The Effect of a Plastic Barrier Drape on Resuscitation Performance and Provider Contamination

Background Patient barriers to protect health care workers from COVID-19 exposure have been studied for airway management. Few are tested for cardiopulmonary resuscitation (CPR). We sought to determine whether a plastic drape barrier affects resuscitation performance and contamination risks for a simulated cardiopulmonary arrest scenario. Methods This pilot trial randomized in-hospital resuscitation teams of 4 to 6 participants to a plastic drape or without a drape in an in situ cardiopulmonary arrest simulation. The mannequin's airway emanated simulated virus particles (GloGerm, Moab, UT), detectable through UV light. Primary outcomes included airway management and CPR quality measures. Secondary outcomes included visible contamination on personal protective equipment (PPE). We used the Non-Technical Skills (NO-TECHS) instrument to measure perceived team performance and the NASA Task Load Index (NASA-TLX) to measure individual workload. Outcome variables were analyzed using an analysis of covariance (ANCOVA) with participant number as a covariate. Results Seven teams were allocated to the intervention (plastic drape) group and 7 to the control. Intubation and ventilation performance (η2 = 0.09, P > 0.3) and chest compression quality (η2 = 0.03–0.19, P > 0.14) were not affected by the plastic drape. However, mean contaminated PPE per person decreased with the drape (2.8 ± 0.3 vs. 3.7 ± 0.3, partial η2 = 0.29, P = 0.05). No differences in perceived workload nor team performance were noted (P > 0.09). Conclusions In this pilot study, the use of a plastic drape barrier seems not to affect resuscitation performance on simulated cardiopulmonary arrest but decreases health care worker contamination risk. Further implementation trials could characterize the true risk reduction and any effect on resuscitation outcomes.

背景 对于气道管理中保护医护人员免受新冠病毒暴露的患者相关屏障已进行了研究。但针对心肺复苏（CPR）的此类研究却很少。我们试图确定在模拟心肺骤停场景中，塑料布屏障是否会影响复苏操作表现以及污染风险。 方法 这项试点试验将由4到6名参与者组成的院内复苏团队随机分为使用塑料布组和不使用塑料布组，进行现场心肺骤停模拟。模拟人气道释放可通过紫外线检测的模拟病毒颗粒（GloGerm，美国犹他州莫阿布）。主要结局包括气道管理和心肺复苏质量指标。次要结局包括个人防护装备（PPE）上的可见污染。我们使用非技术技能（NO - TECHS）工具来评估团队的感知表现，使用美国国家航空航天局任务负荷指数（NASA - TLX）来衡量个人工作量。使用协方差分析（ANCOVA）并将参与者人数作为协变量对结果变量进行分析。 结果 7个团队被分配到干预（塑料布）组，7个团队被分配到对照组。插管和通气操作表现（η² = 0.09，P > 0.3）以及胸部按压质量（η² = 0.03 - 0.19，P > 0.14）不受塑料布的影响。然而，使用塑料布时每人受污染的个人防护装备平均数有所降低（2.8 ± 0.3对比3.7 ± 0.3，偏η² = 0.29，P = 0.05）。在感知工作量和团队表现方面未发现差异（P > 0.09）。 结论 在这项试点研究中，使用塑料布屏障似乎不会影响模拟心肺骤停时的复苏操作表现，但会降低医护人员的污染风险。进一步的实施试验可以确定真正的风险降低程度以及对复苏结果的任何影响。