Are UK doctors getting sufficient protective equipment against covid-19?

• Published in: BMJ Vol. 369; p. m1297
• Main Author: Sayburn, Anna
• Format: Journal Article Web Resource
• Language: English
• Published: England British Medical Journal Publishing Group 02.04.2020; BMJ Publishing Group LTD
• Subjects: Aerosols; Anesthesia; Bronchoscopy; Contamination; Coronaviruses; COVID-19; Disease transmission; Drilling; Endoscopy; Extubation; Eye protection; Feature; Gloves; Hospitals; Intensive care; Intensive care units; Intubation; Masks; Mechanical ventilation; Medical personnel; Ostomy; Patients; Personal protective equipment; Pharynx; Physicians; Pressure; Primary care; Public health; Respiratory tract; Sputum; Suctioning; Supplies; Surgery; Tracheostomy; Ventilators; United Kingdom > UK; United States > US
• ISSN: 1756-1833; 1756-1833
• DOI: 10.1136/bmj.m1297

Revised guidelines from Public Health England recommend that healthcare workers caring for patients with suspected or confirmed covid-19 should “have access to the PPE that protects them for the appropriate setting and context” and that “risk is not uniform and so elements of the updated guideline are intended for interpretation and application dependent on local assessment of risk.” Intubation, extubation, and related procedures, such as manual ventilation and open suctioning of the respiratory tract (including the upper respiratory tract) Tracheotomy/tracheostomy procedures (insertion, open suctioning, removal) Bronchoscopy and upper ear, nose, and throat airway procedures that involve suctioning Upper gastrointestinal endoscopy where there is open suctioning of the upper respiratory tract Surgery and postmortem procedures involving high speed devices Some dental procedures (such as high speed drilling) Non-invasive ventilation, such as bi-level positive airway pressure ventilation and continuous positive airway pressure ventilation High frequency oscillatory ventilation Induction of sputum High flow nasal oxygen What is the guidance from specialist groups? 3 The joint guidance, which is expected to be updated in response to Public Health England’s new guidance, recommended wearing some form of protection while treating all patients (within 2 m), even those in whom covid-19 is not suspected or confirmed. 5 In the US, the American Society of Anesthesiologists, Anaesthesia Patient Safety Foundation, American Academy of Anesthesiologist Assistants, and American Association of Nurse Anesthetists issued a joint statement stating, “We recommend as optimal practice that all anesthesia professionals should utilize PPE appropriate for aerosol generating procedures for all patients [whether suspected or confirmed covid-19 or not] when working near the airway.”