Impact Of Personal Protective Equipment Research Articles

Midwives’ experiences with PPE during the COVID-19 pandemic: The Birth in the Time of COVID (BITTOC) study

BackgroundThe COVID-19 pandemic resulted in rapid changes aimed at reducing disease transmission in maternity services in Australia. An increase in personal protective equipment (PPE) in the clinical and community setting was a key strategy. There was variation in the type of PPE and when it was to be worn in clincial practice. AimThis paper reports on Australian midwives’ experiences of PPE during the pandemic. MethodsThis sequential mixed methods study was part of the Birth in the Time of COVID-19 (BITTOC 2020) study. Data were obtained from in-depth semi-structured interviews with midwives in 2020 followed by a national survey undertaken at two time points (2020 and 2021). Qualitative open-text survey responses and interview data were analysed using content analysis. Findings16 midwives were interviewed and 687 midwives provided survey responses (2020 n = 477, 2021 n = 210). Whilst midwives largley understood the need for increased PPE, and were mainly happy with this, as it was protective, they reported a number of concerns. These included: inconsistency with PPE type, use, availability, quality, fit and policy; the impact of PPE on the physical and psychological comfort of midwives; and the barriers PPE use placed on communication and woman centred care. This at times resulted in midwives working outside of policy. ConclusionThese findings highlight the need for future comprehensive pandemic preparedness that ensures policy and procedure recommendations are consistent and PPE is available, of approriate quality, and individually fitted in order to ensure that Australian maternity services are well placed to manage future pandemics.

Impact of Personal Protective Equipment on Cardiopulmonary Resuscitation and Rescuer Safety

Background. High-quality cardiopulmonary resuscitation (CPR) is a key element in the rescue of cardiac arrest patients but is difficult to achieve in circumstances involving aerosol transmission, such as the COVID-19 pandemic. Methods. This prospective randomized crossover trial included 30 experienced health care providers to evaluate the impact of personal protective equipment (PPE) on CPR quality and rescuer safety. Participants were asked to perform continuous CPR for 5 minutes on a manikin with three types of PPE: level D-PPE, level C-PPE, and PAPR. The primary outcome was effective chest compression per minute. Secondary outcomes were the fit factor by PortaCount, vital signs and fatigue scores before and after CPR, and perceptions related to wearing PPE. Repeated-measures ANOVA was used, and a two-tailed test value of 0.05 was considered statistically significant. Results. The rates of effective chest compressions for 5 minutes with level D-PPE, level C-PPE, and PAPRs were 82.0 ± 0.2%, 78.4 ± 0.2%, and 78.0 ± 0.2%, respectively ( p = 0.584 ). The fit-factor test values of level C-PPE and PAPRs were 182.9 ± 39.9 vs. 198.9 ± 9.2 ( p < 0.001 ). The differences in vital signs before and after CPR were not significantly different among the groups. In addition, the fatigue and total perception scores of wearing PPE were significantly higher for level C-PPE than PAPRs: 3.8 ± 1.6 vs. 3.0 ± 1.6 ( p < 0.001 ) and 27.9 ± 5.4 vs. 26.0 ± 5.3 ( p < 0.001 ), respectively. Conclusion. PAPRs are recommended when performing CPR in situations where aerosol transmission is suspected. When PAPRs are in short supply, individual fit-tested N95 masks are an alternative. This trial is registered with NCT04802109.

The Impact of Personal Protective Equipment on Healthcare Workers on COVID-19 Duty in a Tertiary Care Hospital in South India.

