Chemical protective clothing; a study into the ability of staff to performlifesaving procedures

Objective-To investigate the ability of medical and nursing staff to perfor m certain tasks while wearing a chemical protection suit with a respirator. Tasks chosen were those that would be required before decontamination. Methods-Ten experienced accident and emergency doctors (middle grade and co nsultants) and 10 nurses were asked to perform certain tasks that were judg ed to be life saving, relevant to triage, or necessary to confirm death, on an advanced life support manikin, while wearing a TST-Sweden chemical prot ection suit. The operators were objectively assessed by one of the authors for achieving each task, then asked to make a subjective assessment of the difficulty experienced. Results-Medical staff were asked to ventilate the manikin using a bag-valve -mask, intubate within 30 seconds, apply monitor electrodes and cables and check cardiac rhythm, apply gel pads and defibrillate safely, and finally, fold the cruciform ;triage card to show "RED", and attach it to the manikin . All the doctors completed these tasks, except for one, who could only int ubate the manikin after several attempts. Nursing staff were asked to open and apply an oxygen mask, adjust oxygen flow, size and insert an oropharyng eal airway, ventilate the manikin using a bag-valve-mask, apply a pressure bandage to a Limb, and fold the cruciform triage card to show "YELLOW", and attach it to the manikin. All the nurses completed these tasks. Operators reported varying degrees of difficulty, the most difficult tasks were those requiring fine movements of delicate control. Generally, operators found t he butyl rubber gloves cumbersome. Communication difficulties were frequent ly reported. Although only intubation was formally timed, tasks were percei ved to take longer. Some operators found the suits too warm and uncomfortab le. Conclusion-Should the need arise, the TST-Sweden chemical protection suits would enable experienced doctors and nurses to perform lifesaving measures effectively, without significant impairment to their skills. Tasks would be easier to accomplish with better fitting gloves.