COVID-19: Resource scarcity: Difference between revisions
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==Medical Equipment== | ==Medical Equipment== | ||
===Oxygen Delivery=== | ===Oxygen Delivery=== | ||
*Nasal cannula, Venturi mask, high flow nasal cannula | |||
*Use Y tubing (purchased or 3d printed) to divide oxygen flow to several patients | |||
*Oxygen from portable tanks/wall setup/concentrators | |||
===Non-invasive | ===Non-invasive ventilation=== | ||
*bpap/cpap-Negative pressure room preferred https://em.umaryland.edu/educational_pearls/3741/ | |||
*Decreased aerosolization distance if surgical mask used | |||
===Ventilators=== | ===Ventilators=== | ||
*consider ventilator splitting to ventilate 2 or more patients of similar size and illness | |||
*May need to remove from one patient to give it to another patient https://www.nejm.org/doi/full/10.1056/NEJMsb2005114 | |||
===Isolation | ===Isolation equipment=== | ||
===IV pumps=== | ===IV pumps=== | ||
*Use extended tubing so iv pumps can be placed outside patients’ rooms, decreases need for ppe | |||
*Use drop count method if no pumps available/for maintenance fluids | |||
==Personnel== | ==Personnel== | ||
Revision as of 15:05, 19 April 2020
This page is for the location/creation/preservation of resources. For hospital protocols for resource ALLOCATION please see Hospital preparedness: COVID-19
PPE Shortage and Conserving Supplies Guidelines
In case of PPE shortage or in an attempt to save on PPE supplies, the following guidelines were approved by CDC 3/13/20:
- Same respirator can be worn for multiple serial patient contacts (e.g. in between successive COVID/PUI (patients under investigation) without exchanging respirator. Therefore, in between each patient:
- No need to change mask or eye protection
- BUT need to change gown and gloves
- Respirator reuse possible? Higher risk because of having to touch the mask and either self-inoculate or transmit to another patient (e.g. wear it for a patient, then you remove, and then you put it back on)
- If you must do this because of limited supplies, don and doff properly and perform proper hand hygiene in between
- CDC / NIOSH will allow certain N95s to be used beyond manufacture-designated shelf life
- See list of appropriate models here (manufactured between 2003-2013)
- N95 Reuse? Probably okay to re-use same N95 during an 8 hour shift as long as no tears or visible contamination. Store facedown in labeled re-sealable bag/container.
- Based on non peer reviewed reports from Washington State
Surgical Masks
considered the minimum required for droplet isolation (besides gloves)
Respirators/PAPR
N95/KN95/P95/P100/Powered Air Purifying Respirator or equivalent for aerosols
Medical Equipment
Oxygen Delivery
- Nasal cannula, Venturi mask, high flow nasal cannula
- Use Y tubing (purchased or 3d printed) to divide oxygen flow to several patients
- Oxygen from portable tanks/wall setup/concentrators
Non-invasive ventilation
- bpap/cpap-Negative pressure room preferred https://em.umaryland.edu/educational_pearls/3741/
- Decreased aerosolization distance if surgical mask used
Ventilators
- consider ventilator splitting to ventilate 2 or more patients of similar size and illness
- May need to remove from one patient to give it to another patient https://www.nejm.org/doi/full/10.1056/NEJMsb2005114
Isolation equipment
IV pumps
- Use extended tubing so iv pumps can be placed outside patients’ rooms, decreases need for ppe
- Use drop count method if no pumps available/for maintenance fluids