Context The proper usage of personal protective equipment (PPE) must be prioritised for health care workers (HCWs), where shortages and prolonged use of personal protective equipment can threaten safety in essential health services. Aims To evaluate the effect of personal protective equipment onthe health and well-being ofHCWs, physicians, nurses, and technicians on duty for COVID-19 rotational postings. Settings and design This cross-sectional study was done by simple random sampling. Methods and materials This study was conducted at a tertiary care centre in South India to assess the utilisation of personal protective equipment (PPE) during the second wave of COVID-19. A physical questionnaire was distributed to a total of 266 healthcare workers, aged 20 to 50, who had worked for a minimum of three consecutive days between May and August 2021. The objective of the study was to evaluate the effectiveness of PPE use among healthcare workers during the second wave of the COVID-19 pandemic. Statistical analysis The data analysis in this study was conducted using IBM Statistical Package for Social Sciences (SPSS) version 19 (IBM Corp., Armonk, New York). The mean and standard deviation, or median, were used to present continuous variables, while frequency and percentage were used to present categorical variables. Furthermore, the minimum sample size required for this study was calculated to be 246 participants. Results The survey included 266 healthcare workers. The mean+/-SD of age was 28.18+/-5.64 and consisted of females (54.51%) and males (45.48%). The postings were in emergency (13.15%), intensive care unit (30.82%), and ward (56.01%), respectively. The HCWs who used PPE for four to seven days reported more symptoms than those who used it for one to three days. Discomforts experienced while wearing PPE were chest suffocation (49.62%), difficulty in performing intubation (36.09%), difficulty in seeing clearly (68.79%), dizziness (49.62%), excessive sweating (75.56%), micturition desire (52.63%), nausea (42.48%), retro-auricular pain (56.76%), stomach burns (27.44%), and thirst or dry throat (78.57%). The symptoms suffered after doffing were tiredness (69.17%), dry mouth (67.29%), dizziness (43.60%), headache (55.63%), chest suffocation (36.46%), dry skin (57.14%), reduced ability to concentrate (48.12%), dark-coloured urine (55.63%), reduced alertness (42.48%), and stomach burns (28.94%). The first thoughts after doffing were to drink water (68.42%), eat something (36.09%), clean yourself (61.27%), urinate (33.08%), and have some rest (29.32%), respectively. 81 (30.45%). The HCWs suffered skin injuries while wearing gloves. The time for restoring after a shift was 12 hours (37.59%), 24 hours (34.21%), 36 hours (11.65%), and 48 hours (16.59%). Pressure sores were reported on the forehead by 53 (19.92%) participants, the nose by 54 (20.30%), the cheek by 31 (11.65%), and behind the ear by 77 (65.71%) participants. The optimal size of PPE was experienced only by 76 (28.57%) participants, while 73 (27.44%) of them felt tight and 117 (43.98%) felt loose. Conclusions To minimise discomfort while managing infectious diseases, HCWs can adopt several practices like taking regular breaks, ensuring humane working hours, utilising high-quality PPE, and wearing properly fitting gear. By implementing these measures, HCWs can enhance their ability to handle infectious diseases effectively while prioritising their comfort and well-being.

Impact of personal protective equipment on the clarity of vision among trachoma survey graders and trichiasis surgeons in the context of COVID-19

Background/aimsThe COVID-19 pandemic necessitated the use of personal protective equipment for those involved in trachoma survey grading and trichiasis surgery. We sought to determine which configuration of a face shield...

Impact of SARS-CoV-2 infection in patients with hereditary hemorrhagic telangiectasia: epidemiological and clinical data from the comprehensive Italian retrospective multicenter study

