Reply to Letter: Impact of chemical, biological, radiation, and nuclear personal protective equipment on the performance of low- and high-dexterity airway and vascular access skills

摘要

We thank Dr. Schumacher and colleagues for adding to the debate around skill performance whilst wearing CBRN-PPE and congratulate Schumacher et al. on their recent paper.We chose to assess skills performed in the currently issued NHS CBRN-PPE although we accept that other types of suits and different makes of gloves are available. These variations of CBRN-PPE are not currently issued by the Department of Health and are therefore not widely available within the NHS. We accept that this is an important area of research; however any change in the provision of CBRN-PPE will require significant reinvestment.We agree fully with Schumacher et al.1 that the intramuscular route is the mainstay of immediate patient treatment. However, a number of antidotes, such as those for cyanide as well as other therapies such as fluids require intravascular access. It must also be considered that critically ill patients may have delayed absorption of intramuscular drugs and may require frequent high-doses of atropine.