American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

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ACS Statement on PPE Shortages during the COVID-19 Pandemic

Posted April 1, 2020

The American College of Surgeons (ACS) recognizes that many health care facilities are facing shortages of personal protective equipment (PPE), including face masks, gowns, and respirators. The ACS believes it is essential that surgeons, nurses, anesthesiologists, and other health care personnel be able to speak freely, without fear of retribution, as they seek to find a solution to accessing PPE. We advise surgeons to speak with their institutional leadership on these matters and to be able to direct any concerns to the ACS, with the goal of protecting themselves and their colleagues.

Read the statement.

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Joint Gastroenterology Society Statement on Use of PPE in GI Endoscopy

Posted April 1, 2020

The American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy issued a joint gastroenterology society message on COVID-19 use of personal protective equipment in GI endoscopy. It notes that all members of the endoscopy team should wear N95 respirators (or devices with equivalent or higher filtration rates) for all GI procedures performed on patients with known SARS-CoV-2 infection and those with high risk of exposure. Given the high rate of infection transmission from pre-symptomatic individuals, all patients undergoing GI endoscopy in an area of community spread need to be considered ‘high risk’.

View the full statement.

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New Joint Commission Statement

Posted March 31, 2020

The Joint Commission issued a statement that supports allowing staff to bring their own standard face masks or respirators to wear at work when their health care organizations cannot routinely provide access to protective equipment that is commensurate with the risk to which they are exposed. 

Read the statement.

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Emergency Care Research Institute Offers Advice on Safe Use of Face Masks

Posted March 31, 2020

The Emergency Care Research Institute (ECRI) March 25, offered a live-streamed lab tour, featuring recommendations from ECRI experts on how to use N95 respirators safely when normal procedures are challenging due to shortages. This video addresses critically important issues impacting hospitals now as they care for patients with coronavirus.

The video offers expert advice on using outdated or expired masks, reuse of masks, cleaning and disinfection procedures, ultraviolet disinfection, and navigation of supply-chain shortages. The video participants also explain why ECRI does not recommend homemade masks for health care facilities. The presentation concludes with an informative question and answer session based on questions from hospitals around the globe. To watch the video and for more information on personal protective equipment, click here.

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Society of American Gastrointestinal and Endoscopic Surgeons Offers Guidance on N95 Respirators

Posted March 30, 2020

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has posted guidance on the reuse of N95 respirators and the use of handmade masks. These recommendations are based on advice from Peter Tsai, MD, FACS, the inventor of the filtration fabric in the N95 mask.

  1. When reusing N95 masks, leave a used respirator in dry, atmosphere air for three to four days to dry out. The polypropylene in N95 masks is hydrophobic and contains zero moisture. COVID-19 needs a host to survive. It can survive on metals surface for up to 48 hours, on plastic for 72 hours, and on cardboard for 24 hours. Three to four days will provide adequate time for the virus to die.
    • Take four N95 masks, and number them (#1-4).
    • On day one, use mask #1, then let it dry it out for three to four days.
    • On day two, use mask #2, then let it dry out for three to four days.
    • Same for days three and four.
  2. Sterilize the N95 mask by hanging it in the oven (without contacting metal) at 70C (158F) for 30 minutes. Reportedly, COVID-19 cannot survive at 65C (149F) for 30 minutes. Use a wood clip to hang the respirator in the kitchen oven to do the sterilization. When sterilizing N95 masks, be wary of using ultraviolet (UV) light, which damages the electrostatic charges in the polypropylene material.
  3. Do not place the respirator on or near a metal surface, as the temperature on the metal surface is higher than the air temperature. When removing the mask, hold the edge of the straps attached. Because your hands may be contaminated at this time, do not touch the inside part of the respirator. Wash your hands with soap for 20 seconds afterward.

Dr. Tsai advises against using cotton masks when taking care of COVID-19 patients. Using a high-efficiency particulate air (HEPA) filter with a face mask might increase its effectiveness but may make breathing more difficult.

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University of Pennsylvania Issues Directive on N95s

Posted March 30, 2020

The University of Pennsylvania Perelman School of Medicine, Philadelphia, has issued a directive on reuse of N95 respirators and face shields. According to the directive, health care personnel who are performing procedures on patients who are neither COVID-19-positive nor persons under investigation (PUI), should clean the personal protective equipment using the ultraviolet system in the operative room at the end of the day. Health care personnel performing procedures on COVID-19 patients and PUI must dispose of the N95 following completion of care.

A table outlining the specifications and a flow chart are as follows:

Using UVDI Machine for N95 Masks (Source Penn Medicine)

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