7/10/2020

PPE Daily Update

Ambulatory Practices and Services Located at the Hospital:

Follow Inpatient Guidelines for LifeArmour and Cloth Masks in addition to below:

  • Ensure all patients and visitors wear facemasks to cover mouth and nose.
  • Patients that arrive with “ear looped surgical masks” or a non-valve N95 mask are appropriate and permitted during their visit.
  • Any N95 masks that has a valve (e.g. pictured below) should be covered with a LifeArmour or ear loop mask to prevent unfiltered air to be expelled from the valve.
Cloth MasksCloth Mask Cloth Mask
  • Not recommended for wear in the hospital setting by the CDC as surgical-type masks offer both source control and protection for the wearer against exposure to splashes and sprays of infectious material from others while cloth masks do not.
  • Protects everyone else if YOU have COVID19, but does not protect you from COVID19
  • Interim guidance from PPE committee is that, if you must wear one of these cloth masks (due to discomfort or reaction to LifeArmour mask), please wear it under the LifeArmour or Surgical-type mask.
Surgical MasksSurgical Mask
  • The use of Surgical Masks for non-PUI and non-COVID+ patients is not applicable to Levindale because staff are continuing to universally mask with N95s for patient care until further notice. The mileu on the Brain Health Units and 14-day Quarantine New Admission patients, pose a unique challenge for Levindale which is the rational for maintaining this level of protection for patient care.
  • Protects everyone else if YOU have COVID-19
  • Can be worn in hallways and public spaces around hospital or in patient rooms for non-PUI and COVID negative patients.
  • You can pick up one per day from the floor, but should replace it more frequently if soiled or wet.
  • Can be worn over N95 masks in operating room only
  • Should be given to every patient in the hospital. The patients should wear them if they leave their room or if anyone else (including a provider in full PPE) is in the room.
N95 Masks
(with and without valves)
  • For clinical team members only (with some exceptions for non-clinical team members who enter patient rooms); 1 per day max
  • Hospital-based clinical team only for now
  • Must be fit-tested
  • Protects you from someone else’s COVID19
  • Do not wear makeup or lipstick or these will foul the masks and prevent them from being recycled
  • Do not wear them around the hallways, on your head, on your neck, or swing them around
  • Wear them with COVID-19 positive patients, PUIs, if the patient is unable to give symptoms or if you will spend more than one hour in the room with the patient.
  • Pick up from floor stock or in provider lounge (for providers); write location and floor code on mask
  • Keep them in brown paper bag when you are not using them
  • You can extend use to 3 days. Please wear a face shield whenever you are wearing an N95 (in every patient room) in order to extend the life of the N95 and to fully protect your eyes
  • At the end of use of your N95, please return to your designated return bin for sterilization.
  • Discard the mask if it is visibly soiled
  • Place the N95 mask into the return bin for sterilization immediately after an aerosol-generating procedure (such as being involved in a cardiac arrest), even if it is covered by a face shield
  • White N95s have been coming into the system. These can be used like regular N95s but need to be fit tested and require a small amount of training to put on safely each time. Roll out is happening at some hospitals earlier than others.
N100 Face Masks n100 mask
  • Assigned to certain team members/groups with high N95 use rates as a method of conserving N95s
  • Must be fit-tested and approved for hospital use
  • For fit testing, please contact your hospital’s employee health department
  • You can wear yours from home, if you have one, but they must be fit tested and approved by LBH. You are responsible for changing the filters and cleaning it using the correct cleaning wipes (some wipes will degrade some masks!). Check manufacturer instructions!
  • Due a to a shortage of some wipes, Virex is now available for cleaning your N100 (both Grey 3M and Blue MSA models) during the day. Note that you should not spray it directly on the mask and that it has a 10 minute contact time requirement. Please see supplemental information here.
  • To make sure yours is safe and approved for hospital use, please contact: Martha Hill at Sinai, Timothy Black at Carroll, James Howard at NW, and Jocelyn Pope at Grace
  • Can be used for intubation/extubations and some other aerosolizing procedures (along with face shield)
Gowns GOWNS GOWNS
  • In critically short supply; conserve by limiting the amount of times you go into a PUI or COVID+ room
  • Some departments with high use rates have been given re-usable (washable) gowns, please do not throw these away
  • CDC has approved gowns for multiple use per health care provider – detailed guidelines will be forthcoming
  • LifeBridge Health is producing our own gowns now, will be distributed to floors soon
  • Gown re-use plan is on a hospital by hospital basis. Please check with your command center regarding your particular gown re-use plan
  • The PPE taskforce has recommended increasing the number of disposable gowns available for each PUI based on feedback from the hospital command centers. The Critical care areas have a full supply of cloth reusable gowns
Face Shieldsface shield face shield
  • For clinical team members only (with some exceptions for non-clinical team members who enter patient rooms); 1 per day max
  • Please clean with wipes and re-use as long as they are clear and have structural integrity; these should last many days
  • For use with all patient contact (regardless of whether the patient is COVID+, a PUI, or a non-PUI)
LifeArmour MasksLifeArmour Masks
  • Not adequate to protect individuals in high risk clinical situations
  • When worn by everyone, offers SIGNIFICANT protection to groups; makes the hospital a safer place for patients, staff, and visitors
  • Everyone coming into the hospital gets one per day
  • Should be worn walking around hallways and public spaces of hospital to prevent spread of COVID19
  • Wear with tab facing up (preferred) but can be worn tab down if needed for comfort
  • Staff using public transportation may take an additional mask home for use when traveling
  • Discard at end of day
PAPRs PAPR PAPR
  • Assigned to certain high-risk teams and locations throughout the hospital
  • Must be worn for intubations and extubations as well as some other aerosolizing procedures (with exceptions, see N100 below)
  • Can be assigned to individuals on case by case basis but are in extremely short supply and very uncomfortable to wear

PPE Daily Update

In order for our PPE policies to be clear, this update will be sent out daily. Any changes will be highlighted below.

As of today July 10: Review Highlighted Changes 

Please check here for all policy updates as well as donning, doffing and cleaning videos: www.lifebridgehealth.org/COVIDclinical. If you have any specific questions not addressed here, please email Dr. Charles Albrecht, Vice President and Chief Quality Officer, at calbrech@lifebridgehealth.org


Please note: To protect our staff and patients, it is critical that a facemask be worn at all times, including nursing stations, breakrooms and hallways.

UPDATED Document: PPE Guidelines – What to Wear When?