitative data synthesis was done using a random-effect model incorporating the potential heterogeneity.ResultsA total of 17 simulation-based studies and 1 clinical study were included. All outcomes were judged to be very low certainty of evidence, subject to high risk of bias. The clinical study showed no difference in survival comparing enhanced and conventional PPE. Meta-analysis of 11 RCTs and 6 observational studies found no difference in CPR quality in rescuers wearing PPE compared with no PPE. Pooled rescuer fatigue was significantly worse in the PPE group (mean difference, 2.7 VAS score out of 10; 95% CI, 1.4–4.0).ConclusionsPPE was not associated with reduced CPR quality or lower cardiac arrest survival. Rescuers wearing PPE may report more fatigue. This finding was mainly derived from simulation studies, additional clinical studies are needed.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10230254&blobtype=pdf
Journal	Resuscitation Plus [Resusc Plus]
Volume Number	14
DOI	10.1016/j.resplu.2023.100398
PubMed Central reference number	PMC10230254
PubMed reference number	37265711
e-ISSN	26665204
Language	English
Publisher	Elsevier
Publisher Date	2023-05-24
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2023 The Author(s)
Subject Keyword	Cardiopulmonary resuscitation Chest compression Personal protective equipment
Content Type	Text
Resource Type	Article
Subject	Emergency Nursing Emergency Medicine Cardiology and Cardiovascular Medicine