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Emergency medicine: the use of personal protective equipment against Covid-19 does not impair the quality of cardiopulmonary resuscitation

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(Vienna, 26 February 2021 ) Resuscitating a patient following a circulatory arrest, for example after sudden cardiac death, is one of the most challenging procedures in emergency and rescue medicine and is often life-saving. Together with Vienna Emergency Services, the Department of Emergency Medicine of MedUni Vienna and Vienna General Hospital has investigated what impact the wearing of PPE against Covid-19 by paramedics has on the treatment they provide. The results of the study show that they are able to provide the same high quality of cardiopulmonary resuscitation while wearing Covid-19 PPE.

A total of 48 Vienna Emergency Services paramedics took part in the joint study conducted by the Department of Emergency Medicine of MedUni Vienna and Vienna General Hospital and Vienna Emergency Services. The study investigated both the efficacy of the resuscitation procedures and the physical stress on the paramedics due to the wearing of Covid-19 PPE.

In keeping with a realistic emergency scenario, the study participants carried out three 12-minute resuscitation procedures after rushing up the stairs to the third floor wearing full PPE. The chest compression depth of cardiac massage, which, according to international recommendations, should be at least 5 cm, was measured during the resuscitation procedure. The study found the average chest compression depth to be 5.6 cm, both in the group who carried out resuscitation in full Covid-19 PPE and in the group without any PPE. The maximum deviation between the two groups was two millimetres. The results of the study show that the quality of the common life-saving resuscitation procedures is ensured, even when paramedics are working in full Covid-19 protection.

The study also looked at how much stress is placed on the paramedics by wearing full Covid-19 PPE. No increase in CO2 concentration was found as a result of wearing the mask. Only slight differences were found between the blood pressure readings and heart rate of the group carrying out resuscitation in full Covid-19 PPE and the group without any PPE. The maximum difference in heart rate was 5 bpm and 2 mmHg in blood pressure readings. Even the maximum subjective stress perceived by the paramedics wearing full Covid-19 PPE was only a 4 on a scale of 1 to 10 and therefore in the lower range.

The study was financed from the Covid-19 research programme of the "Medical-scientific fund of the Mayor of the federal capital Vienna" and has been published in the leading journal "Resuscitation". Currently, MedUni Vienna is conducting more than 100 research projects on the subject of Covid-19.

Service:
Kienbacher C, Grafeneder J, Tscherny K, Krammel M, Fuhrmann V, Niederer M, Neudorfsky S, Herbich K, Schreiber W, Herkner H, Roth D. The use of personal protection equipment does not impair the quality of cardiopulmonary resuscitation: A prospective triple-cross over randomised controlled non-inferiority trial. Resuscitation 2021.