Rare Disease patients manifested high concern regarding the possible increased risk of severe outcomes and worsening of disease-specific clinical manifestation due to the impact of COVID-19. Our aim was to assess the prevalence, outcomes, and impact of COVID-19 in patients with a rare disease such as Hereditary Hemorrhagic Telangiectasia (HHT) in Italian population. A nationwide, multicentric, cross-sectional observational study was conducted on patients with HHT from five Italian HHT centers by online survey. The association between COVID-19-related signs and symptoms and nosebleeds worsening, the impact of personal protective equipment on nosebleeds pattern, and the relationship between the presence of visceral AVMs and severe outcomes were analyzed. Out of 605 total survey responses and eligible for analysis, 107 cases of COVID-19 were reported. A mild-course COVID-19 disease, not requiring hospitalization, was observed in 90.7% of patients, while the remaining eight cases needed hospitalization, two of them requiring intensive-care access. No fatal outcome was recorded and 79.3% of patients reported a complete recovery. No difference in infection risk and outcome between HHT patients and general population was evidenced. No significative interference of COVID-19 on HHT-related bleeding was found. The majority of patients received COVID-19 vaccination, with relevant impact on symptoms and need for hospitalization in case of infection. COVID-19 in HHT patients had an infection profile similar to the general population. COVID-19 course and outcome were independent from any specific HHT-related clinical features. Moreover, COVID-19 and anti-SARS-CoV-2 measures did not seem to affect significantly HHT-related bleeding profile.

Impact of personal protective equipment attached powered air-purifying respirator on nursing-skill performance and psychosocial stress of intensive care unit COVID-19 nurses: A cross-sectional study.

To investigate how personal protective equipment with an attached powered air-purifying respirator worn by intensive care unit nurses caring for COVID-19 patients in Korea impacts nursing-skill performance and psychosocial stress. A cross-sectional descriptive study was designed using purposive sampling. Online data collection was conducted from 3 March 2021-20 March 2021on 181 nurses who had worked for more than 1 month in COVID-19 critical care settings wearing personal protective equipment with a powered air-purifying respirator. A structured questionnaire was used to gather data on sociodemographic characteristics, attitude toward personal protective equipment, nursing-skill performance wearing personal protective equipment and psychosocial stress. Data was sourced from structured questionnaire responses. Nursing skill performance decreased to 63.4%, compared with normal performance. Subjects' perceptions and attitudes related to PPE scored 3.56 out of 5; 44.7% of subjects reported severe psychosocial stress, which was significantly affected by attitude toward personal protective equipment usage, nursing performance, experience caring for COVID-19 patients and length of personal protective equipment usage per shift. Greater negative attitude toward usage of personal protective equipment with a powered air-purifying respirator, results in lower nursing-skill performance and higher the psychosocial stress of nurses responding to COVID-19 outbreaks. High negative attitude toward PPE and low nursing-skill performance due to PPE with an attached PAPR results in significant and debilitating psychosocial stress in ICU nurses responding to COVID-19 outbreaks. To respond effectively to future infectious disease outbreaks and improve nursing performance, minimising the inconvenience and restrictions experienced by nurses wearing personal protective equipment is critical. We adhered to relevant EQUATOR guidelines to report. No patient or public contribution.

Evidence-Based Medicine in Otolaryngology Part 14: Falsehood and Bias.

Falsehood and bias can have tangible effects, whether related to the "hoax" of Corona virus disease/COVID-19 or the impact of personal protective equipment in city-wide news. The spread of false information requires the diversion of time and resources into rebolstering the truth. Our objective is thus to elucidate types of bias that may influence our daily work, along with ways to mitigate them. Publications are included which delineate specific aspects of bias or address how to preempt, mitigate, or correct bias, whether conscious or unconscious. We discuss: (1) the background and rationale for proactively considering potential sources of bias, (2) relevant definitions and concepts, (3) potential means to limit effects of inaccurate data sources, and (4) evolving frontiers in the management of bias. In doing so, we review epidemiological concepts and susceptibility to bias within study designs, including database studies, observational studies, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. We additionally discuss concepts such as the difference between disinformation and misinformation, differential or nondifferential misclassification, bias toward a null result, and unconscious bias, among others. We have the means to mitigate sources of potential bias in database studies, observational studies, RCTs, and systematic reviews, beginning with education and awareness. False information may spread faster than true information, so it is beneficial to understand potential sources of falsehood we face, in order to safeguard our daily impressions and decisions. Awareness of potential sources of falsehood and bias forms the foundation for accuracy in our everyday work.

