Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks

Pediatric Emergency Care December 2021

Adler MD, Krug S, Eiger C, Good GL, Kou M, Nash M, Henretig FM, Hornik CP, Gosnell L, Chen JY, Debski J, Sharma G, Siegel D, Donoghue A

 

This study evaluated the impacts of personal protective equipment (PPE) on timeliness or success of emergency procedures performed by pediatric health care providers (HCPs). For session 1, HCPs wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE’s impact on procedures performed in a clinical care context.

 

 

Impact of Personal Protective Equipment on Pediatric Cardiopulmonary Resuscitation Performance: A Controlled Trial

Pediatric Emergency Care • June 2020

Donoghue A, Kou M, Good G, Eiger C, Nash M, Henretig F, Stacks H, Kochman A, Debski J, Chen JY, Sharma G, Hornik C, Gosnell L, Siegel D, Krug S, Adler M, on behalf of the Best Pharmaceuticals for Children Act – Pediatric Trials Network

This study aimed to determine whether personal protective equipment (PPE) results in deterioration in chest compression (CC) quality and greater fatigue for administering health care providers (HCPs). HCPs completed 2 sessions. In session 1 (baseline), HCPs wore normal attire; in session 2, HCPs donned full PPE. We enrolled 108 HCPs. During a clinically appropriate 2-minute period, neither CC quality nor self-reported fatigue worsened to a significant degree in providers wearing PPE. Our data suggest that Pediatric Basic Life Support recommendations for CC providers to switch every 2 minutes need not be altered with PPE use.

 

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Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

Disaster Medicine and Public Health Preparedness • May 2020

Kou M, Donoghue AJ, Stacks H, Kochman A, Semiao M, Nash M, Siegel D, Ku L, Debski J, Chen J-Y, Sharma G, Gosnell L, Krug S, Adler MD

This study examined the effects of personal protective equipment (PPE) on the ability of prehospital providers (PHPs) to perform resuscitation procedures on pediatric patients. This prospective study was conducted at a US simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.

Mercy babyTAPE approved for marketing

The U.S. Food and Drug Administration (FDA) has approved marketing of Mercy babyTAPE. Developed by PTN’s Dr. Susan Abdel-Rahman of Children’s Mercy Hospital, the Mercy babyTAPE device is intended for use by health care professionals to estimate the body weight of infants from birth to 90 days of age.

“Weight is the foremost marker of health and health outcomes in infants. A weighing scale remains the universal gold standard for obtaining weight in children and is highlighted by the World Health Organization as one of four essential pieces of equipment needed when caring for newborns. However, the vast majority of healthcare providers in remote, resource-constrained settings simply do not have access to functional, calibrated scales with the precision necessary to accurately determine weight,” Dr. Abdel-Rahman said.

Many critically ill newborns in the U.S. suffer similar challenges when it comes to weight assessment. For infants receiving care in a neonatal intensive care unit, it can be nearly impossible to remove or account for the weight of life-sustaining medical equipment, prior to obtaining a scale-based weight. The relative error introduced by such equipment can significantly affect the safety profile of the medicines these infants receive. As a result, dosing errors are more likely to occur.

The approved marketing of Mercy babyTAPE is a substantial accomplishment in PTN’s quest to improve healthcare for children by determining optimal dosing of commonly used medications.

A Weight Estimation Strategy for Preterm and Full-Term Infants

Global Pediatric Health • December 2017.

Abdel-Rahman SM, Paul IM, Delmore P, James L, Fearn L, Atz A, Poindexter B, Al-Uzri A, Lewandowski A, Harper B, Smith PB.

Weight is the foremost marker of health outcomes in infants; however, the majority of community workers and health care providers in remote, resource-constrained settings have limited access to functional scales. This study develops and validates a simple weight estimation strategy for infants that addresses the limitations of current approaches.

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An anthropometric survey of US pre-term and full-term neonates

Annals of Human Biology • December 2017.

Abdel-Rahman SM, Paul IM, Delmore P, James L, Fearn L, Atz AM, Poindexter BB, Al-Uzri A, Lewandowski A, Harper BL, Smith PB; Best Pharmaceuticals for Children Act – Pediatric Trials Network.

Anthropometric data prove valuable for screening and monitoring various medical conditions. In young infants, however, only weight, length and head circumference are represented in publicly accessible databases. Our aim was to characterise length and circumferential measures in pre-term and full-term infants up to 90 days post-natal.

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Evaluation of the Mercy TAPE: performance against the standard for pediatric weight estimation.

Annals of Emergency Medicine • October 2013.

Abdel-Rahman SM, Paul IM, James LP, Lewandowski A; Best Pharmaceuticals for Children Act-Pediatric Trials Network.

We assessed the performance of 2 new devices (2D- and 3D-Mercy TAPE) to implement the Mercy Method for pediatric weight estimation and contrasted their accuracy with the Broselow method. We enrolled children aged 2 months through 16 years in this prospective, multicenter, observational study.

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Innovative clinical trial design for pediatric therapeutics

Expert Review of Clinical Pharmacology • September 2011.

Laughon MM, Benjamin DK Jr, Capparelli EV, Kearns GL, Berezny K, Paul IM, Wade K, Barrett J, Smith PB, Cohen-Wolkowiez M.

Until approximately 15 years ago, sponsors rarely included children in the development of therapeutics. US and European legislation has resulted in an increase in the number of pediatric trials and specific label changes and dosing recommendations, although infants remain an understudied group.

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