                                                                                                                 
Novel Coronavirus Disease 2019 (COVID-19): ADDITIONAL GUIDELINES on ra onal use of Personal Protec ve Equipment (se ng approach for Health func onaries working in non-COVID areas)
Ministry of Health and Family Welfare Directorate General of Health Services [Emergency Medical Relief]
                                                                                                               
                                                                
ABOUT THIS GUIDELINE
This guideline is for health care workers and others working in Non COVID hospitals and Non- COVID treatment areas of a hospital which has a COVID block. These guidelines are in con nua on of guidelines issued previously on ‘Ra onal use of Personal Protec ve Equipment’ (h ps://www.mohfw.gov.in/pdf/Guidelinesonra onaluseofPersonalProtec veEquipment.pdf).
This guideline uses “se ngs” approach to guide on the type of personal protec ve equipment to be used in different se ngs.
• Ra onal use of PPE for Non COVID hospitals and Non-COVID treatment areas of a hospital which has a COVID block
• The PPEs are to be used based on the risk profile of the health care worker. The document describes the PPEs to be used in different se ngs.
                                                                                                                                                                       
                                                             
2.1 OUT PATIENT DEPARTMENT
                                                            
S.No.
              
4
Se ng
Pre- anesthe c check-up clinic
Ac vity
Pre-anesthe c check-up
Risk
Moderate risk
Recommended PPE
• N-95 mask
• Goggles*
• Latex examina on gloves
Remarks
  
1
2
3
Help desk/ Registra on counter
Doctors chamber
Chamber of Dental /ENT doctors/ Ophthalmology doctors
Provide informa on to pa ents
Clinical management
Clinical management
Mild risk
Mild risk
Moderate risk
• Triple layer medical mask • Latex examina on gloves
• Triple layer medical mask • Latex examina on gloves
• N-95 mask
• Goggles
• Latex examina on gloves
+ face shield
Physical distancing to be followed at all mes
No aerosol genera ng procedures should be allowed.
Aerosol genera ng procedures an cipated. Face shield, when a splash of body fluid is
expected
     
* Only
recommended when close examina on of oral cavity/dentures is to be done
     
5
Pharmacy counter
Distribu on of drugs
Mild risk
• Triple layer medical mask • Latex examina on gloves
Frequent use of hand sani zer is advised over gloves.
                           
6
Sanitary staff
Cleaning frequently touched surfaces/ Floor
Mild risk
• Triple layer medical mask • Latex examina on gloves
                                                                                   
         
                         
#All hospitals should iden fy a separate triage and holding area for pa ents with Influenza like illness so that suspect COVID cases are triaged and managed away from the main out-pa ent department.
2.2. In-pa ent Department (Non-COVID Hospital & Non-COVID treatment areas of a hospital which has a COVID block)
                                                                                             
S.No.
Se ng
Ac vity
Risk
Recommended PPE
Remarks
1
Ward/individual rooms
Clinical management
Mild risk
• Triple layer medical mask • Latex examina on gloves
Pa ents stable. No aerosol genera ng ac vity.
2
ICU/ Cri cal care
Cri cal care management
Moderate risk
• N-95 mask
• Goggles
• Nitrile examina on gloves
+ face shield
Aerosol genera ng ac vi es performed.
Face shield, when a splash of body fluid is expected
3
Ward/ICU /cri cal care
Dead body packing
Low Risk
• Triple layer medical mask • Latex examina on gloves
4
Ward/ICU/Cri cal care (Non-COVID)
Dead body transport to mortuary
Low Risk
• Triple layer medical mask • Latex examina on gloves
5
Labor room
Intra-partum care
                         
Moderate risk
• Triple Layer medical mask • Face shield
• Sterile latex gloves
• Coverall
• N-95 mask*
                           
Pa ent to be masked in the Labor room, if possible.
*If the pregnant woman is a resident
                          
                          
            
S.No.
         
Se ng
              
Ac vity
         
Risk
Recommended PPE
             
     
Remarks
       
6
Opera on Theater
   
Performing surgery, administering general anaesthesia
             
Moderate Risk
   
• Triple layer medical mask
• Face shield (- wherever
feasible)
• Sterile latex gloves
• N-95 mask
• + Goggles
         
Already OT staff shall be wearing
For personnel involved in aerosol genera ng procedures
*If the person being operated upon is a resident of containment zone
7
Sanita on
Cleaning frequently touched surfaces/ floor/ changing linen
Low Risk
• Triple layer medical mask • Latex examina on gloves
    
2.3. Emergency Department (Non-COVID)

S.No.
Se ng
Ac vity
Risk
Recommended PPE
Remarks
1
Emergency
A ending emergency cases
Mild risk
• Triple layer medical mask • Latex examina on gloves
No aerosol genera ng procedures are allowed
2
Emergency
A ending to severely ill pa ent while performing aerosol genera ng procedures
                             
High risk
• Full complement of PPE (N-95 mask, coverall, goggle, Nitrile examina on gloves, shoe cover)
                                  
                              
             
                             
2.4. Other Suppor ve/ Ancillary Services
                                                                 
        
S.No.
Se ng
Ac vity
Risk
Recommended PPE
Remarks
                  
1
Rou ne Laboratory
Sample collec on and transporta on and tes ng of rou ne (non- respiratory) samples
Mild risk
• Triple layer medical mask Latex examina on gloves
   
2
Rou ne Laboratory
Respiratory samples
Moderate risk
• N-95 mask Latex examina on gloves
   
3
Radio- diagnosis, Blood bank, etc.
Imaging services, blood bank services etc.
Mild risk
• Triple layer medical mask Latex examina on gloves
   
4
CSSD/Laundry
Handling linen
Mild risk
• Triple layer medical mask Latex examina on Gloves
5
Other suppor ve services incl. Kitchen
Administra ve Financial Engineering** and dietary** services, etc.
Low risk
Face cover
** Engineering and dietary service personnel visi ng treatment areas will wear personal protec ve gears appropriate to that area
                                                   
                                           
                            
2.5. Pre-hospital (Ambulance) Services
                                                                    
S.No.
Se ng
    
Ac vity
       
Risk

Recommended PPE
      
Remarks
1
Ambulance Transfer to designated hospital
Transpor ng pa ents not on any assisted ven la on
Low risk
• Triple layer medical mask • Latex examina on gloves
Management of SARI pa ent
High risk
• Full complement of PPE (N-95 mask, coverall, goggle, latex examina on gloves, shoe cover)
While performing aerosol genera ng procedure
Driving the ambulance
Moderate risk
• Triple layer medical mask • Latex examina on gloves
Driver helps in shi ing pa ents to the emergency
Points to remember while using PPE
1. Standard precau on to be followed at all mes
2. PPEs are not alterna ve to basic preven ve public health measures such ashand hygiene, respiratory e que es which must be
followed at all mes.
3. Always follow the laid down protocol for disposing off PPEs as detailed in infec on preven on and control guideline available on
website of MoHFW.
In addi on, pa ents and their a endants to be encouraged to put on face cover.
In case a COVID-19 pa ent is detected in such Non-COVID Health facility, the MoHF                uidelines for the same has to be followed (Available at: h ps://www.mohfw.gov.in/pdf/Guidelinestobefollowedondetec onofsuspectorconfirmedCOVID19ca se.pdf)
                                                         
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