133 Physiological Effects of a Spit Sock

Health care providers and law enforcement utilize spit socks to provide a direct method of universal precautions to prevent exposure to communicable diseases transmitted by bodily fluid projection from an agitated or altered individual. There have been cases in which death of an individual is opined in part to have occurred from limited or reduced ventilation caused by the use of a spit sock. There are no published peer reviewed studies on the use and safety of spit socks in the medical literature. The aim of this study was to evaluate whether there is a clinically significant impact on breathing and ventilation in subjects with a protective spit sock placed on their head. This prospective study evaluated the effect of spit sock application on vital signs and ventilatory parameters of healthy adult volunteers, compared to baseline parameters measured without the spit sock. The subjects were placed on a chair and baseline vital signs and ventilatory parameters were taken, including pulse rate, oxygen saturation, blood pressure, respiratory rate, and end-tidal CO2. The subjects then sat with the spit mask for 15 minutes and their vital signs and ventilatory parameters were recorded after 5min, 10min and 15min of wearing the mask. Vital signs and ventilatory parameters at 5, 10 and 15 minutes after wearing the spit sock were compared to baseline using students t-test with 95% confidence intervals. A total of 15 subjects completed the study. The median age was 28 years and 53% were male. There was no significant difference between baseline measurements and measurements obtained while wearing the spit sock for 5, 10 or 15 minutes for pulse rate (p=0.250, p=0.181, p=0.546 respectively), oxygen saturation (p =0.334, p=1.00, p=0.173 respectively), end-tidal pCO2 (p=0.135, p=0.384, p=0.187 respectively), and diastolic blood pressure (p=0.485, p=0.508, p=0.915 respectively). For respiratory rate, the difference between baseline rate and rate after spit sock application was not significant after 5 and 10 minutes (p=0.898 and p=0.583, respectively), but had statistically significantly decrease at 15 minutes (p=0.048). The systolic blood pressure was significantly lower after 5 and 10 minutes of spit sock application (p=0.028 and p=0.045, respectively), but not significantly different at 15 minutes (p=0.146). No subject had an increase in ETCO2 above 45 or an O2 sat below 94% at any point during the study. No subject indicated any distress nor did the study need to be terminated early due to pre-determined concerning vital signs or ventilatory parameters. In healthy subjects there were no clinically significant changes in physiologic parameters of ventilation while wearing a spit sock. This study offers a foundation for further research into the use and safety of spit socks.