Impact of Personal Protective Equipment on the Quality of Chest Compressions in Prehospital Care: A Prospective Randomized Crossover Study

AbstractIntroduction:The use of personal protective equipment (PPE) in prehospital emergency care has significantly increased since the onset of the coronavirus disease 2019 (COVID-19) pandemic. Several studies investigating the potential effects of PPE use by Emergency Medical Service providers on the quality of chest compressions during resuscitation have been inconclusive.Study Objectives:This study aimed to determine whether the use of PPE affects the quality of chest compressions or influences select physiological biomarkers that are associated with stress.Methods:This was a prospective randomized, quasi-experimental crossover study with 35 Emergency Medical Service providers who performed 20 minutes of chest compressions on a manikin. Two iterations were completed in a randomized order: (1) without PPE and (2) with PPE consisting of Tyvek, goggles, KN95 mask, and nitrile gloves. The rate and depth of chest compressions were measured. Salivary cortisol, lactate, end-tidal carbon dioxide (EtCO2), and body temperature were measured before and after each set of chest compressions.Results:There were no differences in the quality of chest compressions (rate and depth) between the two groups (P >.05). After performing chest compressions, the group with PPE did not have elevated levels of cortisol, lactate, or EtCO2 when compared to the group without PPE, but did have a higher body temperature (P <.001).Conclusion:The use of PPE during resuscitation did not lower the quality of chest compressions, nor did it lead to higher stress-associated biomarker levels, with the exception of body temperature.

Impact of fire protective equipment and the self-contained breathing apparatus on peak exercise in males and females

With an increase in the number of females entering the fire service it is important to understand the potential impact of personal protective equipment (PPE) on females. This study compared selected physiological responses during two graded exercise tests (GXT) performed in a counterbalanced design: GXTPT – wearing athletic clothing while breathing through a low-resistance valve; and GXTPPE – wearing PPE and breathing from a self-contained breathing apparatus (SCBA). Sixteen males and 15 females acted as participants. O2 peak was significantly lower, by approximately 15%, during the GXTPPE compared to the GXTPT condition for both the males and females. Physiologically, the decreased oxygen consumption was strongly related to an attenuated ventilation (r = 0.75 and 0.71) and oxygen pulse (r = 0.94 and 0.93) for the males and females, respectively. The results of this investigation demonstrate that the SCBA and PPE impacts males and females to a similar relative extent and manner. Practitioner summary: Little information exists regarding the impact of the SCBA and PPE on physiological parameters for females. This investigation determined that females have reduced exercise capacities to the same extent as males, which should be considered when evaluating the aerobic demands of fire suppression work and the fitness levels of firefighters. Abbreviations: GXT: graded exercise test; SCBA: self-contained breathing apparatus; personal protective equipment; MMC: metabolic measurement cart; ANOVA: analysis of variance; RPE: rating of percieved exertion; PRD: perceptions of respiratory distress; PTD: percieved thermal distress; O2: rate of oxygen consumption; O2 peak: rate of oxygen consumption at peak exercise; E peak: minute ventilation at peak exercise; E/CO2: ventilatory equivalent for carbon dioxide; FVC: forced vital capacity; FEV1: forced expiratory volume in one second; FEF25-75%: forced expiratory flow; PEF: peak expiratory flow rate; MVV: maximum voluntary ventilation.

