PCS Webinar on Guidelines on Use of PPE by Surgeons Amidst COVID19

UPDATE: May 26, 2020

https://sites.google.com/site/rojosontporsoncovid19/psmid-phics-risk-assessment-of-surgeries-in-the-context-of-covid-19

PSMID-PHICS RISK ASSESSMENT OF SURGERIES IN THE CONTEXT OF COVID-19

May 26, 2020

Glad to hear these guidelines.

The question is: whether the hospitals will adopt these guidelines!

20may15 - attended the PCS Webinar - Guidelines on the Use of Personal Protective Equipment by Surgeons Amidst the COVID-19 Pandemic

Learned a lot.

Topics:

1. Terminologies, Levels of PPE, Creation of Hospital Zones

2. Use of PPE According to Area

3. Updates on Masks / Respirators. Face Shields and Protectors

4. Specifications of Surgical Gowns and Coveralls

ROJoson Learnings, Inputs and Reflections:

Terminologies: 

PPE - Personal Protective Equipment

"Special covering" to protect health care workers (HCW) from being infected by the splashes and sprays from COVID19 patients.

Collective term of wearable equipment and gear that’s meant to protect the wearer from being infected with COVID19.

Protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from COVID19.

Collation of various definitions:

Personal Protective Equipment against COVID19 is a collective term for wearable equipment, gear and other special covering that aim to protect the wearer from being infected with "splashes and sprays" from COVID19 patients.

Alcohol is not part of the definition of PPE - not worn.

Aerosol shield boxes are not part of the definition of PPE - not worn.

Categorization:

• Respirators - face masks, N95, KN85, others

• Eye Protectors - goggles, face shields, others

• Protective clothing - overalls, coveralls, surgical caps, gloves, shoe covers, others

Differences between overalls, coveralls and hazmat suit

Coverall will refer to the full body-suit garment.

Hazmat suit will refer to the coverall.

Overall will refer to the garment that clips over the shoulders.

Dr. Jerusalem presented this slide - levels of PPE - she said a categorization being used in the Philippine General Hospital.  I think the categorization provides guidelines on what PPE to use at different levels of risk to COVID19 (sprays and splashes, aerosol-generating procedures, etc.), with Level 1 being the lowest risk.

My comment here is alcohol hand wash / spray should not be included under Level 1 PPE if we were to use "wearable" as part of the definition of PPE.

Hospital Zones

ROJoson's Comments:

A hospital consists of so specialized units - patient care units; non-patient-care units; under patient-care units,  emergency medicine department, outpatient, inpatient nursing floors, and specialty and specialized units.

Another type of health care institution aside from hospital is a separate or stand-alone clinic with no in-patient services (located outside a hospital setting).

In terms of risk for COVID19, clinics outside a hospital setting will usually carry lower-risk than a hospital setting.  However, even in clinics outside a hospital setting, there should also be a zoning system like the above.

Use of PPE According to Areas in the Hospital

Emergency Medicine Department

Outpatient Clinics

Private Rooms

Operating Rooms

See attached files.

Surgical Gowns and Coveralls

See attached files 

SEE DOCUMENT - PCS RECOMMENDATIONS in attached files.

PPE against COVID19

I came to the following conclusions:

Personal Protective Equipment against COVID19 is a collective term for wearable equipment, gear and other special covering that aim to protect the wearer from being infected with "splashes and sprays" from COVID19 patients.

Categorization:

• Respirators - face masks, N95, KN85, others

• Eye Protectors - goggles, face shields, others

• Protective clothing - overalls, coveralls, surgical caps, gloves, shoe covers, others

Alcohol is not part of the definition of PPE - not worn.

Aerosol shield boxes are not part of the definition of PPE - not worn.

This will be the definition or meaning of PPE against COVID19 that I will use.

There was one slide on the levels of PPE that I saw:

Alcohol hand wash / spray, strictly speaking, should not be considered as PPE.

Another table which I saw:

Alcohol or alcohol-based hand hygiene solution(s) should not be considered as PPE.

There are a lot of interpretations not to say misconceptions going on among authors.

ROJ@20may27;20may29