Novel Coronavirus Disease 2019 (COVID-19): Additional guidelines on rational use of Personal Protective Equipment (setting approach for Health functionaries working in non-COVID areas)

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Salient features:

This article focuses on:

  •   Rational use of PPE for Non COVID hospitals and Non-COVID treatment areas of a hospital which has a COVID block

–       Out patient department

–       In-patient Department

–       Emergency Department (Non-COVID)

–       Other Supportive/ Ancillary Services

–       Pre-hospital (Ambulance) Services

  •    Points to remember while using PPE 

Detailed summary:

Rational use of PPE for Non COVID hospitals and Non-COVID treatment areas of a hospital which has a COVID block

  •   Out Patient Department
  1. Help desk/ Registration counter

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1. Doctors chamber

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1.  Chamber of Dental/ENT doctors/ Ophthalmology doctors

Recommended PPE: Use of N-95 mask, goggles, face shields and latex examination  gloves.

The procedures generating aerosols procedures should be anticipated and face shields should be used when splash of body fluids should be expected.

  1. Pre- anesthetic check-up clinic

Recommended PPE: Use of N-95 mask, goggles and latex examination  gloves.

Goggles are recommended only when close examination of oral cavity/dentures is to be done.

  1. Pharmacy counter

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

It is advisable to use hand sanitizer over the glove frequently.

  1. Sanitary staff 

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  • In-patient Department (Non-COVID Hospital &Non-COVID treatment areas of a hospital which has a COVID block)
  1. Ward or individual rooms: Clinical management

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1. ICU/ Critical care: Critical care management 

Recommended PPE: Use of N-95 mask, goggles, face shields and nitrile examination  gloves.

The procedures generating aerosols procedures should be anticipated and face shields should be used when splash of body fluids should be expected.

  1. Ward/ICU/Critical care: Dead body packing

Recommended PPE: Use of N-95 mask, goggles, face shields and nitrile examination  gloves.

  1. Ward/ICU/Critical care (Non-COVID): Dead body transport to mortuary

Recommended PPE: Use of N-95 mask, goggles, face shields and nitrile examination  gloves.

  1. Labor room : Intra-partum care

Recommended PPE: Use of triple layer medical mask, face shields, sterile latex gloves.

N-95 masks should be used if the pregnant woman is a resident of containment zone.

  1. Operation theatre: Performing surgery and administering anaesthesia

Recommended PPE: Use of triple layer medical mask, face shields, goggles and sterile latex gloves.

Goggles should be used when the personnel is involved in areosol generating procedures.

N-95 masks should be used if the patient is a resident of containment zone.

  1. Sanitation : Cleaning frequently touched surfaces/ floor/ changing linen

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  • Emergency Department (Non-COVID)
  1. Emergency : attending emergency cases 

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1. Emergency : Attending to severely ill patients while performing aerosol  generating procedure

 Recommended PPE: Use of full complement of PPE (N-95 mask, coverall, goggle, Nitrile examination gloves, shoe cover)

  • Other Supportive/ Ancillary Services
  1. Routine Laboratory: Sample collection and transportation and testing of routine (nonrespiratory) samples

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1. Routine Laboratory: Respiratory samples

 Recommended PPE: Use of N-95 mask and latex examination gloves.

3.Radiodiagnosis, Blood bank,etc.: Imaging services, blood bank services,etc.

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

4.CSSD/Laundry: Handling linen

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

5.Other supportive services including kitchen: Administrative financial engineering and dietary services,etc.

 Recommended PPE: Face cover should be used

  • Pre-hospital (Ambulance) Services 

1.Ambulance Transfer to designated hospital: Transporting patients not on any assisted ventilation

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

  1. Ambulance Transfer to designated hospital: Management of SARI patient

 Recommended PPE: Use of full complement of PPE (N-95 mask, coverall, goggle, Nitrile examination gloves, shoe cover)

3..Ambulance Transfer to designated hospital: Driving the ambulance

 Recommended PPE: Use of triple layer medical mask and latex examination gloves.

Points to remember while using PPE

  1. Standard precautions should be followed at all times.
  2. Hand hygiene, respiratory etiquettes which must be followed at all times along with wearing of PPE.
  3. A laid down protocol should be followed for disposing off PPEs.

Reference Link : https://www.mohfw.gov.in/pdf/AdditionalguidelinesonrationaluseofPersonalProtectiveEquipmentsettingapproachforHealthfunctionariesworkinginnonCOVIDareas.pdf

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