Personal protective equipment usage among Iranian police officers during COVID-19 pandemic; a cross-sectional study

Objective: Due to the important role of police during COVID-19 pandemics and lack of previous studies on the impact of personal protective equipment (PPE) in reduction of COVID-19 infection among police officers, we aimed to investigate the role of using PPE in prevention of COVID-19 infection among Iranian police personnel.
 Methods: This cross-sectional survey was conducted in Tehran, Iran during January 2021 to November 2022. The study sample consisted of police personnel who were active in field operations. Demographics (age, height, weight, gender, marital status, number of children and underlying diseases) and job characteristics such as frequency and type of operations, involvement of colleagues with COVID-19, and COVID-19 infection history, using PPE, types of used PPE (mask, face shield, gloves, etc), protective strategies (such as social distancing) and COVID-19 vaccination were recorded. Statistical analysis was performed with IBM SPSS Statistics for Windows, version 25.
 Results: Totally, 340 participants were analyzed (33.54±9.74 years old, 91.2% males), of whom, 150 participants (44.1%) reported at least one episode of confirmed COVID-19 infection. The most common component of PPE used both during operations and daily life was face mask (44.7% and 75%, respectively). The most popular measure with higher adherence compared to others was social distancing with 70% popularity and an adherence score of 5.85±3.74. Three hundred subjects (88.2%) had received at least one dose of COVID-19 vaccine. Among PPE items, using face mask, washing hands with soap, social distancing and vaccination were significantly different between patients with and without prior COVID-19 infection (p>0.05).
 Conclusion: The findings showed that use of PPE is significantly efficacious in reduction of COVID-19 infection among police officers. Therefore, despite difficulties of using PPE among police forces, it is strongly recommended for virus spread control in this population.

Uncomfortable yet necessary: The impact of PPE on communication in emergency medicine.

The efficacy of pre-hospital emergency services is heavily dependent on the effective communication of care providers. This effective communication occurs between providers as part of a team and also among providers interacting with family members and patients. The COVID-19 pandemic introduced a number of communication challenges to emergency care, which are primarily linked to the increased use of personal protective equipment (PPE). We sought to analyze the impacts of the COVID-19 pandemic on emergency medical service (EMS) workers and pre-hospital care delivery. We conducted focus groups and one-on-one interviews with fire-based EMS first responders between September 2021 and 2022. Interviews included questions about job-related stress, EMS skills, work experiences and changes during COVID-19. Interviews were recorded, independently dual coded and analyzed for themes. Two hundred twenty-three first responders participated in 40 focus groups and 40 lead paramedics participated in individual interviews. We found that additional use of PPE was reported to have significantly impaired efficiency and perceptions of quality of care-among EMS team members and also between EMS workers and patients. EMS personnels also experienced on-scene hostility on arrival (from both families and other agencies). Extensive use of PPE muffles voices, obscures facial expressions and can cause team members to have difficulty recognizing and communicating with one another and can be a barrier to showing empathy and connecting with patients. Creative solutions such as putting a hand on someone's shoulder, wearing name tags on suits and explaining rationale for perceived delays were mentioned as methods to transcend these barriers. The appearance of providers in heavy PPE can be unsettling and create barriers to human connection, particularly for pediatric patients. Human connection is an important element of health-care delivery and healing. These findings shed light on new skills that are needed to initiate and maintain human connection in these times of PPE use, especially full-body PPE. Awareness of the communication and empathy barriers posed by PPE is the first step to improving provider-patient interactions in pre-hospital EMS. Additionally, 'communication-friendly' adaptations of PPE equipment may be an important area for future research and development in manufacturing and the health-care industry.

Experiences of personal protective equipment and reasons for non-compliance

Background:The COVID-19 pandemic created challenges in prehospital care. Paramedics have been required to adhere to strict protocols regarding infection control and the use of personal protective equipment (PPE). These protocols have evolved as the pandemic progressed. Understanding the experiences of paramedics in using PPE and their reasons behind not adhering to recommended guidelines should improve the limited evidence base and assist healthcare organisations to form tailored PPE guidance, enabling better protection of paramedics.Aim:This study aimed to analyse evidence on paramedics' experiences of using PPE and explore the reasons behind non-compliance to inform PPE policies.Methods:Searches of five key databases identified papers relating to frontline practitioners' experiences of using PPE; frontline was defined as working in patient-facing roles in prehospital, emergency department or critical care settings. Articles were then subject to thematic analysis as part of this narrative review.Results:Three themes emerged: physical and emotional wellbeing; impact on patient care and clinical effectiveness; and PPE fatigue. The evidence explores health professionals' experiences of working in this difficult environment but very little data exist regarding the impact of PPE, specifically on UK paramedics or their reasons for not adhering to PPE protocols.Conclusion:PPE affects wearers in a variety of ways. Factors behind non-adherence are multifactorial. A paucity of literature exists regarding paramedics' experiences of using PPE.

