Table 2.
Results of studies included in research question 3: comparison of personal protective equipment strategies effect on infection, PPE effectiveness, and quality of CPR.
| Study, year | Design/setting | Population (clinical) | Procedure | Intervention and comparator | Outcomes measured |
|---|---|---|---|---|---|
| Randomised control trials | |||||
| Schumacher et al., 2013 | Manikin RCT (crossover) UK |
16 paramedics | Paediatric cardiac arrest (airway management, defibrillation, drug administration) – paediatric manikin | Intervention group 1: Conventional air-purifying respirators (APR) Intervention group 2: Modern loose-fitting air-purifying respirator-hoods (PAPR-hood) Comparator: no PPE |
Treatment duration: Control: 261 s (SD 12) APR: 275 s (SD 9) PAPR-hood: 286 s (SD 13) P < 0.0001 for difference between groups. |
| Shin et al., 2017 | Manikin RCT (crossover) Korea |
30 healthcare workers | Simulated chest compressions with real-time feedback – adult manikin | Intervention group 1: cup-type respirator mask preformed into a cup shape Intervention group 2: fold-type respirator mask that is flexible and 3-folded Intervention group 3: valve-type respirator mask similar to the fold-type respirator with valve |
Adequate protection rate (%) during chest compressionsa: Cup-type: 44.9% (SD 42.8) Fold-type: 93.2% (SD 21.7) Valve-type 59.5% (SD 41.7%) P < 0.001 for difference between groups. Compression quality similar between groups |
| Watson et al., 2008 | Manikin RCT Canada |
58 firefighters | Simulated CPR – manikin | Intervention Group 1: Standard gown plus N95 respirator, gloves and eye protection Intervention group 2: Modified gown and an N95 respirator, gloves and eye protectionb Comparator: No gown, but PPE included an N95 respirator, gloves and eye protection. |
Time to chest compressions (seconds): Standard gown: 71 (95% CI 66–77 Modified gown 59 (95% CI 54–63) No gown: 39 (95% CI 34–43) P < 0.001 for difference between groups). |
RCT – Randomised Controlled Trial; SD – Standard Deviation; PPE – personal protective equipment; 95% CI – 95% confidence interval.
a
Fit factor calculated as concentration of particles outside respirator divided by concentration inside respirator (maximum value − 200) − fit factor >100 considered adequate protection.
b
Modified gown comprises re-tied neck ties waist ties that are tied at front.