COVID-19: Resource scarcity

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

Respirators/PAPR

• N95/KN95/P95/P100/Powered Air Purifying Respirator or equivalent to protect against aerosols
• N95/KN95 respirators- crisis capacity calls for entire shift/multiple day use
• May be recycled after vaporous hydrogen peroxide treatment (Battelle method)
• Industrial UV light may be used; light must reach every crevice
• Do not bake in a home oven/wash/douse in bleach- will degrade the fibers

Eye Shields/Face Shields/Goggles

• Clean/disinfect and reuse
• Face shields- made by 3d printing or affixing acetate sheets to a foam headband and elastic

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 applied over face piece/nose and mouth

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

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

See Also

• COVID-19
• COVID-19: Example hospital protocols
• COVID-19: Management of recovered patients
• COVID-19 (peds)
• COVID-19 Vaccine (Moderna)
• COVID-19 Vaccine (Pfizer-BioNTech)
• COVID-19 in pregnancy