title: The effect of full protective gear on intubation performance by hospital medical personnel.
abstract: OBJECTIVE
  To assess the influence of protective gear on intubation performance.
  
  
  METHODS
  Prospective, controlled measurement of duration and quality of intubations performed on mannequins by medical personnel with and without protective gear in a crossover design.
  
  
  METHODS
  Eight teams each comprising an anesthesiologist and a nurse.
  
  
  RESULTS
  Intubation duration with and without chemical warfare gear was 69.2 +/- 7 and 47.3 +/- 6 seconds (mean +/- SEM), respectively (p < 0.05). Moreover, rating of intubation quality as "very good" by the anesthesiologists declined significantly from 62.5% without chemical warfare protective gear to 6.25% with the garment and mask. Tube fixation was the rate-limiting step when performed with protective gear (p < 0.05); it was assessed by 81% of the anesthesiologists as the critical step. A learning curve was not observed during the study.
  
  
  CONCLUSIONS
  Protective gear causes a significant prolongation of intubation duration; however, endotracheal intubation can be performed effectively. Technical improvements are warranted for tube fixation because it is the critical step.
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Hendler
authors.forename: O
authors.initials: O
authors.lastname: Nahtomi
authors.forename: E
authors.initials: E
authors.lastname: Segal
authors.forename: A
authors.initials: A
authors.lastname: Perel
authors.forename: M
authors.initials: M
authors.lastname: Wiener
authors.forename: J
authors.initials: J
authors.lastname: Meyerovitch
mesh_terms: D000328:Adult; D000776:Anesthesiology; D002618:Chemical Warfare; D002983:Clinical Competence / Q000592:standards*; D018592:Cross-Over Studies; D003666:Decontamination; D006801:Humans; D007442:Intubation, Intratracheal / Q000592:standards*; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D011446:Prospective Studies; D011481:Protective Clothing / Q000009:adverse effects*; D013997:Time Factors