title: Respiratory protection during simulated emergency pediatric life support: a randomized, controlled, crossover study.
abstract: BACKGROUND
  Emergency pediatric life support (EPLS) of children infected with transmissible respiratory diseases requires adequate respiratory protection for medical first responders. Conventional air-purifying respirators (APR) and modern loose-fitting powered air-purifying respirator-hoods (PAPR-hood) may have a different impact during pediatric resuscitation and therefore require evaluation.
  
  
  OBJECTIVE
  This study investigated the influence of APRs and PAPR-hoods during simulated pediatric cardiopulmonary resuscitation.
  
  
  METHODS
  Study design was a randomized, controlled, crossover study. Sixteen paramedics carried out a standardized EPLS scenario inside an ambulance, either unprotected (control) or wearing a conventional APR or a PAPR-hood. Treatment times and wearer comfort were determined and compared.
  
  
  RESULTS
  All paramedics completed the treatment objectives of the study arms without adverse events. Study subjects reported that communication, dexterity and mobility were significantly better in the APR group, whereas the heat-build-up was significantly less in the PAPR-hood group. Treatment times compared to the control group did not significantly differ for the APR group but did with the PAPR-hood group (261±12 seconds for the controls, 275±9 seconds for the conventional APR and 286±13 seconds for the PAPR-hood group, P < .05.
  
  
  CONCLUSIONS
  APRs showed a trend to better treatment times compared to PAPR-hoods during simulated pediatric cardiopulmonary resuscitation. Study participants rated mobility, ease of communication and dexterity with the tight-fitting APR system significantly better compared to the loose-fitting PAPR-hood.
authors.affiliation: King's College, London, UK. jan.schumacher@kcl.ac.uk
authors.forename: Jan
authors.initials: J
authors.lastname: Schumacher
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Gray
authors.forename: Sophie
authors.initials: S
authors.lastname: Michel
authors.forename: Roger
authors.initials: R
authors.lastname: Alcock
authors.forename: Andrea
authors.initials: A
authors.lastname: Brinker
mesh_terms: D000704:Analysis of Variance; D002648:Child; D018592:Cross-Over Studies; D004632:Emergency Medical Services / Q000379:methods* / Q000458:organization & administration; D060731:Emergency Responders; D004867:Equipment Design; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008020:Life Support Care / Q000379:methods* / Q000592:standards; D008131:London; D008348:Manikins; D016273:Occupational Exposure / Q000517:prevention & control; D012134:Respiratory Protective Devices / Q000009:adverse effects / Q000592:standards*; D012141:Respiratory Tract Infections / Q000517:prevention & control* / Q000628:therapy / Q000635:transmission; D000078329:Workforce