Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

Martín-Rodríguez, Francisco; Sanz-García, Ancor; López-Izquierdo, Raúl; Delgado Benito, Juan F.; Martín-Conty, José L.; Castro Villamor, Miguel A.; Ortega, Guillermo J.

BACKGROUND: More recently, due to the coronavirus disease 2019 pandemic, health care workers have to deal with clinical situations wearing personal protective equipment (PPE); however, there is a question of whether everybody will tolerate PPE equally. The main objective of this study was to develop a risk model to predict whether health care workers will tolerate wearing PPE, C category, 4B/5B/6B type, during a 30-minute simulation. METHODS: A nonexperimental simulation study was conducted at the Advanced Simulation Center, Faculty of Medicine, Valladolid University (Spain) from April 3rd to 28th, 2017. Health care students and professionals were equipped with PPE and performed a 30-minute simulation. Anthropometric, physiological, and analytical variables and anxiety levels were measured before and after simulation. A scoring model was constructed. RESULTS: Ninety-six volunteers participated in the study. Half the sample presented metabolic fatigue in the 20 minutes after finishing the simulation. The predictive model included female sex, height, muscle and bone mass, and moderate level of physical activity. The validity of the main model using all the variables presented an area under the curve of 0.86 (95% confidence interval: 0.786–0.935), and the validity of the model had an area under the curve of 0.725 (95% confidence interval: 0.559–0.89). CONCLUSIONS: Decision-making in biohazard incidents is a challenge for emergency team leaders. Knowledge of health care workers' physiological tolerance of PPE could improve their performance.