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Other PPE Recommendations

An important point for surgeons is the use of PPEs in the operating room. Because there seems to be a variable understanding of the recommendations, we have provided some basic recommendations. The CDC has the following information and recommendations for PPE use for COVID-19 patients, or persons under investigation (PUI).

While in the operating room (OR), N95 respirators are recommended, particularly when operating on confirmed or suspected COVID-19 patients; however, the American College of Surgeons recognizes that many health care facilities have limited access to N95s at this time. Recent recommendations have been developed by the ASA and others for projected shortages of N95 masks. These include: implementing leadership controls to minimize who needs respiratory protection, use of alternatives to N95 masks, practices allowing extended use and or limited reuse of N95 masks, prioritization of N95 masks for health care personnel at highest risk of COVID-19 and consider use of masks approved by the National Institute of Occupational Safety and Health typically used in manufacturing and construction. For individuals at highest risk of exposure at institutions that are unable to provide N95 masks to all members of the OR team, we recommend that all surgeons and other personnel who are not wearing N95s evacuate the OR during intubation, extubation, and other procedures that may generate aerosolized small particles. The Centers for Disease Control and Prevention and the American Society of Anesthesiologists have recommendations to help prioritize.

Ensuring a proper fit of the N95 mask is paramount, so FIT TESTING is needed. The CDC also has delineated some key factors for using the N95 mask effectively, as well as checking for an appropriate mask “seal”.

Finally, shortages of masks increasingly are being reported, so strategies for optimizing facemasks/PPEs from the CDC are provided in this link.

JACS Article Describes New Approaches to N95 Decontamination

Posted April 28, 2020

Amid shortages of personal protective equipment (PPE) because of the COVID-19 pandemic, a St. Louis, MO, health care system has implemented a process to disinfect disposable N95 respirator masks, which allows health care workers to reuse their own mask for up to 20 cycles. The novel disinfection process, developed in collaboration with Washington University School of Medicine, uses vaporized hydrogen peroxide and is described in an “article in press” on the Journal of the American College of Surgeons website in advance of print.

Spanish and Portuguese Translation of Optimum Surgeon Protection Guidance Now Available

Posted April 28, 2020

The American College of Surgeons’ resource on the optimum protection of health care personnel before, during, and after an operation has been translated into Spanish and Portuguese for surgeons and residents in Latin America. This guidance is intended to protect health care personnel in the hospital setting, including in the operation room (OR), during the COVID-19 pandemic. It brings together the latest information, data, and recommendations and explains how to minimize risk of COVID-19 infection after surgery. Specific issues addressed are as follows:

  • Use of personal protective equipment (PPE) in the OR, including appropriate donning/doffing of the PPE
  • Intubation risks
  • Specific operative risk issues
  • After operation/leaving the OR
  • Leaving the facility
  • Going home and protecting family members

SAGES Issues Tips on Reuse and Reprocessing of N95s

Posted April 21, 2020

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has released tips regarding the reuse of N95 respirators for health care facilities that may be experiencing shortages of this form of personal protective equipment. The guidelines differentiate between extended use, reuse, and mask reprocessing and decontamination.

The recommendations noted the Centers for Disease Control and Prevention (CDC) reports that N95 mask use (including between patients) can be safe for up to eight hours and encourages wearing a face shield over the N95 to decrease the chances of soiling the mask. Assuming there is no soiling and minimal to no viral contamination to the mask, the CDC suggests that masks can be reused up to five times. SAGES notes that mask decontamination strategies are actively being investigated by the CDC, mask companies, and large academic/industry collaboratives. SAGES further acknowledges that definitive best practices for N95 reuse and reprocessing are still in development and that the methods outlined are options for times of crisis and should not be used routinely if mask supply is sufficient.

National Health Service Issues Updated PPE Guidance

Posted April 21, 2020

The U.K. National Health Service (NHS) has issued an updated “Guidance: Considerations for acute personal protective equipment (PPE) shortages.” This document aligns with current evidence and Centers for Disease Control and Prevention and World Health Organization guidance on optimizing the supply of PPE and the use of PPE when in short supply.

New HealthEquip App Helps Connect PPE Suppliers with Hospitals in Need

Posted April 17, 2020

In response to the continuing personal protective equipment (PPE) shortages health care personnel are facing, Merit Solutions has partnered with manufacturing and health care leaders to create HealthEquip, an app connecting individuals and organizations with access to PPE that can be donated to hospitals treating COVID-19 patients.

