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Use of personal protective equipment during infectious disease outbreak and nonoutbreak conditions: a survey of emergency medical technicians

Published online by Cambridge University Press:  21 May 2015

Laura M. Visentin ,
Susan J. Bondy ,
Brian Schwartz  and
Laurie J. Morrison
Laura M. Visentin
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.
Susan J. Bondy*
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.
Brian Schwartz
Affiliation:
Sunnybrook Osler Centre for Prehospital Care, Toronto, Ont. Department of Family and Community Medicine, University of Toronto, Toronto, Ont.
Laurie J. Morrison
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ont. Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ont.
*
Dalla Lana School of Public Health, Health Science Building, 155 College St.Toronto ON M5T 3M7; [email protected]

Abstract

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Objective:

We sought to assess the knowledge of, use of and barriers to the use of personal protective equipment for airway management among emergency medical technicians (EMTs) during and since the 2003 Canadian outbreak of Severe Acute Respiratory Syndrome (SARS).

Methods:

Using a cross-sectional survey, EMTs in Toronto, Ont., were surveyed 1 year after the SARS outbreak during mandatory training on the use of personal protective equipment in airway management during the outbreak and just before taking the survey. Practices that were addressed reflected government directives on the use of this equipment. Main outcome measures included the frequency of personal protective equipment use and, as applicable, why particular items were not always used.

Results:

The response rate was 67.3% (n = 230). During the SARS outbreak, an N95-type particulate respirator was reported to be always used by 91.5% of respondents. Conversely, 72.9% of the respondents reported that they never used the open face hood. Equipment availability and vision impairment were often cited as impediments to personal protective equipment use. In nonoutbreak conditions, only the antimicrobial airway filter was most often reported to be always used (52.0%), while other items were used at an intermediate frequency. The most common reason for not always donning equipment was that paramedics deemed it unnecessary for the situation.

Conclusion:

Personal protective equipment is not consistently employed as per medical directives. Reasons given for nonuse included nonavailability, judgment of nonnecessity or technical difficulties. There are important public health implications of noncompliance.

Keywords

Infectious diseaseoutbreakemergency medical systemprehospital medicineparamedicspopulation survey
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 1 , January 2009 , pp. 44 - 56
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

1.Poutanen, SM, Low, DE, Henry, B, et al.Identification of severe acute respiratory syndrome in Canada. N Engl J Med 2003;348: 1995–2001.CrossRefGoogle ScholarPubMed
2.Naylor, D, Basrur, S, Bergeron, MG, et al.Learning from SARS: renewal of public health in Canada. Ottawa (ON): Health Canada; 2003.Google Scholar
3.Bissell, RA, Seaman, KG, Bass, RR, et al.Change the scope of practice of paramedics? An EMS/public health policy perspective. Prehosp Emerg Care 1999;3:140–9.CrossRefGoogle ScholarPubMed
4.Verbeek, PR, McClelland, IW, Silverman, AC, et al.Loss of paramedic availability in an urban emergency medical services system during a Severe Acute Respiratory Syndrome outbreak. Acad Emerg Med 2004;11:973–8.Google Scholar
5.Booth, TF, Kournikakis, B, Bastien, N, et al.Detection of airborne severe acute respiratory syndrome (SARS) coronavirus and en-vironmental contamination in SARS outbreak units. JInfect Dis 2005;191:1472–7.Google Scholar
6.Shaw, K.The 2003 SARS outbreak and its impact on infection control practices. Public Health 2006;120:8–14.Google Scholar
7.Wallington, T, Berger, L, Henry, B, et al.Update: Severe Acute Respiratory Syndrome — Toronto, Canada, 2003. Can Commun Dis Rep 2003;52:547–50.Google Scholar
8.Young, J, D’Cunha, C. Directives to all Ontario prehospital providers and ambulance communications services. Toronto (ON): SARS Provincial Operations Centre, Ontario Ministry of Health and Long-Term Care; 2003. Available: www.health.gov .on.ca/english/providers/program/pubhealth/sars/docs/new_normal /dir_prehospital_care.pdf (accessed 2008 Nov 28).Google Scholar
9.Young, J, D’Cunha, C.Directives to all Ontario prehospital providers and ambulance communications centres regarding management of patients with possible communicable diseases including SARS under outbreak conditions. Toronto (ON): SARS Provincial Operations Centre, Ontario Ministry of Health and Long-Term Care; 2003.Available: www.health.gov.on.ca /english/providers/program/pubhealth/sars/docs/docs2/dir_prehosp _outbreak_120703.pdf (accessed 2008 Nov 28).Google Scholar
10.Provincial equipment standards for Ontario ambulance services for use of Ontario land and air ambulance services. Toronto (ON): Ministry of Health and Long-Term Care; 2000.Google Scholar
11.Yassi, A, Bryce, E, Moore, D, et al.Protecting the faces of health care workers: knowledge gaps and research priorities for effective protection against occupationally-acquired respiratory infectious disease. Toronto (ON): The Change Foundation; 2004.Google Scholar
12.Watson, L, Sault, W, Gwyn, R, et al.Cardiopulmonary resuscitation in an out-of-hospital cardiac arrest simulation model: the “delay effect” of donning a gown. Prehosp Emerg Care 2006;10:145.Google Scholar
13.Campbell, A.Spring of fear. Toronto (ON): SARS Commission; 2006.Google Scholar
14.Last, JM.A dictionary of epidemiology. 4th ed.New York (NY): Oxford University Press; 2001.Google Scholar
15.Lateef, F, Lim, SH, Tan, EH.New paradigm for protection: the emergency ambulance services in the time of severe acute respiratory syndrome. Prehosp Emerg Care 2004;8:304–7.Google Scholar
16.Smyser, MS, Bryce, J, Joseph, JG.AIDS-related knowledge, attitudes, and precautionary behaviors among emergency medical professionals. Public Health Rep 1990;105:496–504.Google Scholar
17.Davidson, G, Gillies, P.Safe working practices and HIV infection: knowledge, attitudes, perception of risk, and policy in hospital. Qual Health Care 1993;2:21–6.Google Scholar
18.Gellert, GA, Maxwell, RM, Higgins, KV, et al.AIDS and prehospital personnel: knowledge and prevention of occupational exposure. Prehospital Disaster Med 1996;11:112–6.Google Scholar
19.Mencl, F, Birkle, M, Blanda, M, et al.EMT’s knowledge regarding transmission of infectious disease. Prehosp Emerg Care 2000;4:57–61.Google Scholar
20.Salant, P, Dillman, DA.How to conduct your own survey. New York (NY): John Wiley & Sons; 1994.Google Scholar
21.National Physician Survey Collaborative. NPS 2007 methodology and generalizability of results. Mississauga (ON): College of Family Physicians of Canada, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada; 2008.Google Scholar