The effect of full protective gear on intubation performance by hospital medical personnel

Objective: To assess the influence of protective gear on intubation performance. Design: Prospective, controlled measurement of duration and quality of intubations performed on mannequins by medical personnel with and without protective gear in a crossover design. Participants: Eight teams each comprising an anesthesiologist and a nurse. Results: Intubation duration with and without chemical warfare gear was 69.2 ± 7 and 47.3 ± 6 seconds (mean ± SEM), respectively (p < 0.05). Moreover, rating of intubation quality as 'very good' by the anesthesiologists declined significantly from 62.5% without chemical warfare protective gear to 6.25% with the garment and mask. Tube fixation was the rate-limiting step when performed with protective gear (p < 0.05); it was assessed by 81% of the anesthesiologists as the critical step. A learning curve was not observed during the study. Conclusion: Protective gear causes a significant prolongation of intubation duration; however, endotracheal intubation can be performed effectively. Technical improvements are warranted for tube fixation because it is the critical step.