Impact of Personal Protective Equipment on Intravascular AccessEffectiveness

Abstract

A year ago, the world faced the problem of infections with the new SARS-CoV-2 coronavirus, which quickly became a pandemic. The risk of infection for emergency medical personnel is relatively high, so in the era of a pandemic, the best solution would be for medical personnel to provide medical assistance to patients in pre-hospital conditions, when wearing full personal protective equipment (PPE) for aerosol generating procedures (AGPs) (1,2). However, as many studies show, the use of protective suits may reduce the effectiveness of the procedures performed, both in terms of the effectiveness of a procedure and the extension of its time (3-5). In many clinical situations where drugs must be administered quickly or fluid resuscitation is started, prompt intravascular access is a priority for emergency care. However, in the case of a collapsed vascular bed, and the use of prophylactic double gloves, accessing it can be difficult or even impossible. Then an alternative to peripheral intravenous access (PIV) could be intraosseous access (IO). As indicated by many studies, the intraosseous access is a full-fledged intravascular access, through which we can administer both drugs to the patient and use fluid resuscitation or transfuse blood and blood products.According to the research by Castle et al. (6) the mean length of the procedure for obtaining intraosseous access with PPE AGP was 36±9.8 seconds and was statistically significantly shorter than with obtaining intravascular access (126.9±39.8; p