WLAVA:COVID-19 PPE

Official GLA PPE Recommendations

Last Updated 4/9/20

PPE for Suspected COVID-19 Patients: Critically Ill or Aerosolizing Procedures

• Airborne
• Droplet
• Contact precautions (with eye protection)
• Negative pressure room (if available)
• Critically ill (i.e., receiving ICU-level care)
• Eye protection (face shield or goggles)

PPE for All Other Suspected COVID-19 Patients

• Standard
• Droplet
• Contact precautions (with eye protection)
• Eye protection (face shield or goggles)

Guidance on Donning and Doffing for ED Patient Encounters

For Patients w/COVID-19 Isolation Precautions

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

For Patients w/o COVID-19 Isolation Precautions

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

GLA Airway/CODE Donning & Doffing Checklist

N95

• CODE Scenario: N95 Donning & Doffing (File:PPE Donning Checklist ER 2020 N95 for CODE - 4.4.pdf)
• Airway Buddy: N95 Donning & Doffing (File:PPE Donning Checklist ER 2020 N95 buddy - 4.4.pdf)

PAPR

• PAPR Donning & Doffing (File:PPE Checklist ER 2020 airway PAPR 4.4.pdf)

PPE PAPR Donning Video

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

PPE PAPR Doffing Video

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

PPE Buddy Doffing Video

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

Radiology COVID-19 and PPE

• Very low threshold for placing facemask on patients with respiratory symptoms or symptoms potentially concerning for COVID.
  • All patients with respiratory symptoms are supposed to have this anyway, but we may have to enforce further
• In the current climate, portable CXRs generally preferred (especially for respiratory symptoms)
• Very low threshold for staff wearing face masks whenever interacting directly with patients including when obtaining XRs
• Make sure patients are wearing face mask properly if they are sent down to imaging (Remind transport to check face mask).
• We can do portable CXRs in Fast Track if either the patient is in a bed (Room D only) or the patient is very compliant and able to sit still in our exam chairs without risking dropping the cassette.

Updates on GLA ED Supply of PPE

3D Printed Face Shields

• These are not completely splashproof 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.

The 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

• Please do not mark 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 - comes in 3 sizes (located in Med Room).

Goggles

• ED staff will given safety googles
  • Come see me/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:
  • Perform hand hygiene
  • Put on gloves
  • Use an alcohol wipe across the entire INNER surface
  • Use a hospital disinfectant (SaniWipe AF3) to wipe the entire OUTER surface
  • Allow to air dry
  • Place in brown paper bag till next use
  • Remove gloves and perform hand hygiene
  • GLA Infection Control Reference file:
    • File:APPROVED_20200330.1030.Interim GLA guidance for Eye Protection Cleaning.pdf

GLA Main 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

Other WLA VA Pages

• WLAVA: COVID19 ED Operational Updates
• WLAVA: COVID-19 ED Airway Main
• WLAVA: Enhanced Screening Tent
• EST Provider Orientation
• WLAVA:Enhanced Screening Tent Telehealth