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Wednesday, June 03, 2020

Explained: The procedures followed by healthcare workers while tending to COVID-19 patients

For all healthcare workers who come in contact with suspected or positive cases of COVID-19, it is important to have access to equipment such as Personal Protective Equipment (PPE) to prevent themselves from getting infected.

By: Explained Desk | New Delhi | Updated: April 1, 2020 12:38:00 pm
Explained: Procedures followed by healthcare workers while tending to COVID-19 patients Healthcare workers assist a patience at one of the intensive care units (ICU) at German Trias i Pujol hospital in Badalona, in the Barcelona province, Spain. (AP Photo: Anna Surinyach)

For those people such as healthcare workers, who are at the frontlines of dealing with the coronavirus pandemic, the risk of exposure to the disease is greater. Therefore, for all such healthcare workers who come in contact with suspected or positive cases of COVID-19, it is important to have access to equipment such as Personal Protective Equipment (PPE) to prevent themselves from getting infected.

What are PPEs and why are they required?

PPE is a set of equipment that employees may need to use in order to keep them safe when dealing with COVID-19 patients. PPEs can include items such as gowns, respirators, face masks, safety-footwear harnesses, eye protection gear and gloves.

According to the Occupational Safety and Health Administration (OSHA), PPEs are required to ensure the “greatest possible protection” for employees in the workplace. Employees must also be trained in using the PPEs, disposing them off and maintaining them. It is especially important that employees know how to don and take off a PPE to protect themself from getting infected. They must also know the limitations of the PPE in offering protection.

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What are the SOPs for wearing a PPE?

The UK’s National Health Service (NHS) has issued two separate guidelines for donning and doffing PPEs, one for aerosol generating procedures and another for non-aerosol generating procedures. NHS recommends performing hand hygiene before putting on the PPE. Other pre-donning instructions include ensuring that healthcare workers are hydrated, tying their hair back, removing jewellery and checking that PPE in the correct size is available.

Explained: Procedures followed by healthcare workers while tending to COVID-19 patients In this Friday, March 27, 2020 healthcare workers assist a patience at one of the intensive care units (ICU) at German Trias i Pujol hospital in Badalona, in the Barcelona province, Spain. (AP Photo: Anna Surinyach)

The first step when undertaking aerosol-generating procedures is to don the long-sleeved fluid repellant disposable gown, followed by performing a “fit check” on the respirator. This is followed by wearing eye protection followed by wearing gloves. During such procedures, for taking PPEs off, the healthcare workers should remove the gloves first since the outsides may be contaminated. After this they should perform hand hygiene. Next, the gown should be removed since there are high chances that the front of the gown will be contaminated. This is followed by removing the eye protection gear, respirator and lastly, washing hands with soap and water.

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For non-aerosol generating procedures, the NHS guidelines state putting on an apron and tying it at the waist after perfoming hand-hygiene, this is followed by wearing a face mask with the upper straps of the mask positioned on the crown of the head and lower straps at the nape of the neck. The next step is to mould the metal straps over the bridge of the nose using both hands, donning eye protection if required and lastly, putting on gloves. The NHS has advised the disposal of all PPEs as clinical waste. For removing PPEs after such procedures, the NHS recommends similar steps, which involves taking off the gloves, cleaning hands, unfastening the apron, removing eye protection if worn, cleaning hands again, removing the face mask, which should not be reused. The last step is to perform hand hygiene.

The World Health Organization (WHO) has similar guidelines, which involve putting on the gown, followed by face shield or putting on a medical mask and gear for eye protection. The last step is to roll on the gloves over the cuff of the gown. For taking off the PPE, the WHO recommends removing the most heavily contaminated items first, peeling off the gown and gloves and disposing them off safely, followed by removing the face shield or eye protection gear and medical mask. Lastly, hand hygiene should be performed.

Here’s a quick Coronavirus guide from Express Explained to keep you updated: What can cause a COVID-19 patient to relapse after recovery? | COVID-19 lockdown has cleaned up the air, but this may not be good news. Here’s why | Can alternative medicine work against the coronavirus? | A five-minute test for COVID-19 has been readied, India may get it too | How India is building up defence during lockdown | Why only a fraction of those with coronavirus suffer acutely | How do healthcare workers protect themselves from getting infected? | What does it take to set up isolation wards?

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