Safe On-Boat Resuscitation by Lifeguards in COVID-19 Era: A Pilot Study Comparing Three Sets of Personal Protective Equipment

Abstract

Introduction: On-boat resuscitation can be applied by lifeguards in an inflatable rescue boat (IRB). Due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and recommendations for the use of personal protective equipment (PPE), prehospital care procedures need to be re-evaluated. The objective of this study was to determine how the use of PPE influences the amount of preparation time needed before beginning actual resuscitation and the quality of cardiopulmonary resuscitation (CPR; QCPR) on an IRB. Methods: Three CPR tests were performed by 14 lifeguards, in teams of two, wearing different PPE: (1) Basic PPE (B-PPE): gloves, a mask, and protective glasses; (2) Full PPE (F-PPE): B-PPE + a waterproof apron; and (3) Basic PPE + plastic blanket (B+PPE). On-boat resuscitation using a bag-valve-mask (BVM) and high efficiency particulate air (HEPA) filter was performed sailing at 20km/hour. Results: Using B-PPE takes less time and is significantly faster than F-PPE (B-PPE 17 [SD = 2] seconds versus F-PPE 69 [SD = 17] seconds; P = .001), and the use of B+PPE is slightly higher (B-PPE 17 [SD = 2] seconds versus B+PPE 34 [SD = 6] seconds; P = .002). The QCPR remained similar in all three scenarios (P >.05), reaching values over 79%. Conclusion: The use of PPE during on-board resuscitation is feasible and does not interfere with quality when performed by trained lifeguards. The use of a plastic blanket could be a quick and easy alternative to offer extra protection to lifeguards during CPR on an IRB.

Transmission of Infections during Cardiopulmonary Resuscitation

“…Recently, the utilization of drones for PPE or automated external defibrillator delivery for communication of safety instructions has been proposed as a potential strategy to encourage, instruct, and reassure rescuers who perform CPR during the pandemic ( 112 ). Finally, the use of a plastic blanket as a quick and alternative PPE has been suggested in order to offer extra protection to the lifeguards during on-boat resuscitation without any delay of the CPR initiation ( 113 ).…”

Analysis of Physiological Response during Cardiopulmonary Resuscitation with Personal Protective Equipment: A Randomized Crossover Study

“…The effect of PPE on resuscitation is not yet consistent. While some studies have found no significant change in the CPR quality [ 17 , 18 ], a recent systematic review suggests that PPE may affect the rate and depth of cardiac compressions (CC) [ 2 ]. Despite that, the resuscitation time in all studies reviewed did not exceed 4 min.…”

Performance of Basic Life Support by Lifeboat Crewmembers While Wearing a Survival Suit and Life Vest: A Randomized Controlled Trial

“…Due to the current COVID-19 pandemic, increasing attention has been focussed on the personal protective equipment (PPE) worn by rescuers. As a consequence, aquatic rescue organizations around the world are re-evaluating their resuscitation protocols, seeking on the one hand to avoid contamination of rescuers as much as possible, while on the other hand assuring high quality resuscitation ( 25 – 27 ). The results of the current study may be of interest to rescue organizations, as they do not demonstrate a profound negative effect of the heavy survival suits with life jackets on BLS quality.…”