Personal Protective Equipment for COVID-19 by Health Care Workers No

Main Article Content

Wilawan Picheansathian

Abstract

Abstract: The novel Coronavirus, COVID-19 (SARS-CoV-2) has recently created a worldwide pandemic. This virus is transmitted between people through close contact and respiratory droplets. Health care workers are the people most at risk of infection in the hospital since they are people in close contact with a COVID-19 patient or caring for COVID-19 patients. Thus, health care workers should use standard, contact, and droplet precautions when caring for patient with suspected or confirmed COVID-19. These precautions contain a number of measures. This paper presents literature reviews regarding personal protective equipment (PPE), including gloves, medical masks, goggles or face shields, and a long-sleeved gown. In performing aerosol-generating procedures, the N95 respirators are recommended over medical masks. Health care workers should select the proper PPE and should be trained in how to put on, remove, and dispose the protective equipment in order to avoid contamination. Effectiveness of PPE using depends strongly on adequate and regular supplies, and appropriate staff training.

Article Details

How to Cite
Picheansathian, W. (2020). Personal Protective Equipment for COVID-19 by Health Care Workers : No. Thai Journal of Nursing and Midwifery Practice, 7(1), 7–24. Retrieved from https://he02.tci-thaijo.org/index.php/apnj/article/view/241945
Section
Invited paper

References

Morens DM, Fauci AS. Emerging Infectious Diseases: Threats to Human Health and Global Stability. PLoS Pathog 2013; 9(7): e1003467. doi:10.1371/ journal.ppat.1003467.

Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: What we know. Int J Infect Dis. 2020 Mar 12;94:44-48. doi: 10.1016/j.ijid.2020.03.004.

Tong ZD, Tang A, Li KF, Li P, Wang HL, Yi JP, et al. Potential presymptomatic transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis 2020;26(5):1052-1054. doi: 10.3201/eid2605.200198.

Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 —Singapore. MMWR 2020;69(14):411-415. doi: http://dx.doi.org/10.15585/mmwr. mm6914e1

Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One.2012;7:e35797. doi: 10.1371/journal. pone.0035797.

WHO. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: Scientific brief 29 March 2020. Available from: http://www. WHO/2019-nCoV/ Sci_Brief/Transmission_modes/2020.2.

Pan X, Chen D, Xia Y, Wu X, Li T, Ou X, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis. 2020 Apr;20(4):410-411. doi: 10.1016/S1473- 3099(20)30114-6.

Ong SW, Tan YK, Chia PY, Lee TH, Ng OT, Wong MS, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323(16):1610-1612. doi:10.1001/jama. 2020.3227.

Doremalen NV, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; 382:1564-1567. doi: 10.1056/NEJMc2 004973.

Guo ZD, Wang ZY, Zhang SF, Li X, Li L, Li C, et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis. 2020 Jul [5 May 2020].Available from: https:// doi.org/10.3201/eid2607.200885.

Burdorf A, Porru F, Rugulies R. The COVID-19 (Coronavirus) pandemic: consequences for occupational health. Scand J Work Environ Health 2020;46(3):229-230. doi:10.5271/sjweh. 3893.

Siddique H, Parveen N, Topping A. Coronavirus deaths of two nurses lead to calls for more protection. The Guardian[Internet]. 2020 [cited 4 April 2020]. Available from: https://www.theguardian.com/ society/2020/apr/03/coronavirus-deaths-of-two-nurses-lead-to-calls-for-more-protection.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-42. doi:10.1001/jama.2020. 2648

Giuffrida A, Tondo L. As if a storm hit`: more than 40 Italian health workers have died since crisis began. The Guardian[Internet]. 2020 [cited 5 May 2020]. Available from: https://www.theguardian.com/ world/2020/mar/26/as-if-a-storm-hit- 33-italian-health-workers-have-died-since-crisis-began.

Joob B, Wiwanitkit V. COVID-19 in medical personnel: observation from Thailand. J Hosp Infect. 2020 Apr;104(4):453. doi: 10.1016/j.jhin. 2020.02.016. Epub 2020 Feb 27

Siegel JD, Rhinehart E, Jackson M, Chiarello L, the Healthcare Infection Control Practice Advisory Committee. 2007 Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164. doi: 10.1016/j. ajic.2007.10.007.

WHO. Infection Prevention and Control Guidance for COVID-19 . Available from: https://www.who. int/emergencies/diseases/novel-coronavirus- 2019/technical-guidance/infection-prevention-and-control.

Department of Medical Service, Working Committee on Medical Care from Ministry of Health, Faculty of Medicines from Universities and Professional Associations. Guidelines for use of personal protective equipment, PPE. Available from:https:// ddc.moph.go.th/viralpneumonia/file/g_health_ care/g07_ppe.pdf. (In Thai)

Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al- Ansary LA, Bawazeer GA, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews 2011, Issue 7.Art. No.: CD006207. doi: 10.1002/14651858.CD006207.pub4.

WHO. Rational use of personal protective equipment ( PPE) for coronavirus disease ( COVID-19) : interim guidance, 19 March 2020. Available from: https://apps.who.int/iris/handle/10665/ 331498. License: CC BY-NC-SA 3.0 IGO.

Loh NW, Tan Y, Taculod J, Gorospe B, Teope AS, Somani J, et al. The impact of high-flow nasal cannula (HFNC) on coughing distance: implications on its use during the novel coronavirus disease outbreak. Can J Anesth. Published online, 18March 2020. Available from: https://doi.org/10.1007/ s12630-020-01634-3.

WHO. Requirements and technical specifications of personal protective equipment (PPE) for the novel coronavirus (2019-ncov) in healthcare settings. Available from: file:///C:/Users/acer133_user/ Downloads/requirements-%20PPE-coronavirus- 2020-02-07-eng%20(1).pdf.

