Barrier Techniques to Reduce Aerosolization During Cardiopulmonary Resuscitation

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious disease transmitted by contact, droplets, and aerosols. Front line health-care workers (HCWs), particularly emergency physicians and acute care providers, are vulnerable to being exposed while treating their sick patients. Despite appropriate personal protective equipment use, HCW gets infected, suggesting the need for multiple layers of protection such as barrier devices. Methods: We aimed to determine the effectiveness of our novel “Resuscitation Cover All”(RCA) in reducing the exposure of HCW to simulated respiratory particles and its feasibility during cardio pulmonary resuscitation (CPR). This was a pilot simulation-based study. Five CPR simulation sessions were performed in Standard and RCA protocols, individually. Exposures through contact, droplets, and aerosols were simulated using a standardized volume of liquid detergent. Under Wood's lamp illumination, exposures of participants were compared between the protocols. Rate and depth of chest compressions, time taken to intubate, interruptions in CPR, and first-pass success were analyzed. Results: Overall mean exposure in standard protocol was 4950.4 ± 1461.6 (95%confidence interval [CI]:3135.7–6765.2) sq.pixels and RCA protocol was 2203.6 ± 1499.0 (95%CI: 342.4–4064.9) sq.pixels ( P = 0.019). In standard, chest compressor had the highest exposure of 3066.6 ± 1419.2 (95%CI: 2051.3–4081.9) sq.pixels followed by defibrillator assistant 1166.4 ± 767.4 (95%CI: 617.4–1715.4) sq.pixels. Chest compressor of RCA had reduced exposure compared to that of standard ( P < 0.001). Hands were the most frequently exposed body part. Airway manager of RCA had no exposure over head and neck in any session. No significant difference in CPR performance metrics was observed. Conclusion: This pilot simulation-based study shows that the novel RCA device could minimize the exposure of HCW to simulated respiratory particles during CPR. Also, it might not alter the high-quality CPR performance metrics. We need more real-life evidence.

show abstract

“…Proposed that draping a patient's mouth and nares during manual chest compressions minimized the risk of HCW exposure. [ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of “Resuscitation Cover All” in Minimizing COVID-19 Transmission to Health-Care Workers during Cardiopulmonary Resuscitation

Ayyan

Raju

Anandhi

et al. 2022

Journal of Global Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…This study is relevant for lay rescuers to diminish their risk of contracting air-borne infections during CPR. There is evidence that CPR, including compression-only CPR, has the potential to generate aerosols [10][11][12]. Paroya et al detected aerosols on the gloves and gowns of both the BVM provider and the chest compression provider [11].…”

Section: Relevance To Rationale and Specific Aimsmentioning

confidence: 99%

“…There is evidence that CPR, including compression-only CPR, has the potential to generate aerosols [10][11][12]. Paroya et al detected aerosols on the gloves and gowns of both the BVM provider and the chest compression provider [11]. As space blankets are basic components of first aid kits, they are readily available to lay rescuers and hence can be used to remove aerosols from air leakage by adsorption and drainage below the barrier.…”

Section: Relevance To Rationale and Specific Aimsmentioning

confidence: 99%

“…Airborne particles, especially tiny aerosols, can remain suspended in the environmental air for prolonged periods thus creating persistent hazards to the health of rescuers and patients [5,8,9]. There is evidence that chest compressions and ventilation have the potential to generate aerosols [10][11][12]. The lack of personal protective equipment (PPE) predominantly affects lay rescuers performing cardiopulmonary resuscitation (CPR) in the prehospital setting [13,14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adsorption Capacity of Plastic Foils Suitable for Barrier Resuscitation

Holczmann

Lederer

Isser³

et al. 2022

Coatings

View full text Add to dashboard Cite

Chest compressions and ventilation attempts can generate aerosols during resuscitation. It is important to determine whether different materials suitable for the blanketing of cardiac arrest patients can diminish exposure to aerosols. In this study, three volatile organic compounds, ethanol, acetone, and isoprene, commonly found in human breath in moistened air, acted as substitutes for aerosols. Here, we present information on the adsorption of these volatiles to three blanketing materials: polyvinyl chloride, polyethylene, and aluminum coated polyethylene terephthalate. After exposure to the surfaces of these materials the test volatiles were quantified by the proton transfer reaction-time of flight-mass spectrometry. There was a trend towards a potentially higher reduction for acetone (p = 0.071) and isoprene (p = 0.050) on polyethylene, compared to polyvinyl chloride and aluminum coated polyethylene terephthalate during the rise interval. Adsorption capacity did not differ between the foils and was between 67% and 70%. From our studies, we propose that the aluminum-coated polyethylene terephthalate surface of space blankets prove adequate to diminish exposure to volatiles in moistened air, and hence to aerosols.

show abstract

Barrier Techniques to Reduce Aerosolization During Cardiopulmonary Resuscitation

Abstract: Supplemental Digital Content is available in the text.

Cited by 2 publications

References 1 publication

Effectiveness of “Resuscitation Cover All” in Minimizing COVID-19 Transmission to Health-Care Workers during Cardiopulmonary Resuscitation

Effectiveness of “Resuscitation Cover All” in Minimizing COVID-19 Transmission to Health-Care Workers during Cardiopulmonary Resuscitation

Adsorption Capacity of Plastic Foils Suitable for Barrier Resuscitation

Contact Info

Product

Resources

About