You are here

Article Text

Article menu
Download PDFPDF
Original research
Impact of personal protective equipment on neonatal resuscitation procedures: a randomised, cross-over, simulation study
  1. Francesco Cavallin1,
  2. Fiorenzo Lupi2,
  3. Benedetta Bua3,
  4. Marion Bellutti2,
  5. Alex Staffler2,
  6. Daniele Trevisanuto3
  1. 1 Independent Statistician, Solagna, Italy
  2. 2 Department of Neonatology, Bolzano Hospital, Bolzano, Italy
  3. 3 Department of Woman’s and Child’s Health, University Hospital of Padova, Padova, Italy
  1. Correspondence to Dr Daniele Trevisanuto, Department of Woman's and Child's Health, University of Padova, Padova, Italy; daniele.trevisanuto{at}unipd.it

Abstract

Background and objective Healthcare providers should use personal protective equipment (PPE) when performing aerosol-generating medical procedures during highly infectious respiratory pandemics. We aimed to compare the timing of neonatal resuscitation procedures in a manikin model with or without PPE for prevention of SARS-COVID-19 transmission.

Methods A randomised controlled cross-over (AB/BA) trial of resuscitation with or without PPE in a neonatal resuscitation scenario. Forty-eight participants were divided in 12 consultant–nurse teams and 12 resident–nurse teams. The primary outcome measure was the time of positive pressure ventilation (PPV) initiation. The secondary outcome measures were duration of tracheal intubation procedure, time of initiation of chest compressions, correct use of PPE and discomfort/limitations using PPE.

Results There were significant differences in timing of PPV initiation (consultant–nurse teams: mean difference (MD) 6.0 s, 95% CI 1.1 to 10.9 s; resident–nurse teams: MD 11.0 s, 95% CI 1.9 to 20.0 s), duration of tracheal intubation (consultant–nurse teams: MD 22.0 s, 95% CI 7.0 to 36.9 s; resident–nurse teams: MD 9.1 s, 95% CI 0.1 to 18.1 s) and chest compressions (consultant–nurse teams: MD 32.3 s, 95% CI 14.4 to 50.1 s; resident–nurse teams: MD 9.1 s, 95% CI 0.1 to 18.1 s). Twelve participants completed the dressing after entering the delivery room. PPE was associated with visual limitations (43/48 participants), discomfort in movements (42/48), limitations in communication (32/48) and thermal discomfort (29/48).

Conclusions In a manikin model, using PPE delayed neonatal resuscitation procedures with potential clinical impact. Healthcare workers reported limitations and discomfort when wearing PPE.

Trial registration number NCT04666233.

  • neonatology
  • resuscitation

Data availability statement

Data are available upon reasonable request.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/archdischild-2021-322216

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request.

    View Full Text

    Footnotes

    • Contributors FC was responsible for the statistical design and analysis, and contributed to study protocol, data interpretation and writing of the manuscript. FL contributed to preparation of study protocol, data collection, data interpretation and critically reviewed the manuscript. BB contributed to preparation of study protocol, data collection, data interpretation and critically reviewed the manuscript. MB contributed to data collection, data interpretation and critically reviewed the manuscript. AS contributed to preparation of study protocol, data interpretation and critically reviewed the manuscript. DT conceived the study, contributed to study design, data interpretation and writing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.