You don’t need to be a healthcare professional to know that wearing PPE, such as masks and gloves, can feel stuffy. For most of us, that makes a quick run to the store or chat with a neighbor uncomfortable. But for frontline nurses and doctors during COVID-19, extra protective layers have made 12-hour shifts much more grueling.
Now, there might be a solution.
New research out of Radboud University, published in Temperature, has discovered a simple intervention that can keep healthcare staff more comfortable, even while they wear masks, gloves, gowns, and mechanical respirators for hours on end. The solution? Allow nurses to put on chill vests similar to those worn by elite athletes before marathons.
Perhaps cooling vests sound like an over-engineered solution to counteract the discomfort of PPE. In fact, working inside PPE doesn’t just feel hot; it really is hot, as temperatures inside PPE can exceed 90 degrees F.
Radboud researchers monitored 17 nurses over two days in a COVID-19 ward, and each spent one day working with a cooling vest and one day without. Physiologically speaking, not much changed for nurses wearing the vests. Their average heart rate was only two beats per minute lower with the vest on. And their core body temperature stayed the same with or without the vest. As it turns out, while PPE makes the environment under our clothes hotter, the human body is still excellent at regulating its own internal temperature, even working in such stuffy conditions.
However, nurses reported feeling far more comfortable when wearing the vests. Without a vest, 81% of participants reported feeling uncomfortably hot, while 94% reported feeling slightly warmer than they wanted. (In other words, nearly every nurse recognized that PPE made them feel worse.) With the vest, everything changed. Only 18% of nurses reported feeling uncomfortable from heat, and only 36% reported feeling slightly warm.
Bottom line: Without vests, a majority of nurses were a little to very uncomfortable. With the vests, a vast majority of nurses were comfortable. And as a result, the nurses reported feeling like they could work normally, even though they were wrapped in PPE (though we should note that actual nurse efficiency and error rates weren’t validated as part of the study).
In any case, the investment seems feasible for wards that can afford a few dozen vests. Operationally, the $190, 2.6-pound CoolOver-branded vests were worn on top of scrubs but under PPE. They were chilled in a refrigerator before being stored in standard Coleman coolers on-site at COVID-19 wards. After use, the vests were wiped down with alcohol and rechilled for another shift. (The vests can keep their cool for 12 hours at a time, though nurses donned them in three-hour chunks with breaks in between.)
Even though the secondary clinical benefits are unproven, it’s easy to imagine that more comfortable healthcare workers will lead to overall better healthcare for patients. But even if not, the nurses and doctors who have spent the last year risking their lives on the front lines of this pandemic deserve all the support that technology can offer—even if that support is just about comfort.