What are some innovations in case of PPE or equipment shortages: face masks, gowns, masks, ventilators etc? 

Posted on April 20, 2020 by Rakesh Dewan

Summary

Strategies to optimize the availability of PPE involve minimizing the need for PPE, using PPE appropriately and coordinating the PPE supply chain. WHO and CDC have released general guidelines on optimizing the PPE supply. There are innovative efforts occurring continuously to help mitigate the PPE supply shortage challenge from using ultraviolet radiation to sterilize for reuse to using snorkel and scuba equipment! 

I.   BACKGROUND

Personal protective equipment (PPE) is used every day by healthcare personnel (HCP) to protect themselves, patients, and others when providing care (1). PPE helps protect HCP from potentially infectious patients and materials, toxic medications, and other potentially dangerous substances used in healthcare delivery (1). 

PPE shortages are currently posing a tremendous challenge to the US healthcare system because of the COVID-19 pandemic (1). Healthcare facilities are having difficulty accessing the needed PPE and are having to identify alternate ways to provide patient care (1).

II.   WHO Guidelines (2):

  • Website: https://apps.who.int/iris/bitstream/handle/10665/331695/WHO-2019-nCov-IPC_PPE_use-2020.3-eng.pdf
  • Excellent guidelines that cover an array of topics such as: 
    • Recommendations for optimizing the availability of PPE
    • Recommended PPE during the COVID-19 outbreak (according to setting, personnel and type of activity)
    • Considerations for decision making processes during severe shortages of PPE
    • Options for temporary measures due to the shortage of PPE: break down (in table format) the type of PPE, the measure being implemented (i.e. extended use, reprocessing etc), the description of how to implement the measure, the limitations/risks/removal criteria  and feasibility considerations during critical supply shortages. 
    • What the WHO does and does NOT recommend
    • Studies on medical masks and respirator reprocessing methods

III.   CDC Guidelines to Optimize PPE Supply (1):

 

  • Extensive documentation explaining how to manage eye protection, supply of isolation gowns, face masks and N95 respirators (1).

 

    • The guidelines are provided based on three general strata used to describe surge capacity (i.e. conventional capacity, contingency capacity and crisis capacity) (1).

IV.   INNOVATIVE LINKS TO PPE USAGE:

 

  • UVC Sterilizer for COVID-19 Emergency (3)

 

 

  • Shortage of PPE Due to COVID-19 Driving Innovation by RT in The Philippines (4)

 

 

  • N95 Filtering Facepiece Respirator Ultraviolet Germicidal Irradiation (UVGI) Process for Decontamination and Reuse (5)

 

      • At the University of Nebraska Medical Center, health care workers are hanging up strings of used masks in a room with two UV light towers. After a five minutes treatment, the masks are ready to be used again. 

 

  • JAMA Article: Sourcing Personal Protective Equipment During the COVID-19 Pandemic (6)

 

 

  • Innovative Testing Strategy Reduces PPE Usage (7)

 

Questions? Comments? Does this need to be updated? Do you have valuable points to add ? Please email ask.reakt@ubc.ca.

References

  1. CDC. Coronavirus Disease 2019 (COVID-19) [Internet]. Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/eye-protection.html
  2. Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages Interim guidance 6 April 2020 Background [Internet]. Available from: https://apps.who.int/iris/bitstream/handle/10665/331695/WHO-2019-nCov-IPC_PPE_use-2020.3-eng.pdf
  3. Instructables. UVC Sterilizer for COVID-19 Emergency [Internet]. Instructables. Instructables; 2020 [cited 2020 Apr 22]. Available from: https://www.instructables.com/id/UVC-Sterilizer-for-COVID-19-Emergency/
  4. Shortage of PPE Due to COVID-19 Driving Innovation by RT in The Philippines [Internet]. Imaging Technology News. 2020 [cited 2020 Apr 22]. Available from: https://www.itnonline.com/article/shortage-ppe-due-covid-19-driving-innovation-rt-philippines
  5. Lowe J, Paladino K, Farke J, Boulter K, Cawcutt K, Emodi M, et al. N95 Filtering Facepiece Respirator Ultraviolet Germicidal Irradiation (UVGI) Process for Decontamination and Reuse [Internet]. 2020 [cited 2020 Apr 22]. Available from: https://www.nebraskamed.com/sites/default/files/documents/covid-19/n-95-decon-process.pdf
  6. Livingston E, Desai A, Berkwits M. Sourcing Personal Protective Equipment During the COVID-19 Pandemic. JAMA. 2020 Mar 28

Disclaimer

The above is intended to serve as a rapidly-created, accessible source of information curated by medical students and healthcare professionals. It is for educational purposes only and is not a complete reference resource. It is not professional medical advice, and is not a substitute for the discretion, judgment, and duties of healthcare professionals. You are solely responsible for evaluating the information above.