The app, made in association with Microsoft, the American Hospital Association, Kearney, Kaiser Permanente, and UPS, tracks donations, manages the shipping, and ensures the shipping is paid for by the receiving hospital. Donations of masks, face shields, gloves, gowns, and more are matched with hospitals based on need and demand, and they can include a single box of PPE or an entire truckload. The free app is available to any donating party and health care system as a web portal or on Apple and Android devices. Additional information is available online.

Italian Company Develops 3D-Printed Adapter to Turn Snorkeling Mask into Ventilator

Posted April 10, 2020

Isinnova, an engineering and design company in Italy, recently has developed a 3D-printed adapter that turns a mass-market snorkeling mask into a noninvasive ventilator for COVID-19 patients. The company began work on the device after being contacted by a retired Italian physician, who had an idea to adapt an available component into an emergency ventilator mask that have been in short supply in the pandemic.

Isinnova worked with Decathlon, the French company that produces the snorkeling masks, to understand the base product and build an adapter that would connect the mask to a ventilator system. The adapter, called the “Charlotte valve,” is quick to 3D print and has been tested successfully on a patient in a hospital in Chiari, Province of Brescia.

The company patented the adapter but has made multiple versions of the 3D printer files freely available on their website, in addition to design sketches and other printer settings.

Personal Protective Equipment Use Overview from Milan, Italy

Posted April 10, 2020

Antonio Spinelli, MD, PhD, FASCRS, Chief of the Division of Colorectal Surgery at Humanitas University Hospital in central Milan, Italy, shared an overview of personal protective equipment (PPE) use from a COVID-19 epicenter. Information and an overview of PPE consumption at Hospital Clinico San Carlos follows.

Each INTENSIVE CARE UNIT (12 beds) (to cover 24h shifts)
12 doctors (8 consultants + 4 residents)
32 nurses
2 access for radiology technician (bedside X ray)
2 access for cleaning personnel
about 2 access for consulting specialists (ex. cardiologist, infectious disease)
24h full equipment for 50 workers in ICU (12 beds) (double gloves, gowns, faceshields and n95 masks)
PPE need estimate: 100 gloves, 50 gowns, 50 face shields, 50 masks

WARD (up to 40 beds) (to cover 24h shifts)
10 doctors (5 consultants + 5 residents)
24 nurses
1 access for radiology technician (bedside X ray)
2 access for cleaning personnel
about 2 access for consulting specialists (ex. cardiologist, infectious disease)
24h full equipment for 39 workers in WARD (up to 40 beds) (double gloves, gowns, faceshields and n95 masks)
PPE need estimate: 78 gloves, 39 gowns, 39 face shields, 39 masks

2 surgeons
3 nurses
1 anesthesiologist
1 cleaning personnel
PPE need estimate: 14 gloves, 7 gowns, 7 face shields, 7 masks

1 endoscopist
1 nurse
1 anesthesiologist (if required)
1 cleaning personnel
PPE need estimate: 8 gloves, 4 gowns, 4 face shields, 4 masks

Nature Medicine Study Examines Respiratory Virus Shedding and Efficacy of Face Masks

Posted April 8, 2020

The effectiveness of face masks in reducing the transmission of COVID-19 from an infected wearer to an uninfected person continues to be a key area of research in addressing spread of the disease. Nature Medicine recently released a study that examined the respiratory droplet and aerosol transmission of coronaviruses and examined the degree to which surgical masks prevented transmission.

The study looked at more than 100 coronavirus-infected patients and measured the presence of the virus in both droplet and aerosol form. The findings were significant. When the patients were not wearing a face mask, 30 percent had coronavirus present in their exhaled droplets, and 40 percent had droplets present in their exhaled aerosols. When patients were wearing face masks, no virus was detected in their exhalations, adding to the body of evidence that surgical face masks are an important means of preventing the spread of COVID-19. The implications of these results support recently updated recommendations that both COVID-19-infected patients and hospital personnel should wear face masks in hospital settings.

Occupational Safety and Health Administration Guidance on Workplace Preparation in Response to the COVID-19 Pandemic

Posted April 8, 2020

Surgeons should be aware that the Occupational Safety and Health Administration (OSHA) has published guidance on preparation for the workplace in response to the COVID-19 pandemic. That document can be found here. This guidance document states (page 15) that “those who work within 6 feet of patients known to be, or suspected of being, infected with SARS-CoV-2 and those performing aerosol-generating procedures, need to use respirators” and that the respirators to which it refers are “National Institute for Occupational Safety and Health (NIOSH)-approved, N95 filtering facepiece respirators or better” and that they “must be used in the context of a comprehensive, written respiratory protection program that includes fit-testing, training, and medical exams.”

