WLAVA:COVID-19 PPE: Difference between revisions
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'''Last Updated 4/26/20'''
'''Last Updated 5/24/20'''
 
==GUIDANCE ON DONNING AND DOFFING FOR ED PATIENT ENCOUNTERS==
===Mask Guidance===
===PATIENT ENCOUNTER SCENARIOS AND DETAILED PPE===
** 1860 and 1870 N95 respirators are being distributed only to the OR and Procedure Center.
** ED is receiving only 3M 8000 N95 respirators.
** We have very very few 1860/1870 left for the entire ED (MDs, RNs, ICTs, etc).
*** We will not be resupplied with 1860/1870s.
** Remind consultants that 8000s are N95 respirators and this is an ID guideline.
*** They can request an 1860s/1870s is if they failed formal fit test for 8000s.
====What Mask Should I Wear?====
*'''PAPR:'''
** Provider intubating. Nursing as per their leadership recommendations.
* '''3M 8000 N95 Respirator:'''
** All providers working in the ED who passed fit testing.
*** Airway buddy.
*** Personnel seeing PUIs.
*** Nurse performing NP swab.
*** CODES or intubations.
** No need to wear a surgical mask over these.
*** Can discard with every PUI. Can continue to wear between non-PUI to non-PUI.
* '''3M 1860/1870 N95 Respirator:'''
** Providers that failed formal 8000 N95 fit testing.
** Wear a surgical mask over this and discard surgical mask with every PUI.
** If used for a CODE or Intubation, discard the N95.
** If used daily because you failed 8000 N95 fit test, consider saving these using paper bag method.
 
====3M 8000 N95 Fit Testing====
* EVERYONE needs to be fit tested for the N95 8000s as these will be the ones handed out. Next fit test dates are:
** Monday 4/27/20 6:30-11:30, building 500 Rm 3232
*** Please complete questionnaire online if you have not done it within the past year.
*** URL: http://respiratormedicalevaluation.com
 
====Mask Decontamination Suspended====
* SPS is no longer collecting masks.
* Discard the 8000 N95 respirators.
* Save 1860s/1870s for future use as long as they weren't used for code/intubation.
** Use paper bag method x wait 5 days, 5x max.
 
====♦♦♦UV Sterilization Technique 4/24/20====
* Not institutionally advised and use at your own risk.
* The UVC machine on the top shelf in the med room would require '''9 min 30 secs''' to sterilize anything that is put inside if you choose to use it. (Thanks to Miguel for figuring this out)
 
====♦♦♦PAPR Cleaning 4/24/20====
* After an intubation or CODE with PAPR use, '''remind the charge nurse to call SPS to pick it up for cleaning.'''
* Placing PAPR in the dirty utility room, on the cart instead of the floor. It may be assumed to be trash if on the ground.
* If SPS is not called, PAPR may not be cleaned for days  and has a high chance of getting lost.
* If restocking Airway carts and there are no more PAPRs left in the Med Room, notify the ED Nurse Managers or COVID Team.]
 
===Guidance On Donning & Doffing For Ed Patient Encounters===
====Patient Encounter Scenarios & Detailed PPPE====
[[File:06B68CDD-1AD2-4390-8044-22D7FC1A4DEB.jpg|thumb|center|Patient Encounter Scenarios and Detailed PPE]]
[[File:06B68CDD-1AD2-4390-8044-22D7FC1A4DEB.jpg|thumb|center|Patient Encounter Scenarios and Detailed PPE]]


====For Patients '''W/ COVID''' Isolation Precautions ====
===FOR PATIENTS'''W/COVID''' ISOLATION PRECAUTIONS===
[[File:DBB5C750-02D7-4CA3-B085-80ECD361D51C.png|thumb|center|Donning and Doffing Guidance for Patients w/COVID-19 Isolation Precautions]]
[[File:DBB5C750-02D7-4CA3-B085-80ECD361D51C.png|thumb|center|Donning and Doffing Guidance for Patients w/COVID-19 Isolation Precautions]]


