{
    "abstract": "The use of personal protective equipment (PPE) is essential during cardiopulmonary resuscitation (CPR) to prevent disease transmission, but its impact on rescuer fatigue and CPR quality remains debated.\nTo simultaneously evaluate the effect of PPE on cognitive load and resuscitation quality.\nIn a simulation-based trial at a German tertiary care hospital, 31 healthcare workers performed two 2-minute chest compression (CC) cycles on a manikin, once with PPE and once without. Compression quality (rate, depth, hand position, chest recoil) was assessed. Cognitive load was measured post-task using NASA- and Simulation Task Load Index (NASA- and SIM-TLX). Primary outcome was the difference in cognitive load with and without PPE, and secondary outcomes included differences in CC quality parameters.\nSIM-TLX identified a significant impact of PPE on task complexity and perceptual strain, while situational stress, distractions, task control, and NASA-TLX parameters (mental, physical, temporal demand, frustration, effort, performance) showed no significant differences. No significant differences were found in compression rate (113\u00a0bpm without PPE vs. 109\u00a0bpm with PPE), depth (61\u00a0mm without vs. 62\u00a0mm with PPE), correct hand position (81% without vs. 78% with PPE), and complete chest recoil (94% without vs. 84% with PPE). However not significant, PPE use showed more negative outliers in hand position and chest recoil.\nPPE increases values on two subscales of the SIM-TLX (task complexity and perceptual strain), but does not significantly impact chest compression quality in CPR simulations.",
    "authors": [
        {
            "affiliation": "Department of Internal Medicine, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Johannes",
            "initials": "J",
            "lastname": "Heymer"
        },
        {
            "affiliation": "Department of Internal Medicine, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Daniel",
            "initials": "D",
            "lastname": "R\u00e4pple"
        },
        {
            "affiliation": "Department of Internal Medicine, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Matthias",
            "initials": "M",
            "lastname": "Ott"
        },
        {
            "affiliation": "Department of Anesthesiology, Surgical Intensive Care, Emergency Medicine, and Pain Management, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Florian",
            "initials": "F",
            "lastname": "Dengler"
        },
        {
            "affiliation": "Simulation Center STUPS, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Christina",
            "initials": "C",
            "lastname": "Jaki"
        },
        {
            "affiliation": "Department of Internal Medicine, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Daniel",
            "initials": "D",
            "lastname": "Bent"
        },
        {
            "affiliation": "Department of Internal Medicine, Klinikum Stuttgart, Kriegsbergstra\u00dfe 60, 70174 Stuttgart, Germany.",
            "firstname": "Anna",
            "initials": "A",
            "lastname": "Hegar"
        }
    ],
    "conclusions": "PPE increases values on two subscales of the SIM-TLX (task complexity and perceptual strain), but does not significantly impact chest compression quality in CPR simulations.",
    "copyrights": "\u00a9 2025 The Author(s).",
    "doi": "10.1016/j.resplu.2025.100936\n10.1161/CIR.0000000000000903",
    "journal": "Resuscitation plus",
    "keywords": [
        "Cognitive load",
        "Fatigue",
        "Human factors",
        "Non-technical skills",
        "PPE",
        "SIM-TLX",
        "Simulation training"
    ],
    "methods": null,
    "publication_date": "2025-04-15",
    "pubmed_id": "40230366\n33773826\n32371027\n33046289\n34703728\n33303273\n37265711\n33524489\n38077106\n27465839\n21597890\n3423447\n8886902\n39151508\n36654893\n36233748\n33773831\n32561474\n34425154\n33081527\n24231759\n25447038",
    "results": "SIM-TLX identified a significant impact of PPE on task complexity and perceptual strain, while situational stress, distractions, task control, and NASA-TLX parameters (mental, physical, temporal demand, frustration, effort, performance) showed no significant differences. No significant differences were found in compression rate (113\u00a0bpm without PPE vs. 109\u00a0bpm with PPE), depth (61\u00a0mm without vs. 62\u00a0mm with PPE), correct hand position (81% without vs. 78% with PPE), and complete chest recoil (94% without vs. 84% with PPE). However not significant, PPE use showed more negative outliers in hand position and chest recoil.",
    "title": "Use of personal protective equipment and cognitive load during cardiopulmonary resuscitation - A randomized cross-over simulation-based study.",
    "xml": "<Element 'PubmedArticle' at 0x7885041ff150>"
}