Abstract
Objective: The objectives of this study were (a) to determine the physical impact of the personal protective equipment (PPE) used in COVID-19 care, specifically the impact on the hydration state of the temperature and the comfort of the healthcare workers who use it, and (b) to show the high-fidelity simulated environment as an appropriate place to test the experimental designs to be developed in real environments for COVID-19. Background: All healthcare staff use full PPE in the care of COVID-19 patients. There are problems, such as excessive sweating, which have not been quantified thus far. Methods: A descriptive pilot design was used in a simulated high-fidelity setting. There was paired activity, with mild–moderate physical activity, between 45 and 60 min continuously, with the COVID-19 PPE. Sixteen intensive care nurses were selected. The before–after differential of weight, thirst, weight use of the PPE, body temperature, thermal body image, general and facial warmth sensation, and perspiration sensation were measured. Results: All subjects lost weight in the form of sweat with both PPEs during the simulation scenario, with a mean of 200 g (0.28% of initial weight), and increased thirst sensation. Body thermal image increased by 0.54 °C in people using the full COVID-19 PPE. Conclusions: The use of PPE in the management of critically ill COVID-19 patients generates weight loss related to excessive sweating. The weight loss shown in this pilot test is far from the clinical limits of dehydration. The use of ventilated PPE, such as PAPR, reduce the body temperature and heat sensation experienced by the users of it; at the same time, it improves the comfort of those who wear it. The simulated environment is a suitable place to develop the piloting of applicable research methodologies in future studies in a real environment.
Highlights
The COVID-19 pandemic we have been suffering since the beginning of January 2020 has profoundly changed how society, in general, and health professionals, in particular, provide care to hospitalized patients.Despite the negative manifestations derived from the impact of COVID-19 on health systems, facing this pandemic has taught us a series of lessons for this and other pandemics to come [1]
The results showed that the subjects who utilized protective equipment (PPE), whatever the type, suffered a loss of weight
Our research shows that both types of PPE cause an increase in the sensation of heat; it was higher in the PPE-Conv users than the PPE-PAPR users
Summary
The COVID-19 pandemic we have been suffering since the beginning of January 2020 has profoundly changed how society, in general, and health professionals, in particular, provide care to hospitalized patients.Despite the negative manifestations derived from the impact of COVID-19 on health systems, facing this pandemic has taught us a series of lessons for this and other pandemics to come [1]. All health workers use PPE to protect themselves against physical contact, respiratory droplets (aerosols), and airborne transmission [2,3] This implies the use of respiratory protection devices, such as filtering half-masks for protection against particles, with a filtering efficiency (according to standard UNE-EN 149: 2001 + A1:2010) of 92% (FFP2) for processes with a low risk of aerosolization or with a filtering efficiency of higher than 95% for processes with a high risk of aerosolization (FFP3 or N95), eye protection against aerosols and splashes (goggles and/or face shields) [4] and protective clothing. This clothing consists of a long-sleeved gown with adjustable cuffs that is waterproof, for the general care of confirmed COVID-19 patients, and increasing this protection with a hood and/or boot covers, or a full bodysuit in the case of a positive COVID-19 patient with “unpredictable” behavior, where activities are carried out under potential aerosolization [4,5]
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