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Personal Protective Equipment (PPE) Guidelines

When any infection outbreak affects a broad population, the concerned authorities are responsible for making specific recommendations for infection control measures in different circumstances and settings. However, the FDA plays a significant role in regulating personal protective equipment. All Personal Protective Equipment that is intended for use as a medical device must follow the FDA's regulations and should positively meet applicable voluntary consensus standards for protection. This includes N95 respirators, surgical masks, medical gowns, and gloves. When the rules and regulations (which vary according to the type of PPE) are followed, they provide reasonable assurance that the equipment is safe for use and effective.

What is Personal Protective Equipment (PPE)?

Personal protective equipment, also commonly referred to as "PPE'' is equipment worn to minimize exposure to hazards that cause serious workplace illnesses and injuries. These may result from several factors: contact with chemical, physical, radiological, electrical, mechanical, or other hazards. Personal protective equipment includes things like safety glasses, gloves, shoes, respirators, earplugs or muffs, hard hats, vests, coveralls, and full bodysuits.

They are usually designed to protect the wearer from injury or to contain the spread of an infection or illness. PPE should fit comfortably, encouraging worker use. Fitting plays a vital role and makes the difference between being safely covered or dangerously exposed. When engineering, administrative controls, or work practice are not feasible or often do not offer sufficient protection, employers must provide personal protective equipment to their workers and ensure its proper use. Employers are also additionally required to train each worker to help them know a few things:

  • What kind of PPE is necessary?
  • When is it necessary?
  • How to properly put it on, adjust, wear, and take it off?
  • Proper care, useful life, maintenance and disposal of the equipment
  • The limitations of the equipment

How does PPE Work?

When used correctly, they act as a barrier between infectious materials like viral and bacterial contaminants and the skin, nose, mouth, or eyes (mucous membranes). The barrier has the potential to prevent the transmission of contaminants from body fluids, blood, or respiratory secretions. It also offers protection to patients who may be at high risk for contracting infections or who have a medical precondition like immunodeficiency, from being exposed to potentially infectious substances brought in by visitors and healthcare workers.

When used effectively, responsibly and correctly with other implemented infection control practices like using alcohol-based hand sanitizers frequently or aggressive hand washing and covering coughs and sneezes, it will minimize the spread of the virus from one person to another. Effective use of PPE, however, must include adequately removing and disposing of the contaminated Personal Protective Equipment to eradicate the possibility of exposure.

COVID-19 and the Shortage of Personal Protective Equipment

PPE shortages are posing a threat to the entire healthcare system because of the ongoing crisis. Healthcare facilities are having great difficulty accessing the needed Personal Protective Equipment and are having to work out alternate ways to provide optimum support and care to patients. Optimization strategies for PPE must be adhered to with other options available for use when PPE supplies are stressed, running low, or absent. Contingency strategies can also help stretch PPE supplies when shortages are anticipated. For instance, facilities may have sufficient supplies now, but they are likely to run out very soon. Crisis strategies must be considered during severe Personal Protective Equipment shortages. They can be used with the contingency options to help stretch available supply for the ones who are critical and need it the most. Healthcare facilities should be prompt and effective when resuming standard practices as PPE availability returns to normal.

Authorities right now, along with healthcare coalitions or departments must work together to develop strategies that identify and extend PPE supplies so that it is available when needed the most. Healthcare facilities around the world should begin using Personal Protective Equipment contingency strategies now, along with maximizing the use of engineering controls like barriers and maintained ventilation systems and administrative controls like altering work practices to minimize patient contracts. Given the scale of the pandemic, it is not surprising that healthcare facilities are experiencing PPE shortages. They need to consider crisis capacity strategies that must be carefully and efficiently planned before implementation. The effectiveness of such policies may be uncertain; hence they may pose a risk for transmission between HCP and patients.

How to Put on Personal Protective Equipment Gear?

There may be more than one acceptable method. However, training and practice are critical. In keeping with guidelines from WHO and CDC, here's one example of donning:

  • Ensure the identified and gathered PPE is proper and apart, especially the gown size.
  • Follow strict, effective hand hygiene practices like using hand washes or alcohol-based hand sanitizers before you put it on.
  • Put on your isolation gown; you may need assistance from others to tie it around. However, ensure their hands are sanitized and establish minimal contact.
  • Put on NIOSH approved N95 filtering facepiece respirator or higher (you can also go for a facemask if a respirator is not available). Both your mouth and nose should be sufficiently covered and protected. Ensure your mask is not worn under your chin or stored in a scrubs pocket between patients.
  • Put on goggles or face shields that provide full-face coverage, although with the former, fogging is common.
  • Gloves should adequately cover the cuff of the gown.
  • Only after having done all of the above, you may enter the patient room.

Can PPE be Reused or Shared?

The first word should answer your question: Personal. With few exceptions, most PPE is designed to be used only one time and by only one person before disposal. Therefore, one must refrain from washing and reusing or sharing this equipment with other users. In fact, one must take extra care to dispose of the PPE or make it fit for reuse depending on the type.

Moreover, if Personal Protective Equipment uses at a massive scale is to be implemented, there should also be a PPE program in place. It will address the hazards present, the maintenance and selection of PPE, the training of employees, and monitoring of the program to ensure its ongoing effectiveness. While it can be used at any number and kind of setting, it is common in healthcare facilities. It is used by healthcare personnel to protect themselves and others when providing care. It helps protect them from not just infectious patients but also materials, toxic medications, and other potentially dangerous substances used in healthcare delivery.

To mitigate shortages, various industries that don't usually produce PPE are working hard to make supplies for medical professionals, and have increasingly adopted 3D technology. Also, government leaders are trying to supply hospitals with shipments of PPE. Yet, despite the efforts, it's still not enough. Thus, responsible and judicious use and following best practices may be useful in these extraordinary circumstances.

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