Lim SM, Cha WC, Chae MK, Jo IJ. Contamination during doffing of personal protective equipment by healthcare providers. Clin Exp Emerg Med 2015: 30;2(3):162-167. eCollection 2015 Sep. doi: 10.15441/ceem.15.019.

WHO. How to put on and take off personal protective equipment (PPE). Available from: http://www. who.int/csr/resources/publications/putontake¬offPPE/en/.

French CE, McKenzie BC, Coope C, Rajanaidu S, Paranthaman K, Pebody R, et al. Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review. Influenza Other Respir Viruses, 2016. 10(4): 268-90. doi: 10.1111/irv.12379.

CDC. EYE SAFETY. Available from: https://www. cdc.gov/niosh/topics/eye/eye-infectious.html.

Bin-Reza F, Chavarrias VL, Nicoll A, Chamberland ME. The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence. Influenza Other Respir Viruses. 2012 Jul;6(4):257-67. doi: 10.1111/j.1750- 2659.2011.00307.x.

Offeddu V, Yung CF, Low MSF, Tam CC. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clin Infect Dis. 2017 Nov 13;65(11):1934-1942. doi: 10.1093/cid/cix681

Smith JD, MacDougall CC, Johnstone J, Copes RA, Schwartz B, Garber GE. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ 2016;188(8):567-574. doi: 10.1503/cmaj. 150835.

WHO. Advice on the use of masks in the context of COVID-19. Available from: file:///C:/Users/ acer133_user/Downloads/WHO-2019-nCov- IPC_Masks-2020.3-eng.pdf

Balazy A1, Toivola M, Adhikari A, Sivasubramani SK, Reponen T, Grinshpun SA. Do N95 respirators provide 95% protection level against airborne viruses, and how adequate are surgical masks? Am J Infect Control. 2006; 34(2):51-7.

Price A, Chu L. What are good ways to address the shortage of face masks by anesthesiologists? Available from: https://www.scph.org/sites/ default/files/editor/facemask_shortage_0.pdf.

MacIntyre CR, Seale H, Dung TC, Hien NT, Aga PH, Chugtai AA, et al. A cluster randomised trial of cloth masks compared with medical masks in healthcare workers. BMJ Open 2015;5:e006577. doi:10.1136/bmjopen - 2014 -006577.

3M. Infection Prevention N95 Particulate Respirators, 1860/1860S and 1870. Available from: https:// multimedia.3m.com/mws/media/323208O/ n95-particulate-respirators-1860-1860s- 1870-faqs.pdf.

Qian Y, Willeke K, Grinshpun SA, Donnelly J, Coffey CC. Performance of N95 respirators: filtration efficiency for airborne microbial and inert particles. Am Ind Hyg Assoc J. 1998 Feb;59(2):128-32.

Fischer-Mackey J. Fit testing and user seal checking to evaluate respirator. GHDonline. Available from: https://www.ghdonline.org/ic/discussion/how-much-better-is-respirator-fit-testing-compared/ brief/index.html.

Darnell MER, Subbarao K, Feinstone SM, Taylor DR. Inactivation of the coronavirus that induces severe acute respiratory syndrome, SARS-CoV. J Virol Methods. 2004;121(1):85-91. doi:10. 1016/j.jviromet.2004.06.006.

Mills D, Harnish DA, Lawrence C, Sandoval- Powers M, Heimbuch BK. Ultraviolet germicidal irradiation of influenza-contaminated N95 filtering facepiece respirators. Am J Infect Control. 2018; 46(7):e49-e55. doi:10.1016/j.ajic.2018. 02.018.

Kilinc FS. A Review of Isolation Gowns in Healthcare: Fabric and Gown Properties.J Eng Fiber Fabr 2015; 10(3): 180–190. PMID: 26989351.

Picheansathian W, Chotibang J. Glove utilization in the prevention of cross transmission: a systematic review. JBI Database of Systematic Reviews & Implementation Reports 2015;13(4) 188 – 230. doi: 10.11124/jbisrir-2015-181.

Tenorio A, Badri S, Sahgal N, Hota B, Matushek M, Hayden M, et al. Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant enterococcus species by health care workers after patient care. Clin Infect Dis. 2001;32(5):826-9. Epub 2001 Feb 23.

Ong SWX, Tan YK, Chia PY. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323(16):1610-1612. doi:10.1001/jama.2020.3227.

Occupational Safety and Health Administration (US). Worker protections against occupational exposure to infectious diseases. Available from: https://www.osha.gov/SLTC/bloodbornepathogens/ worker_protections.html .

Potter AW, Gonzalez JA, Xu X. Ebola response: modeling the risk of heat stress from personal protective clothing. PLoS ONE 2015;10(11): e0143461. doi: 10.1371/journal.pone.0143461.

Ong JJY, Bharatendu C, Goh Y, Tang JZY, Sooi KWX, Tan YL, et al. Headaches associated with personal protective equipment - A cross-sectional study among frontline healthcare workers during COVID-19. Headache.2020 May;60(5):864- 877. doi: 10.1111/head.13811.

Tong PS, Kale AS, Ng K, Loke AP, Choolani MA, Lim CL, et al. Respiratory consequences of N95- type Mask usage in pregnant healthcare workers-a controlled clinical study. Antimicrob Resist Infect Control 2015;16(4):48. doi: 10.1186/s13756- 015-0086-z.

Katoh I, Tanabe F, Kasai H, Moriishi K, Shimasaki N, Shinohara K, et al. Potential Risk of Virus Carryover by Fabrics of Personal Protective Gowns. Front. Public Health 2019; 7:121-126. Available from: https://doi.org/10.3389/fpubh.2019. 00121.