From the Guidelines
Healthcare workers should wear personal protective equipment including N95 respirators or higher-level respirators, eye protection, gloves, and isolation gowns when caring for patients with suspected or confirmed COVID-19, as recommended by the most recent guidance from the American Heart Association 1.
Key Recommendations
- Contact precautions for COVID-19 should include droplet and airborne precautions
- Patients with suspected or confirmed COVID-19 should be placed in single-occupancy rooms with negative pressure airflow if possible, and the door should remain closed
- If negative pressure rooms are unavailable, patients should be placed in private rooms with the door closed
- Healthcare facilities should limit the number of personnel entering the room and implement visitor restrictions
- Hand hygiene with alcohol-based hand sanitizer or soap and water for at least 20 seconds should be performed before and after all patient contact and after removing PPE
Rationale
The virus that causes COVID-19 primarily spreads through respiratory droplets and aerosols when an infected person coughs, sneezes, talks, or breathes 1. The use of personal protective equipment, including N95 respirators or higher-level respirators, eye protection, gloves, and isolation gowns, is essential to prevent transmission 1. The most recent guidance from the American Heart Association recommends that all healthcare providers wear a respirator along with other PPE for patients with suspected or confirmed COVID-19 infection, when performing aerosol-generating procedures or in a setting where aerosol-generating procedures are regularly performed 1.
Important Considerations
- The definition of suspected cases should be consistent with the most current definitions from relevant public health officials as well as local standards and protocols
- Healthcare providers should continue to follow the most-up-to-date recommendations from the World Health Organization, CDC, and regional health authorities and local institutions
- Cardiac arrest survival rates have decreased dramatically during the COVID-19 pandemic, and early initiation of CPR is crucial to improve survival rates 1
From the Research
Contact Precautions for COVID-19
The following contact precautions are recommended for Coronavirus disease (COVID-19):
- Performing hand hygiene frequently with an alcohol-based hand rub or with soap and water if hands are dirty is the most effective preventive measure for COVID-19 2
- Medical masks and eye protection during close contact efficiently protects against respiratory diseases transmitted via droplets 2
- Airborne precautions include goggles and respiratory protection with the use of an N95 or an equivalent mask respirator to prevent airborne transmission 2
- N95 respirators have filtration efficiency of 95% of aerosol particles and are used where fluid resistance is also required together with respiratory protection, e.g. during surgery or interventional procedures 3
- Personal protective equipment (PPE) such as masks, respirators, gloves, and gowns or body covers play a major role in the prevention and control of COVID-19 4
- Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation, and PPE should be matched to the potential mode of viral transmission occurring during patient care 5
Types of Masks
- Medical masks are used for droplet transmission 2
- N95 respirators are used for airborne transmission and have filtration efficiency of 95% of aerosol particles 2, 3
- Surgical N95 respirators are used where fluid resistance is also required together with respiratory protection, e.g. during surgery or interventional procedures 3
Personal Protective Equipment (PPE)
- PPE is an important component of a system protecting staff and other patients from COVID-19 cross-infection 5
- Appropriate use of PPE significantly reduces risk of viral transmission 5
- Recommendations from international organisations are broadly consistent, but equipment use is not 5
- Uncertainty remains around certain details of PPE including use of hoods, mask type and the potential for re-use of equipment 5