Changes to Trust PPE guidance
As of today, Thursday 16th June, PPE guidance has been updated.
Full details can be found at What to wear and when – STHK COVID-19 Guidance
A summary of the key changes are below:
Social Distancing:
There is no longer a requirement to socially distance.
Wearing of masks:
Masks no longer need to be worn in Trust buildings – With some exceptions (see below)
ALL Staff MUST wear type IIR surgical masks when:
- Providing direct clinical care to untriaged patients in areas where potential for respiratory infection is high (specifically Emergency Department including SDEC, AMU, Bevan Court 1 Ambulatory Care, Urgent Treatment Centre as well as first home visit by Community Services staff)
- Providing direct clinical care to any patients on 2A (including Satchi Suite) and Lilac Centre (as these patients are more likely to be highly vulnerable to respiratory infections including COVID-19)
Providing direct patient care – not carrying out an aerosol generating procedure
There is no longer a requirement to wear a full set of standard PPE when providing direct clinical care (i.e. within 2m) of any patient. However,
- Staff MUST wear a standard full set of PPE (i.e. type IIR surgical mask, gloves, apron plus if there is significant risk of exposure to bodily fluids eye protection) when caring for any patient with any suspected or confirmed respiratory infection (including COVID-19).
- Staff MUST wear gloves and apron when caring for any patient without suspected or confirmed respiratory infection but with non-respiratory cross infection hazards requiring contact precautions (e.g. MRSA/CDI/VRE/CPE)
Aerosol generating procedures (AGPs)
- When carrying out AGPs on patients with any suspected or confirmed respiratory infection, staff MUST continue to wear an FFP3 mask, visor, gloves and long sleeved fluid repellent gown
- When carrying out AGPs on patients without a suspected or confirmed respiratory infection, staff MUST wear : FFP3 mask, visor, gloves and apron. In such patients, a long sleeved gown is required only if there is significant risk of exposure to bodily fluids
For staff who wish to continue to wear masks, based on personal preference or their individual Health Work and Well Being risk assessment, in scenarios other than those detailed in the PPE guidance, type IIR surgical masks will continue to be available in all clinical and non-clinical areas.
Updated PPE guidance when attending all cardiac arrests
- Following recognition of a Cardiac Arrest, rescuer to commence chest compression only CPR wearing a surgical type IIR facemask, visor, plastic apron and gloves whilst awaiting for help to arrive
- First responder to attach defib pads and deliver shocks if indicated, once AED/Defib is passed into room/bay. First responder to recommence chest compressions whilst waiting for the emergency teams arrival.
- Once emergency team has arrived and donned gloves, FFP3 mask, visor and plastic apron (note: long sleeved gown only needed if the patient has a known respiratory infection), first responder to step out of the room prior to any ventilation/intubation/suction or any other AGPs are performed.
No more than 5 team members to enter a room or bay whilst a cardiac arrest is in progress
· Cardiac Arrest Trolley MUST stay outside the room – only defibrillator and pads to be taken into the room
· One person to stay with the trolley outside the room as “Gatekeeper” wearing a surgical mask, plastic apron, gloves and eye protection.
· The Gatekeeper must ensure emergency team don on gloves, FFP3 mask, visor and plastic apron (note: long sleeved gown only needed if the patient has a known respiratory infection), before entering the room and continuing advanced resuscitation including AGPs e.g. Intubation. Full PPE x 5 stored in grab bag attached to the arrest trolley and in ward clean utility room
· The Gatekeeper is responsible for passing items from the trolley into the room as required by finger-tip
· Disposable equipment must not leave the room until bagged for disposal
· Blood samples are to be placed in a blue bag held by an external member (not the gatekeeper) they will complete a requisition form if required. In the case of ABGs this person (someone who can do ABG testing) should take the ABG sample to the nearest ABG machine available to carry out the testing wearing gloves
· Non-disposable equipment – defibrillator, leads etc must be cleaned as per IPC instructions immediately to ensure equipment is available ASAP
Please direct any questions relating to the above cardiac arrest procedure and guidance to paul.craven@sthk.nhs.uk