====For Patients '''W/O COVID''' Isolation Precautions====
===FOR PATIENTS'''W/O COVID''' ISOLATION PRECAUTIONS===
[[File:ABDFBBCB-FADB-4295-9CA0-3A5BD6EC916D.png|thumb|center|Donning and Doffing Guidance for Patients w/o COVID-19 Isolation Precautions]]
[[File:ABDFBBCB-FADB-4295-9CA0-3A5BD6EC916D.png|thumb|center|Donning and Doffing Guidance for Patients w/o COVID-19 Isolation Precautions]]


==Airway/Code Donning & Doffing Checklist==
==AIRWAY/CODE DONNING AND DOFFING CHECKLIST==
* Latest laminated version included in the Airway Cart (PAPR Drawer)
* Latest laminated version included in the Airway Cart (PAPR Drawer)
'''N95'''
'''N95'''
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====PPE PAPR DONNING VIDEO ====
===PPE PAPR DONNING VIDEO ===
{{#widget:YouTube|id=w253AxiuFzk}}
{{#widget:YouTube|id=w253AxiuFzk}}


====PPE PAPR DOFFING VIDEO====
===PPE PAPR DOFFING VIDEO===
{{#widget:YouTube|id=vKnZaTdhRQs}}
{{#widget:YouTube|id=vKnZaTdhRQs}}


====PPE BUDDY DOFFING VIDEO====
===PPE BUDDY DOFFING VIDEO===
{{#widget:YouTube|id=sl78L2DtloY}}
{{#widget:YouTube|id=sl78L2DtloY}}


===More info on GLA PPE===
===DONATED 3D PRINTED FACE SHIELDS===
====Donated 3D Printed Face Shields====
* These may not be completely splash proof because of the holes in the front.  
* These may not be completely splash proof because of the holes in the front.  
* It's best to use goggles to protect your eyes. Please keep the headbands.  
* It's best to use goggles to protect your eyes. Please keep the headbands.  
* You may discard the clear plastic sheets but they can also be cleaned and reused.
* You may discard the clear plastic sheets but they can also be cleaned and reused.


====Length of Time for Face shield Usage====
===LENGTH OF TIME FOR FACE SHIELD USAGE===
* CDC stated, "Eye protection should be discarded if damaged (e.g., face shield can no longer fasten securely to the provider, if visibility is obscured and reprocessing does not restore visibility)."  
* CDC stated, "Eye protection should be discarded if damaged (e.g., face shield can no longer fasten securely to the provider, if visibility is obscured and reprocessing does not restore visibility)."  
** A way to optimize the face shield and minimize staff exposure is to have one or two designated person each shift for PUI.
** A way to optimize the face shield and minimize staff exposure is to have one or two designated person each shift for PUI.


====PAPR Hoodx====
===PAPR HOODS===
*'''PAPR hoods are reusable '''SHARED''' supply, please send to SPS for decontamination.'''
*'''PAPR hoods are reusable '''SHARED''' supply, please send to SPS for decontamination.'''
* Please do not mars PAPR hoods with your name. We are going to be using them indiscriminately based on your size.  
* Please do not mars PAPR hoods with your name. We are going to be using them indiscriminately based on your size.  
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[[File:PAPR Hood.jpg|thumb|center|PAPR w/Hood]]
[[File:PAPR Hood.jpg|thumb|center|PAPR w/Hood]]


====Bunny Suit====
===BUNNY SUIT===
* We are not re-using these, '''discard''' after each use.  
* We are not re-using these, '''discard''' after each use.  
* Come in 3 sizes (located in Med Room).
* Come in 3 sizes (located in Med Room).


====GOGGLES====
===GOGGLES===
* ED staff will be given safety googles  
* ED staff will be given safety googles  
** Come see Jonie/Kian/Manny/TBlair to get one if you need it
** Come see Jonie/Kian/Manny/TBlair to get one if you need it


====REUSING PPE====
===REUSING PPE===
* '''PAPR hoods''' - Used PAPR hoods are now community property amongst ED staff since they are being cleaned by SPS (will be labeled ER).  
* '''PAPR hoods''' - Used PAPR hoods are now community property amongst ED staff since they are being cleaned by SPS (will be labeled ER).  
*'''Cleaning Eye Protection:'''
*'''Cleaning Eye Protection:'''
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***[[:File:APPROVED_20200330.1030.Interim GLA guidance for Eye Protection Cleaning.pdf]]
***[[:File:APPROVED_20200330.1030.Interim GLA guidance for Eye Protection Cleaning.pdf]]


