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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