Use of personal protective equipment during infectious disease outbreak and nonoutbreak conditions: a survey of emergency medical technicians.
OBJECTIVE
We sought to assess the knowledge of, use of and barriers to the use of personal protective equipment for airway management among emergency medical technicians (EMTs) during and since the 2003 Canadian outbreak of Severe Acute Respiratory Syndrome (SARS).


METHODS
Using a cross-sectional survey, EMTs in Toronto, Ont., were surveyed 1 year after the SARS outbreak during mandatory training on the use of personal protective equipment in airway management during the outbreak and just before taking the survey. Practices that were addressed reflected government directives on the use of this equipment. Main outcome measures included the frequency of personal protective equipment use and, as applicable, why particular items were not always used.


RESULTS
The response rate was 67.3% (n = 230). During the SARS outbreak, an N95-type particulate respirator was reported to be always used by 91.5% of respondents. Conversely, 72.9% of the respondents reported that they never used the open face hood. Equipment availability and vision impairment were often cited as impediments to personal protective equipment use. In nonoutbreak conditions, only the antimicrobial airway filter was most often reported to be always used (52.0%), while other items were used at an intermediate frequency. The most common reason for not always donning equipment was that paramedics deemed it unnecessary for the situation.


CONCLUSIONS
Personal protective equipment is not consistently employed as per medical directives. Reasons given for nonuse included nonavailability, judgment of nonnecessity or technical difficulties. There are important public health implications of noncompliance.
Visentin
Laura M
LM
Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.
Bondy
Susan J
SJ
Schwartz
Brian
B
Morrison
Laurie J
LJ
D000328:Adult; D003625:Data Collection; D004196:Disease Outbreaks; D004634:Emergency Medical Technicians; D005135:Eye Protective Devices / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011481:Protective Clothing / Q000706:statistics & numerical data; D011482:Protective Devices / Q000706:statistics & numerical data*; D012134:Respiratory Protective Devices / Q000706:statistics & numerical data; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000635:transmission