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Covid-19: NHS staff told they should re-use some PPE, as stock shortages continue

by Sofia Lind
20 April 2020

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Public Health England (PHE) has published new guidance on the use of PPE ‘when in short supply’, recommending re-use of items including facemasks.

The temporary guidance applies only for ‘urgent or emergency face-to-face contacts’ in a ‘health and social care setting’.

Its most recently updated guidance on PPE during the Covid-19 pandemic, published 2 April, had already recommended sessional use of PPE, but the new guidance, published on Friday (17 April), goes further by recommending re-use.

It says, regarding fluid repellent surgical face masks (FRSM) – which are recommended in general practice – that these can be re-used if they have elastic ear hooks but not if they are tie-on. Inbetween uses they should be stored correctly and marked with the person’s name.

The document further recommends healthcare providers ‘consider shifting disposable gowns or coveralls to reusable options, retaining disposable gowns only for high risk aerosol-generating procedures’.

It does not recommend the re-use of gloves, but says healthcare professionals should ‘not use double gloves for care of suspected or confirmed Covid-19’.

PHE said that the ‘considerations are to ensure that health and care workers are appropriately protected from Covid-19, where items of PPE are unavailable, and should be considered as temporary measures until the global supply chain is adequate to meet the UK’s needs’.

PHE added that the document ‘aligns with current evidence and Centers for Disease Control (CDC) and World Health Organization (WHO) guidance on optimising the supply of personal protective equipment (PPE) and the use of PPE when in short supply’.

BMA consultants committee chair Dr Rob Harwood said: ‘If it’s being proposed that staff re-use equipment, this must be demonstrably driven by science and the best evidence – rather than availability – and it absolutely cannot compromise the protection of healthcare workers.

‘Too many healthcare workers have already died.  More doctors and their colleagues cannot  be expected to put their own lives on the line in a bid to save others, and this new advice means they could be doing just that. It’s not a decision they should have to make.’ 

Re-use of fluid repellent surgical face masks (FRSM) and disposable respirators (FFP3/ FFP2/ N95)

  • the mask should be removed and discarded if soiled, damaged, or hard to breathe through;
  • masks with elastic ear hooks should be re-used (tie-on face masks are less suitable because they are more difficult to remove);
  • hand hygiene should be performed before removing the face mask;
  • face masks should be carefully folded so the outer surface is held inward and against itself to reduce likely contact with the outer surface during storage;
  • the folded mask should be stored between uses in a clean sealable bag/ box which is marked with the person’s name and is then properly stored in a well-defined place;
  • hand hygiene should be performed after removing the face mask;
  • some models of PPE cannot be physically reused as they deform once being donned and do not go back to original condition (meaning it would be difficult to re-don and achieve a fit check). Fit checks should be performed each time a respirator is donned if it is reused.

Source: PHE: Considerations for acute personal protective equipment (PPE) shortages