• Yukari Goto, Naruhiro Jingushi, Hiroaki Hiraiwa, Hiroaki Ogawa, Yoshinori Sakai, Daisuke Kasugai, Taku Tanaka, Michiko Higashi, Takanori Yamamoto, and Atsushi Numaguchi.
• Department of Emergency and Critical Care, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, Aichi 466-8560, Japan. Electronic address: gotoyu@med.nagoya-u.ac.jp.
• Am J Emerg Med. 2021 Nov 1; 49: 172-177.

BackgroundAirborne personal protective equipment is required for healthcare workers when performing aerosol-generating procedures on patients with infectious diseases. Chest compressions, one of the main components of cardiopulmonary resuscitation, require intense and dynamic movements of the upper body. We aimed to investigate the protective effect of tight-fitting powered air-purifying respirators (PAPRs) during chest compressions.MethodsThis single-center simulation study was performed from February 2021 to March 2021. The simulated workplace protection factor (SWPF) is the concentration ratio of ambient particles and particles inside the PAPR mask; this value indicates the level of protection provided by a respirator when subjected to a simulated work environment. Participants performed continuous chest compressions three times for 2 min each time, with a 4-min break between each session. We measured the SWPF of the tight-fitting PAPR during chest compression in real-time mode. The primary outcome was the ratio of any failure of protection (SWPF <500) during the chest compression sessions.ResultsFifty-four participants completed the simulation. Overall, 78% (n = 42) of the participants failed (the measured SWPF value was less than 500) at least one of the three sessions of chest compressions. The median value and interquartile range of the SWPF was 4304 (685-16,191). There were no reports of slipping down of the respirator or mechanical failure during chest compressions.ConclusionsAlthough the median SWPF value was high during chest compressions, the tight-fitting PAPR did not provide adequate protection.Copyright © 2021 Elsevier Inc. All rights reserved.

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