1. If you are assessing suspected COVID19 patients: 

 

 

2.  How to Don and Doff PPE 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.  PPE Guidelines for Aerosol-generating procedures 

  • As mentioned above, PPE requirements for aerosol-generating procedures are gown, N95 respirator mask, full face shield, and gloves. 

 

  • What are aerosol-generating procedures? [1,2]

  • Non-invasive ventilation (NIV) 

  • High-flow nasal cannula (HFNC) (Airway devices >6L/min) **done in airborne infection isolation room) [2]

  • Endotracheal intubation

  • Cardiopulmonary resuscitation

  • Bronchoscopy

  • Airway aspiration

  • Tracheostomy care 

  • Necropsy

  • Continuous positive air pressure 

  • Nebulizer therapy

  • Induction of sputum discharge 

 

  • Please note: 

  • Recommendations for aerosolizing procedures:[1,2] 

  • To double glove when performing procedures and care for COVID19 patients (in case of tears).

  • Recommended to add whole-body protecting clothing + cap/hood for tracheal intubation, laryngoscopy, and cardio-pulmonary resuscitation

  • Recommended to add full facepiece negative-pressure respirator, powered air-purifying respirators, and positive pressure airline respirators for high risk procedures such as bronchoscopy and autopsy [1,3] 

  • A paper published from South Korea describes  use of N95 masks for all COVID19 patient assessment and surgical masks only for transfer of medical waste [1] 

4. World Health Organization table on recommendations for PPE for diverse situation [6]

(Resource Link: WHO: Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19))

The table below is derived as an outline summary of recommendations from the WHO. Detail and nuance has been omitted. Please see direct link for the complete version of the table of recommendations. Note that FFP2, mentioned in the full table, are European equivalents to N95s 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.  If you are a pathologist or dealing with those who have deceased from COVID19:[4]

Link: UK source: Royal College of Pathologists - Autopsy practice related to possible COVID19 cases

References: 

 

  1. Huh, S. (2020). How to train the health personnel for protecting themselves from novel coronavirus (COVID-19) infection during their patient or suspected case care. Journal of Educational Evaluation for Health Professions, 17, 10

  2. Cheung, J. C. H., Ho, L. T., Cheng, J. V., Cham, E. Y. K., & Lam, K. N. (2020). Staff safety during emergency airway management for COVID-19 in Hong Kong. The Lancet Respiratory Medicine.

  3. Personal Protective Equipment. (n.d.). Retrieved from http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/infection-control/personal-protective-equipment

  4. Osborn, M., Lucas, S., Stewart, R., Swift, B., & Youd, E. Briefing on COVID-19.

  5. Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. Published online March 11, 2020. doi:10.1001/jama.2020.3633

  6. World Health Organization. (2020). Rational use of personal protective equipment for coronavirus disease (COVID-19): interim guidance, 27 February 2020 (No. WHO/2019-nCov/IPCPPE_use/2020.1). World Health Organization.

  7. Personal Protective Equipment. (n.d.). Retrieved from http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/infection-control/personal-protective-equipment

 
 
 
 

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