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Vascular access outcomes while wearing PPE – Full Text

"This comprehensive meta-analysis suggests that the use of PPE significantly extends the duration of intravascular procedures" Drozd et al (2021).
Abstract:

Background: Obtaining vascular access is one of the key procedures in patients in emergency settings.

Aims: The study was conducted as a meta-analysis and a systematic review, with the aim of addressing the following question: Which intravascular access method shouldbe used when wearing full personal protective equipment (PPE)to patients with COVID-19?

Methods: We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials (RCTs), comparing intravascular access methods performed by operators wearing full level C PPE. We evaluated the procedure time and success rate of intraosseous and peripheral intravenous access.

Results: Eight RCTs were included in quantitative synthesis. The use of PPE during intravascular access procedures has an influence on the procedure time of intraosseous access (MD=11.69; 95%CI: 6.47, 16.92; P<0.001), as well as reduced the success rate by 0.8% in intraosseous access and by 10.1% in intravenous access. Under PPE conditions, intraosseous access, compared with peripheral intravenous access, offered a shorter procedure time (MD = -41.43; 95% CI: -62.36, -24.47; P< 0.001).

Conclusion: This comprehensive meta-analysis suggests that the use of PPE significantly extends the duration of intravascular procedures. However, under PPE conditions, operators were able to obtain intraosseousaccess in a significantly shorter time and with a higher success rate.

Reference:

Drozd A, Smereka J, Filipiak KJ, Jaguszewski M, Ładny JR, Bielski K, Nadolny K, Ruetzler K, Szarpak Ł. Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19. Kardiol Pol. 2021 Jan 7. doi: 10.33963/KP.15741. Epub ahead of print. PMID: 33415967.