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First responder communication in CBRN environments: FIRCOM-CBRN study
  1. Jan Schumacher1,2,
  2. James Arlidge1,
  3. Declan Dudley1,
  4. Jennifer Van Ross1,
  5. Francesca Garnham3,
  6. Kate Prior4,5
  1. 1 Anaesthetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  2. 2 School of Medical Education, King’s College London, London, UK
  3. 3 Department of Emergency Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  4. 4 Anaesthesia, King’s College Hospital NHS Foundation Trust, London, UK
  5. 5 Royal Navy, London, UK
  1. Correspondence to Dr Jan Schumacher, School of Medical Education, King’s College London, London SE1 7EH, UK; jan.schumacher{at}


Introduction Recent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection.

Objective To determine the influence of currently used respirators and VPUs on medical communication and speech intelligibility.

Methods 37 trauma anaesthetists carried out an evaluation exercise of six different respirators and VPUs including one control. Participants had to listen to audio clips of a variety of sentences dealing with scenarios of emergency triage and medical history taking.

Results In the questionnaire, operators stated that speech intelligibility of the Avon C50 respirator scored the highest (mean 3.9, ±SD 1.0) and that the Respirex Powered Respiratory Protective Suit (PRPS) NHS-suit scored lowest (1.6, 0.9). Regarding loudness the C50 plus the Avon VPU scored highest (4.1, 0.7), followed by the Draeger FPS-7000-com-plus (3.4, 1.0) and the Respirex PRPS NHS-suit scored lowest (2.3, 0.8).

Conclusions We found that the Avon C50 is the preferred model among the tested respirators. In our model, electronic voice projection modules improved loudness but not speech intelligibility. The Respirex PRPS NHS-suit was rated significantly less favourably in respect of medical communication and speech intelligibility.

  • resuscitation
  • CbRn
  • communications

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  • Contributors JS planned the study, was responsible for the overall content as guarantor, compiled and submitted the manuscript. JA collected the data. JVR collected the data and helped to compile the manuscript. FG compiled the ‘Medical Emergency History Taking and Communication Script’. KP provided military medicine expertise and helped to compile the manuscript.

  • Funding Funding was provided by departmental support.

  • Competing interests None declared.

  • Ethics approval The study received National Research Ethics Service approval by the South London REC Office and GSTFT Research and Development approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.