====GLA Contact For Official PPE Purchasing (Not Donations)====
===GLA CONTACT FOR OFFICIAL PPE PURCHASING (NOT DONATIONS)===
* Terry Wolgamott: Terry.Wolgamott@va.gov
* Terry Wolgamott: Terry.Wolgamott@va.gov


====GLA Contacts for PPE Donations====
===GLA CONTACTS FOR PPE DONATIONS===
* If you know someone who is interested in donating masks, or other items, to our medical center please have them contact our Voluntary Service dept.
* If you know someone who is interested in donating masks, or other items, to our medical center please have them contact our Voluntary Service dept.
**Alexia Lunningham, Chief of Voluntary Service: Alexia.Lunningham@va.gov or 310-286-3994
**Alexia Lunningham, Chief of Voluntary Service: Alexia.Lunningham@va.gov or 310-286-3994

Revision as of 03:40, 25 May 2020

Last Updated 5/24/20

GUIDANCE ON DONNING AND DOFFING FOR ED PATIENT ENCOUNTERS

PATIENT ENCOUNTER SCENARIOS AND DETAILED PPE

Patient Encounter Scenarios and Detailed PPE

FOR PATIENTSW/COVID ISOLATION PRECAUTIONS

Donning and Doffing Guidance for Patients w/COVID-19 Isolation Precautions

FOR PATIENTSW/O COVID ISOLATION PRECAUTIONS

Donning and Doffing Guidance for Patients w/o COVID-19 Isolation Precautions

AIRWAY/CODE DONNING AND DOFFING CHECKLIST

  • Latest laminated version included in the Airway Cart (PAPR Drawer)

N95

PAPR


PPE PAPR DONNING VIDEO

{{#widget:YouTube|id=w253AxiuFzk}}

PPE PAPR DOFFING VIDEO

{{#widget:YouTube|id=vKnZaTdhRQs}}

PPE BUDDY DOFFING VIDEO

{{#widget:YouTube|id=sl78L2DtloY}}

DONATED 3D PRINTED FACE SHIELDS

  • These may not be completely splash proof because of the holes in the front.
  • It's best to use goggles to protect your eyes. Please keep the headbands.
  • You may discard the clear plastic sheets but they can also be cleaned and reused.

LENGTH OF TIME FOR FACE SHIELD USAGE

  • CDC stated, "Eye protection should be discarded if damaged (e.g., face shield can no longer fasten securely to the provider, if visibility is obscured and reprocessing does not restore visibility)."
    • A way to optimize the face shield and minimize staff exposure is to have one or two designated person each shift for PUI.

PAPR HOODS

  • PAPR hoods are reusable SHARED supply, please send to SPS for decontamination.
  • Please do not mars PAPR hoods with your name. We are going to be using them indiscriminately based on your size.
  • We secured a limited supply of Inner Hoods with neck covering for use with PAPR.
Inner Hood for PAPR
  • We secured a limited supply of special PAPRS with Hood with neck covering.
    • There is only one in the airway cart and one in the Med Room.
PAPR w/Hood

BUNNY SUIT

  • We are not re-using these, discard after each use.
  • Come in 3 sizes (located in Med Room).

GOGGLES

  • ED staff will be given safety googles
    • Come see Jonie/Kian/Manny/TBlair to get one if you need it

REUSING PPE

  • PAPR hoods - Used PAPR hoods are now community property amongst ED staff since they are being cleaned by SPS (will be labeled ER).
  • Cleaning Eye Protection:

GLA CONTACT FOR OFFICIAL PPE PURCHASING (NOT DONATIONS)

  • Terry Wolgamott: Terry.Wolgamott@va.gov

GLA CONTACTS FOR PPE DONATIONS

  • If you know someone who is interested in donating masks, or other items, to our medical center please have them contact our Voluntary Service dept.
    • Alexia Lunningham, Chief of Voluntary Service: Alexia.Lunningham@va.gov or 310-286-3994
    • Shirley Bearden, Voluntary Service Specialist: Shirley.Bearden@va.gov or 310-268-3194

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