Maskne-Dermatosis of a Pandemic. A Survey on the Impact of PPE on Facial Skin Among HCW and N-HCW in Poland.

IntroductionDuring the SARS-CoV-2 pandemic, personal protective equipment (PPE) became the new social norm for preventing COVID-19, but with an impact on the skin barrier. This study aimed to analyze the factors influencing PPE wearing, following hygiene rules, and effect on facial skin, including onset or exacerbation of dermatoses among healthcare workers (HCW) and non-healthcare workers (N-HCW).MethodsIn 2020, an original survey was carried out among 300 N-HCW and 60 HCW with 60 questions about using PPE and skin lesions experienced before and during the pandemic. Cross-sectional statistical analysis was completed to assess the interplay between environmental factors and maskne occurrence.ResultsThe N-HCW group included 74% females and 26% males with an average age 24.67 ± 0.74. Among HCW respondents 91.7% were women and 8.3% were men, with an average age of 30.07 ± 0.36. All participants used PPE. Volunteers for N-HCW mainly chose a disposable (53.3%) and reusable masks (37.3%), while HCW preferred surgical (66.7%) and FFP2/FFP3/N95 masks (30%) and almost never used reusable masks (3.3%). HCW mainly spent 5–8 h with PPE, and N-HCW spent 1–4 h with PPE/day. Respondents with dermatological problems before the pandemic were more aware of the maskne and paid more attention to hygiene with PPE. Significantly, HCW experienced more severe facial skin lesions than N-HCW (p < 0.0001). There was statistical significance in following the basic hygienic rules of wearing PPE between both groups, where HCW practiced them more.ConclusionsMaskne is a current and urgent problem to be cured. HCW should receive help if they develop maskne, such as limited time spent in PPE and treatment of the results of wearing it, as it is the main trigger of developing maskne. In addition, education about the correct use and choice of PPE should be improved.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00796-w.

Impact of coronavirus pandemic litters on microfiber pollution-effect of personal protective equipment and disposable face masks.

Coronavirus Pandemic is the current biggest challenge against humanity. Apart from the personal health issues and higher mortality by the coronavirus, recent research works have also reported the environmental impacts of the pandemic. The review aims to analyze the current status of face masks and personal protective equipment littering and subsequent environmental impact in terms of microplastic and microfiber pollution. Recent researches in this domain are collected from the leading databases with relevant keywords and critically analyzed. The review results report a multi-fold increment in the usage of personal protective equipment, particularly face masks after the pandemic. Mismanagement of these items leads them to reach the marine environment through a variety of transportation. The results show a significant amount of increment in plastic and pandemic-related littering after the pandemic. The systematic review shows that the use of synthetic fibers in disposable personal protective equipment and masks leads to release of fibers that can add-on to microfiber pollution. The results are also true in the case of reusable masks as the repeated laundry and disinfection methods release a significantly higher amount of microfibers. Only very few studies have addressed the release of microfiber from the mask, and no studies have reported the impact of personal protective equipment. The worldwide mass adaptation and improper disposal of these materials increase the seriousness of the problem multiple folds. These findings suggest the immediate requirement of critical analysis of the pandemic-related littering and microfiber release characteristics. The research also urges the need for the implementation of an environmental management plan as a mitigation strategy around the globe.

