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What is appropriate PPE for treating COVID-19 patients

Respirators/Masks/Facial Covering: Definitions and Differences
posted on 7:11 PM, May 12, 2020

All respirators, from an N95 to a P100 to a Powered Air-Purifying Respirator (PAPR) with appropriate cartridge filters, are considered to have good filtering capability in the setting of an aerosolized biological agent. There is some increased protection provided by the higher “protection factor” of the PAPRs with an in-date high efficiency particulate air (HEPA) filter compared to filtering facepiece respirators such as n95s, but this needs to be weighed against the decreased time that can be spent in the former (heat stress, dehydration, battery pack life) as well as the difficulties with their use (e.g., familiarity, lack of ability to use stethoscopes, decreased hearing from fan noise) and more involved cleaning, donning and doffing procedures. Individuals should receive training in use of a PAPR if such respiratory protection is indicated. 

COVID-19 patients can be safely treated using a face shield or goggles, an appropriately fitting respirator with a good seal, gloves and a gown. Specific recommendations and considerations of high-risk (e.g., intubation or bronchoscopy, cardiopulmonary resuscitation) vs lower-risk procedures (e.g., food or medication delivery, drawing blood), numbers of patients, and frequency of contact may also impact decision making and allocation of limited PPE. Consultation with institutional resources (industrial hygiene, occupational health, infection control) and updated professional society and federal recommendations is encouraged.

REFERENCES:

FEMA has developed fact sheets addressed to both healthcare and non-healthcare settings emphasizing a 3-tier set of actions to Reduce, Reuse, and Repurpose PPE (protection from respiratory and skin/mucous membrane contact). These are available at:

Coronavirus (COVID-19) Pandemic: Addressing PPE Needs in Non-Healthcare Setting

Coronavirus (COVID-19) Pandemic: Personal Protective Equipment Preservation Best Practices

Short Fact Sheet: https://www.fema.gov/media-library-data/1587131519031-6501ee8a0ce72004832fa37141c53bc0/PPE_FACTSHEET.pdf