The OSHA regulation enforcing this standard can be found here and reads in part, “A respirator shall be provided to each employee when such equipment is necessary to protect the health of such employee.”Reference to these regulations could be considered in circumstances whereby surgeons are precluded from using appropriate and necessary personal protective equipment, particularly in circumstances in which they have their own N95 mask.

Stanford Creates PPE Taskforce to Protect COVID-19 OR Team Members

Posted April 8, 2020

The Journal of the American College of Surgeons has published a best practice guideline—“Precautions for Operating Room Team Members during the COVID-19 Pandemic”—that highlights the development of an institutional algorithm to protect operating room team (OR) members during the COVID-19 pandemic and how to conserve personal protective equipment (PPE). Researchers from the department of surgery at Stanford University, CA, created a PPE taskforce that was tasked with developing a common algorithm for PPE use to be used throughout the interventional platform (OR, interventional suites, and endoscopy).

DIY Intubation Shield Provides Extra Barrier of Protection

Posted April 8, 2020

The American College of Hyperbaric Medicine (ACHM) has produced a four-minute video tutorial outlining how to construct a do-it-yourself (DIY) intubation shield. The cost-effective shield, made of readily available materials, provides an extra barrier of protection for health care personnel during the COVID-19 pandemic and may be used for both intubation and extubation. Printable diagram and construction information may be accessed here.

Plan Ahead and Be Prepared: HHS Provides Tool to Calculate Potential PPE Needs

Posted April 8, 2020

Many hospitals are experiencing shortages of personal protective equipment (PPE) and drugs necessary to provide safe, high-quality care to COVID-19 patients. To help U.S. health care centers prepare for the potential onslaught of these patients, the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) has issued a Hospital Personal Protective Equipment Planning Tool to assist hospitals in determining approximate minimum PPE needs based on special pathogen categories and facility-specific variables. Calculators are available for Ebola/viral hemorrhagic fever, as well as special respiratory pathogens such as Middle East respiratory syndrome/severe acute respiratory syndrome (MERS/SARS), and pandemic influenza. The ASPR cautions that the tool is intended for preplanning purposes—not for use during an outbreak.

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.

Universal Masking of Health Care Personnel During COVID-19: Should It Be Implemented?

Posted April 3, 2020

A thoughtful perspective piece in the New England Journal of Medicine discusses the advantages and risks of universal masking of health care workers who have no direct interactions with symptomatic patients. The article weighs the possible reduction of transmission from asymptomatic and minimally symptomatic health care workers with COVID-19 to other providers and patients against issues of mask availability and the risk of diverting attention from more fundamental infection-control measures.

AHA 100 Million Mask Challenge Asks Manufacturers to Produce PPE

Posted April 3, 2020

The COVID-19 pandemic has created severe PPE shortages in the U.S. and throughout the world, and health care workers are running low on PPE to protect their own health as they treat patients with the disease. Building off an initiative launched in Washington State that asked the local community to help produce PPE for hospitals, the American Hospital Association (AHA) is expanding the 100 Million Mask Challenge nationwide to harness the manufacturing and business community’s collective desire to help by asking them to rapidly produce surgical masks and face shields for health care workers on a broad scale. The challenge aims to enable new relationships between hospitals and health systems in need of surgical masks and manufacturers with the capacity to produce them.

The AHA plans to expand the scope of this effort as the needs of the nation’s health care workers grow. Visit the AHA website or follow #100MillionMasks on social media for more information.

Assessment of Filtering Ability of Homemade Cloth Surgical Masks: Summary of Findings

Posted April 3, 2020

Investigators subjected 13 different homemade cloth surgical masks to rigorous testing to see how they compare with standard surgical mask and N95 respirators, in partnership with the Manufacturing Development Center at the Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC. Masks varied widely in their ability to remove particles approximating the size of viruses and bacteria. N95 masks filtered 97 percent of particles 0.3 microns (thousandths of a milimeter) in diameter, surgical masks filtered 62−65 percent, and homemade cloth masks varied widely. The investigators note that more research is needed.