Study of Short-Term Effects on the Soil of Disposable Protective Face Masks Used in the COVID-19 Pandemic

The paper analyzes the impact of personal protective equipment used by the population as a result of the COVID-19 pandemic on the environment. The scale of the additional amount of waste generated as a result of the use of protective face masks, etc. is noted. The globality of the existing problem and its multiparametric impact on the components of the environment are indicated. The short-term effect of a number of disposable protective face masks on the condition of soil by chemical component has been studied. The dependence of leaching of heavy metals from masks on soil acidity was experimentally analyzed, the dynamics of mobile phosphorus and potassium in soil samples was studied. It is shown that the presence of masks in the soil leads to exceeding the standard for zinc content, while for copper content and manganese content exceeding the standard is not observed in the study period, for lead there are fluctuations in content beyond standard value. The need for long-term research on the impact of face masks on the environment, and in particular soils, was noted.

The Impact of Personal Protective Equipment on Speech Discrimination and Verbal Communication in the Operating Room and the Role of Audio Communication Devices.

Recent work has highlighted communication difficulties when wearing personal protective equipment (PPE) in the clinical setting, but currently, there are little objective data on its effects. We assessed the impact of PPE on verbal communication in a simulated operating room and evaluated use of an audio communication device. Frontline health professionals across specialties including surgery, anesthetics, and nursing undertook speech discrimination testing with and without standardized levels of PPE in a simulated operating room environment. Background noise (30- and 70-a-weighted decibel multitalker babble) at 2 distances (2 and 4 m) were selected representative of operating room environments. Bamford-Kowal-Bench (BKB) scoring (192 sentences per participant) was performed. A Digital Multichannel Transceiver System (DMTS) was evaluated. We assessed the effects of PPE use, distance, and use of the DMTS with pairwise comparisons, using a Bonferroni correction, and assessed participant experience via Likert scales. Thirty-one healthcare professionals were tested. Without PPE in 70-a-weighted decibel "babble," median BKB sentence scores were 90% and 76% at 2 and 4 m (adjusted P < 0.0005). The median BKB sentence scores dropped to 8% and 4% at 2 and 4 m in PPE (adjusted P < 0.0005). Improved speech discrimination was achieved with DMTS use to 70% and 76% at 2 and 4 m. Personal protective equipment led to a statistically significant reduction in BKB scores across all conditions compared with baseline. Overall participant confidence in PPE clinical communication was low. Addition of PPE dramatically impairs speech discrimination and communication in high levels of background noise characteristic of clinical environments, which can be significantly improved using DMTS. Measures should be taken by teams through both through reduction of background noise and consideration of assistive technologies maximizing patient safety. This may be further rehearsed in a simulation environment.

Impact of Personal Protective Equipment in the Covid-19 Era: A Study of Health Workers in Ghana

COVID-19 has become well-known in the world. The measures to kill the virus have also become hard to come by. Personal Protective Equipment (PPE) has been using by health workers to contain the virus in Ghana hence the study sought to ascertain the impact of Personal Protective Equipment on Ghanaian health workers in the COVID-19 era. The study used primary and secondary sources of data. Importantly, a simple random sampling technique was used to engage a total of 2,420 health workers in Ghana, and also convenience sampling technique was used to select 150 public hospitals and 150 private hospitals for the study. The study used both questionnaires and in-depth interviews to gather the required information. The information obtained from the participants was analyzed by content and statistical analysis. It was revealed that health workers have been using Personal Protective Equipment frequently to contain the spread of the COVID-19 virus in the health care setting in Ghana. It was recommended that health workers should use the Personal Protective Equipment according to indication. Intensive monitoring was also recommended to check the proper uses of the Personal Protective Equipment by health workers in Ghana. Lastly, a sensitization programme was recommended to give more insight on the importance of using Personal Protective Equipment by health workers in Ghana.

Impact of personal protective equipment on psychological and physical health during menstruation: A cross-Sectional study among female frontline healthcare workers during COVID pandemic.

