COVID-19: Resource scarcity

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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

Ventilators

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

Personnel

See Also

References