Document: Review Article - Personal protective equipment during the COVID-19 pandemic – a narrative review
ESAIC Academy. Cook T. 04/14/20; 293210
Topic: Education
Timothy Cook
Contributions
Contributions
Abstract
Summary
Personal protective equipment has become an important and emotive subject during the current coronavirus (COVID-19) epidemic. COVID-19 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately one metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from COVID-19 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care – contact, droplet, or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol-generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.
Personal protective equipment (PPE) is a current hot topic – probably the most talked about and emotive subjects for front line healthcare staff working with patients with coronavirus disease (COVID-19). There are two main related problems: shortages of equipment; and inappropriate use of equipment. This review seeks to add some clarity regarding modes of transmission of COVID-19, what PPE is recommended, when and why (Box 1). It also explores where uncertainty exists. It proposes a nomenclature for PPE based on mode of transmission. Its focus is predominantly UK-centric and readers from elsewhere should consult local guidance.
Personal protective equipment has become an important and emotive subject during the current coronavirus (COVID-19) epidemic. COVID-19 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately one metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from COVID-19 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care – contact, droplet, or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol-generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.
Personal protective equipment (PPE) is a current hot topic – probably the most talked about and emotive subjects for front line healthcare staff working with patients with coronavirus disease (COVID-19). There are two main related problems: shortages of equipment; and inappropriate use of equipment. This review seeks to add some clarity regarding modes of transmission of COVID-19, what PPE is recommended, when and why (Box 1). It also explores where uncertainty exists. It proposes a nomenclature for PPE based on mode of transmission. Its focus is predominantly UK-centric and readers from elsewhere should consult local guidance.
Summary
Personal protective equipment has become an important and emotive subject during the current coronavirus (COVID-19) epidemic. COVID-19 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately one metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from COVID-19 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care – contact, droplet, or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol-generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.
Personal protective equipment (PPE) is a current hot topic – probably the most talked about and emotive subjects for front line healthcare staff working with patients with coronavirus disease (COVID-19). There are two main related problems: shortages of equipment; and inappropriate use of equipment. This review seeks to add some clarity regarding modes of transmission of COVID-19, what PPE is recommended, when and why (Box 1). It also explores where uncertainty exists. It proposes a nomenclature for PPE based on mode of transmission. Its focus is predominantly UK-centric and readers from elsewhere should consult local guidance.
Personal protective equipment has become an important and emotive subject during the current coronavirus (COVID-19) epidemic. COVID-19 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately one metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from COVID-19 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care – contact, droplet, or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol-generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.
Personal protective equipment (PPE) is a current hot topic – probably the most talked about and emotive subjects for front line healthcare staff working with patients with coronavirus disease (COVID-19). There are two main related problems: shortages of equipment; and inappropriate use of equipment. This review seeks to add some clarity regarding modes of transmission of COVID-19, what PPE is recommended, when and why (Box 1). It also explores where uncertainty exists. It proposes a nomenclature for PPE based on mode of transmission. Its focus is predominantly UK-centric and readers from elsewhere should consult local guidance.
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