Everyone is aware of the PPE problem. What to do about it? What are some strategies? What are others doing? I’ll share some examples. To be honest, I don’t know exactly what is best. The experiences are all over the place. I’ll share a few things with you to help you make your best decision, if your organization doesn’t decide for you. If this continues to explode as I suspect, then Medics should learn from the civilians on the front line already developing strategies now. START FOLLOWING THIS NOW.
First, we need to understand a few foundational things about how diseases spread.
Fomites– objects or materials which are likely to carry infection, such as clothes, utensils, and furniture.
When we come into contact with an infectious agent and then touch objects, the object becomes a fomite. If anyone touches the fomites and then touches their mouth, they transmit the disease. So, PPE is important. Good discipline is important. Washing hands often- also important. Be careful of infectious surfaces, or even your phone! This was the number one reason that the experts were warning against wearing masks at the beginning- because you could inoculate yourself if removing a mask improperly- and because of severe shortages. I think we are changing our minds not this now.
WHAT PPE Should we be Wearing?
This is the million dollar question. I already shared in a previous post that ” it’s not airborne, but its borne in the air ” – a great article. Go check that out if you have not yet read it. It’s a great article that really highlights the difficulty that we are having. The virus seems to be concentrated in droplets and so it spreads 6 feet or so when sneezing/coughing. However, we know that it takes approximately 3 hours to settle and that it has been found in air vents, etc. So, should we be taking airborne precautions? We don’t really know how much of the virus is needed to inoculate us, or how much it would take for us to be asymptomatic carriers. We just don’t know.
“There is much to learn about the newly emerged COVID-19, including how and how easily it spreads. Based on what is currently known about COVID-19 and what is known about other coronaviruses, spread is thought to occur mostly from person-to-person via respiratory droplets among close contacts.”Centers for Disease Control, COVID 19 Website for Healthcare Providers https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html
And Why is This Different from H1N1?
**CHECK OUT THIS FANTASTIC ARTICLE BY AN AMERICAN FAMILY PHYSICIAN WHO TOOK CARE OF PATIENTS IN CHINA WHEN THIS ALL STARTED. LESSONS LEARNED!**
What Are Most HealthCare Systems Doing Now for PPE?
- Some are using surgical masks on all healthcare workers.
- Some are using N-95s, but limiting the workers to only receiving one per day
- Some are using surgical masks routinely all day, but switching to N-95 for aerosolizing risky procedures
- Some are even giving out masks to all patients who enter. – this is what was recommended by a physician in Italy.
I will share some screenshots of a social media group I am a part of and the different innovations that they have been discussing. Healthcare workers are concerned. They are getting creative. Forgive the image quality of screenshots, but this is the easiest way to share the information.
SOME INTERESTING PROPOSALS
MAYBE WE CAN SUBSTITUTE ANOTHER DEVICE?
MAYBE WE CAN RE-USE THE N-95 IF WE USE A COVER?
PERHAPS WE CAN USE UV LIGHT?
THE NEBRASKA MEDICINE PROTOCOL
Check out this link to a fantastic website from Nebraska Medicine. They have developed an entire protocol! Click HERE. Also, recommend to not use alcohol on the outside of the mask as it may degrade the mask.
Can We Re-use a Mask after 5-7 days? Maybe!
Some discussions have been circulating around social media from medical professionals/healthcare workers about this very subject. We think that the longest time that the virus has been detected is 9 days. Most studies are showing 3-7 days, at most. Theoretically, we could issue 10 masks to a provider and have them place the mask each day into a numbered brown paper bag (plastic not recommended). Then, the worker would rotate daily to a new mask and theoretically the virus will have died from the previous days. (Reference here)
MEDICS SHOULD CONTINUE TO TRAIN! PREPARE NOW
- Sustainment Training here
- Performing a Nasopharyngeal Swab- Video
- Blog Feed – Scroll down to get to more topics
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This content is the author’s opinion alone and does not necessarily reflect the opinion, official position, or stance of the Department of Defense, or any other branch of the United States Military.
All content is intended to be educational only. Medics should operate under the supervision of a medical provider and abide by all local laws while stateside. Medics should only practice at the level credentialed, and only at the level allowed. This content is not intended to treat or give a substitution for any credentialed provider. Content is intended to aid in a deployed prolonged care setting. Take guidance from your leaders. Utilize these posts as preparation and as a supplement to your provider’s direction and teaching.