When it comes to battling COVID-19, medical staff all over the world have been at the forefront. While this implies that our healthcare personnel are selfless, it also makes them more vulnerable to catch the deadly virus. In order to protect them, it is essential to have proper Personal Protective Equipment in place.
Latest guidelines suggest that any clinician working in a hospital, primary care or community care setting (within two metres of a suspected or confirmed coronavirus COVID -19 patient) should wear an apron, gloves, surgical mask and eye protection ‘based on the risk’.
For the riskiest procedures on possible and confirmed cases, a long-sleeved, disposable, fluidrepellent gown (covering the arms and body) or disposable, fluidrepellent coveralls, the highest specification filtering face mask (FFP3), a full-face shield or visor and gloves are recommended. At the opposite end of the scale, for lower-risk situations, singleuse disposable aprons, surgical masks and gloves are considered adequate.
Let’s discuss the appropriate PPE for healthcare professionals in detail:
Filtering facepiece class 3 respirators
Respirators are used to prevent inhalation of small airborne particles arising from AGPs. Since they are so critical in a healthcare setting, all respirators should:
- Cover both nose and mouth.
- Not be allowed to dangle loosely around the neck of the wearer after use.
- Not be touched once it is put on.
- Be removed outside the COVID-19 ward.
- Be compatible with other facial protection used (protective eyewear) so that this does not interfere with the seal of the respiratory protection.
- Be discarded and NOT used if it is damaged, soiled, damp or its seal is compromised.
Respirators are for single session use and are to be discarded as healthcare (clinical) waste (hand hygiene must always be performed after disposal).
Fluid resistant surgical masks
Fluid-resistant surgical masks (FRSM) form a barrier against respiratory droplets reaching the mucosa of the mouth and nose. Their protective effect against severe acute respiratory syndrome (SARS) and other respiratory viral infections has been well established.
• Cover both nose and mouth.
• Not be touched with bare hands once put on.
• Be changed when they become moist or damaged.
• Be worn once and then discarded. Hand hygiene must be performed after disposal
Eye and face protection
Eye and face protective equipment is meant to protect HCPs against contamination to the eyes from respiratory droplets, aerosols arising from AGPs and from splashing of secretions (including respiratory secretions), blood or body fluids. It includes any one of the following:
• Surgical mask with integrated visor.
• Full face shield or visor.
• Polycarbonate safety spectacles or equivalent.
It should be noted that regular corrective spectacles are not considered adequate eye protection. Disposable aprons and gowns Disposable aprons must be provided to the medical staff to protect their uniform or clothes from contamination when providing direct patient care.
This type of PPE must be fluid repellent and must be worn when there is a risk of splashing of body fluids such as during AGPs in higher risk areas or in operative procedures. If non-fluid-resistant gowns are used, a disposable plastic apron should be worn. If extensive splashing is anticipated then use of additional fluid repellent items may be appropriate.
Disposable aprons should be used once and must be disposed off immediately after completion of a procedure or after each patient contact. Hand hygiene should be ensured immediately after.
Disposable gloves must be worn when providing direct patient care and when exposure to blood or other body fluids is likely. Disposable gloves are subject to single use and must be disposed of immediately after completion of a procedure patient contact, followed by hand hygiene. Double gloving is not necessary.
The kind of personal protective equipment and gear to be used differs from facility to facility depending upon the chances of an infected person visiting that facility. So facilities must begin with asking themselves some simple questions:
• Is there a patient or person, who is infectious that is likely to visit your facility?
• Is there a suspected COVID positive case around the facility?
While removing the PPE, particularly gloves, it is recommended to use tools and solutions like GlowGerm, which ensure the safe removal of PPE when a UV light is shined upon it. Alternatively, you can also use the beak technique to remove gloves.
The shortage of PPE
Despite the urgency of a pandemic, the world is facing an acute shortage of PPE. In fact, the World Health Organization (W.H.O) has said that “the chronic, global shortage of PPE 'is one of the most urgent threats to our collective ability to save lives'.”
Can PPE be reused?
Most PPE should not be reused because of the risks of contamination. Some eye and face protection can be used if decontaminated but in many cases it is only designed for single use.