During the Coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment (PPE) has undoubtedly provided a shield of protection for the healthcare workers fighting the disease. However, the layers of the PPE kit restrict basic human activities and also have been associated with various other problems like dehydration, suffocation, breathlessness, headache, and dermatitis. A cross-sectional study was done among 180 Female health workers who wore the PPE kit during COVID-19 duty in a tertiary health care center during the period March 2021 to May 2021. The content-validated survey tool developed by Google Forms used as a platform was sent to 180 Female health workers of COVID-19 hospitals to minimize face-to-face or physical interaction. The Work-Related Quality of Life Scale (WRQoL) was used. The majority of the participants were interns (48.9%) and belonged to the age group of 21 to 25 years (67.7%). The approximate duration of wearing a PPE kit was 6 to 12 h for almost half of the study participants. Sanitary pads were used by over 90% of the participants. Only 59 out of 180 (32.7%) were provided with an extra PPE kit during menstruation. About 131 (72.7%) Female Health workers (FHWs) (FHWs) had to remove the PPE kit due to excessive sweat during menstruation; 110 FHW's out of 180 (61.1%) who participated in the study had to remove the PPE kit due to severe thirst and dehydration. Sweating (91%), dehydration (86.7%), rashes (49.9%), extreme thirst (56.5%), abdominal cramps (53.3%), and headache (59.8%) were the major complaints of the participants. The majority of the participants had low quality of life scores based on WRQoL. Use of PPE for long hours especially during menstruation can affect one both physically and psychologically compromising the work performance and decision-making. Minor changes in the work place environment can drastically improve the work-related quality of life.

Lived experiences of healthcare workers on the front line during the COVID-19 pandemic: a qualitative interview study

ObjectivesThis study aimed to investigate the presence of perceived stressors, psychological safety and teamwork in healthcare professionals. As the timeframe for this study spanned the first wave of the COVID-19...

Impact of Personal Protective Equipment on Out-of-Hospital Cardiac Arrest Resuscitation in Coronavirus Pandemic.

BackgroundandObjectives: This retrospective study evaluated the clinical impact of enhanced personal protective equipment (PPE) on the clinical outcomes in patients with out-of-hospital cardiac arrest. Moreover, by focusing on the use of a powered air-purifying respirator (PAPR), we investigated the medical personnel’s perceptions of wearing PAPR during cardiopulmonary resuscitation. Materialsand Methods: According to the arrival time at the emergency department, the patients were categorized into a conventional PPE group (1 August 2019 to 20 January 2020) and an enhanced PPE group (21 January 2020, to 31 August 2020). The primary outcomes of this analysis were the return of spontaneous circulation (ROSC) rate. Additionally, subjective perception of the medical staff regarding the effect of wearing enhanced PPE during cardiopulmonary resuscitation (CPR) was evaluated by conducting a survey. Results: This study included 130 out-of-hospital cardiac arrest (OHCA) patients, with 73 and 57 patients in the conventional and enhanced PPE groups, respectively. The median time intervals to first intubation and to report the first arterial blood gas analysis results were longer in the enhanced PPE group than in the conventional PPE group (3 min vs. 2 min; p = 0.020 and 8 min vs. 3 min; p < 0.001, respectively). However, there were no significant differences in the ROSC rate (odds ratio (OR) = 0.79, 95% confidence interval (CI): 0.38–1.67; p = 0.542) and 1 month survival (OR 0.38, 95% CI: 0.07–2.10; p = 0.266) between the two groups. In total, 67 emergent department (ED) professionals responded to the questionnaire. Although a significant number of respondents experienced inconveniences with PAPR use, they agreed that PAPR was necessary during the CPR procedure for protection and reduction of infection transmission. Conclusion: The use of enhanced PPE, including PAPR, affected the performance of CPR to some extent but did not alter patient outcomes. PAPR use during the resuscitation of OHCA patients might positively impact the psychological stability of the medical staff.