PPE Resources

Posted April 3, 2020

A number of organizations and companies are providing protective eyewear and other PPE to hospitals and health care professionals, including:

Goggles for Docs



University of Kansas Health System Updates PPE Recommendations

Posted April 3, 2020

The University of Kansas Health System has issued an updated personal protective equipment (PPE) recommendation graphic (which previously appeared in Bulletin: ACS COVID-19 Updates issue #3). The updated graphic, available on the American College of Surgeons website, includes a new recommendation stating that if an interaction between a health care worker and a suspected or COVID-19 positive patient requires being within three feet, the patient should also wear a surgical mask. The graphic also recommends reading the extended and re-use guidelines for N95 respirators.

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.

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.

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.

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.

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)
Using UVDI Machine for N95 Masks (Source Penn Medicine)

Joint Commission COVID-19 PPE Statement

Posted March 27, 2020

The American College of Surgeons (ACS), the American Medical Association, The Joint Commission, and other concerned stakeholder organizations issued a public statement outlining our concerns about the existing shortages of masks, face shields, other personal protective equipment (PPE), ventilators, swab kits, and testing capacity that frontline caregivers and patients critically need. The statement calls for federal, state, and local policymakers to immediately remove any impediments in the supply chain.

PPE is needed immediately to protect the caregivers who are risking their own health to care for patients in the most need. Shortages of ventilators and intensive care facilities threaten the lives of the sickest patients.

The statement strongly supports emergency efforts at the federal level to dramatically increase the production and distribution of PPE and other necessary medical equipment and supplies. It also supports the availability of telehealth services during this time to use less PPE while preventing the spread of infection.

We must all work immediately to remove any impediments anywhere in the supply chain and come together at the federal, state, and local levels to develop an approach for a fair, equitable, and swift distribution across the nation that is based upon evidence of the most need. Read the full statement.

UNMC Offers Guidance on Extended Use and Limited Reuse of PPE

Posted March 27, 2020

The COVID-19 pandemic has caused widespread shortages of personal protective equipment (PPE), including facemasks, respirators, and protective eyewear in hospitals across the U.S. and around the world. As a result, some facilities have found it necessary to extend the use of, or reuse, PPE.

The University of Nebraska Medical Center (UNMC), Omaha, has provided guidance on extended use and limited reuse of PPE, adapted from the Centers for Disease Control and Prevention (CDC) and the University of Maryland, Baltimore, sources. The document offers useful definitions and directions.

Extended use refers to the practice of wearing PPE for encounters with several patients. Reuse refers to using the same PPE for multiple encounters with patients but removing it between encounters.

The document lays out some guiding principles, including the following:

  • Extended use is preferred over reuse
  • Facemasks, powered air purifying respirators (PAPRs), N95s, and eye protection can be reused carefully and in a limited manner during this shortage
  • PPE should be used by a single individual
  • Disposable N95 respirators for COVID-19 patients can be reused or have extended use if they are sealed, were not used in aerosol-generating procedures, or have been otherwise soiled
  • N95s are prioritized for personnel at high risk of infection or complication
  • Traffic to patient treatment areas should be limited

General guidelines state that N95s should be locked or secured in designated areas, labeled with individual staff names and usage times, and that full-face shields also are dedicated to individual staff.

The document provides guidance for extended use of surgery/procedure facemasks; detailed directions for donning and doffing N95 respirators that considers storage and maintaining sterility when either a procedure mask barrier or a full face shield is used; instructions for limited reuse of full face shields; and instructions for reuse of PAPR hoods, including disinfection, storage, of disposal of PAPR components.

Additional COVID-19 resources from UNMC can be accessed here.

University of Kansas Health System Provides PPE Guidance

Posted March 27, 2020

The University of Kansas Health System also has issued personal protective equipment (PPE) recommendations. The guidance outlines PPE recommendations for the following: patient care for patients not suspected for COVID-19, patient care for patients suspected or testing positive for COVID-19, and aerosol generating procedures on patients suspected or positive for COVID-19 and airway procedures on all patients. For patients with no COVID symptoms, health care professionals can safely wear a surgical ear loop mask in ambulatory clinics, the emergency department (ED), acute care units (ACUs), intensive care units (ICUs), and other procedural areas. If a patient has COVID symptoms or has a COVID test pending or test positive and receives care in ambulatory clinics, the ED, ACUs, ICUs, health care personnel should wear eye protection/face shield, a surgical/ear loop mask, gown, and gloves. When any aerosol generating procedure is performed in ambulatory clinics, the ED, ACUs, ICUs, and other procedural areas, health care personnel must wear a powered air-purifying respirator (PAPR) or N95 respirator, a face shield/eye protection, gown, and gloves.

CDC Issues Additional PPE Resources

Posted March 27, 2020

The CDC has posted additional COVID-19 resources, including a PPE burn rate calculator. This spreadsheet-based model provides information for healthcare facilities to plan and optimize the use of PPE for response to COVID-19. Access the CDC resources.

Novel PPE Approach

Posted March 27, 2020

The shortage of PPE for people who are in direct contact with potentially infected COVID-19 patients is a significant problem. A simple, elegant, practical solution is to supply the caregiver was seven N-95 masks and seven individual paper bags. Each bag will be labeled Monday, Tuesday, Wednesday etc. At the end of each day if the mask is not soiled it will be placed in the specifically labeled paper bag and kept by the individual provider. On the next day the process will be repeated. The rationale is that it is unlikely the virus will survive on the mask for seven days. It is feasible that it would be safe to use the mask again in a week. There will be an initial outlay of seven masks for each provider but this process could extend the use of the masks. If a mask is soiled or in some way unusable it would be discarded and replaced. This process will also provide comfort to the provider since they will have their own supply of PPE.

Proper Donning and Doffing of PPE to Treat COVID-19 Patients

Posted March 24, 2020

A similar donning and doffing technique can be used as the Centers for Disease Control and Prevention (CDC) recommended for physicians on the front lines during the Ebola crisis. Informational materials are available that demonstrate the procedures described in CDC guidance for putting on and removing PPE.

PPE for Office Visits

Posted March 24, 2020

The same recommendations made for hospital care should be applied to outpatient office visits. The safety of patients and health care professionals is best served by allowing patients to stay home whenever possible to avoid bringing together large numbers of people. Although much of the focus has been on surgery and procedure areas, outpatient office areas experience a much higher volume of traffic with more providers in a smaller area without routine PPE during patient interactions. In addition to trying to discourage social interaction in these settings, additional preservation of PPE is a priority, which is undermined by continuing to see patients without urgent problems in outpatient offices. Thus, whenever possible outpatient evaluation should be by permissible remote connectivity. Patients who the provider deems in need of urgent personal evaluation may still be offered in-person office visits.

State Enacts Policy Regarding the Redistribution of PPE

Posted March 24, 2020

Oregon has initiated a policy whereby surplus PPE must be arranged to be delivered to the state by March 27 for redistribution. The language excludes certain life- and limb-threatening diagnoses, and the stipulation to arrange for delivery of excess supplies is vague.

Providers Innovating to Avert or Resolve PPE Shortages

Posted March 24, 2020

To conserve PPE during this time, Billings Clinic, MT, has mass produced and distributed 3D-printed surgical masks with reusable filters. The source file is available on the clinic’s network for any health system that would like to use the instructions. The U.S. Food and Drug Administration has granted the clinic temporary approval of the masks.

Glove Conservation Guidance Letter Issued

Posted March 24, 2020

The U.S. Food and Drug Administration recognizes that the need for PPE, such as medical gloves, may outpace the supply available to health care facilities during the COVID-19 outbreak. Consequently, the agency has issued a <atarget="_blank" href="">letter to health care providers that refers specifically to potential shortages relating to surgeons’ gloves and patient examination gloves.</atarget="_blank">

The conservation strategies are categorized for a range of needs and supply levels and are intended to assist health care organizations as they determine procedures during the COVID-19 pandemic. The conservation strategies described are intended to augment specific controls and procedures developed by health care facilities, the Centers for Disease Control and Prevention (CDC), or the CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) to aid in infection prevention and control. These strategies are not limited to use in the care of patients infected with COVID-19. Health care facilities may find additional useful information in guidelines on modifications to medical standards of care during a crisis.

Additional PPE Resources

Surgical Innovation Fellowship, Boston Children’s Hospital

Posted March 24, 2020

Making Your Own Reusable Elastomeric Respirator for Use During COVID-19 Viral Pandemic N95 Shortage


Posted March 21, 2020

The CDC has developed a video, entitled How to Safely Put on PPE, Selected Equipment: N95 and Gown, to demonstrate this approach. You can access that video on the CDC website. Please note: Although developed during concerns over an Ebola outbreak, these video instructions are also relevant for COVID-19.

Infection Control Practices

Posted February 25, 2020

We recommend that you familiarize yourself with these infection control practices in the event you encounter someone with COVID-19 symptoms in your practice:

  • Don N95 respirator masks
  • Don full personal protective equipment (PPE), including protective eyewear
  • Doff PPE responsibly as you would for exposure to any infectious disease
  • After doffing equipment, decontaminate hands with an ETOH-based gel

To review protective gear steps, download and view this three-page CDC instructional document.