Philippine Journal of Surgical Specialties Vol. 75, No. 1, January-June 2020, pp 15-26

Recommendations for the Rational and Effective Use of Personal Protective Equipment (PPE): Guidelines for Extended Use, Re-use and Acceptable Reprocessing Methods

Author(s): Philippine College of Surgeons

The COVID-19 pandemic is exerting tremendous pressure on all healthcare systems worldwide. Strategies must be employed to care for patients the best we can while protecting health care workers (HCWs) from contracting the disease themselves. DOH has confirmed that community transmission of COVID-19 has been sustained since March, thus it is prudent to consider all patients as a suspect for COVID-19. Ensuring the availability and appropriate use of personal protective equipment (PPE) is necessary for the safety of healthcare workers, especially during this time. The mandate to protect the health care workers from COVID-19 has resulted in an alarming increase in demand for PPE worldwide, especially in healthcare facilities, leading to a shortage in some areas.

A report from the Philippines calculated that at least 12 PPE per patient per day is required whenever a suspected COVID-19 patient seen at the emergency room, who will undergo multiple diagnostic tests, will be admitted and monitored in 8-hour work shifts. Hence, at least 168 PPE sets from admission to discharge will be utilized in 14 days, which is the usual duration of hospital stay of COVID-19 patients. If the patient will require a surgical procedure, an additional of at least 10 PPE sets will be needed, excluding subsequent needs for the postoperative care of the patient. Using these figures, the total cost of PPE for one admitted suspected COVID-19 patient can easily be estimated adding up to a cost that becomes overwhelming.

Most institutions and regulatory bodies suggest adapting levels of protection worn by HCWs to the risk of contracting the disease based on patient COVID-19 status, the level of the interaction (procedure, time of contact, distance etc.) and transmission dynamics of the virus (contact, droplet or aerosol). This will avoid the unnecessary over-consumption of precious PPEs on relatively low-risk patient encounters and conserving them for the high-risk settings.

Key words: Personal Protective Equipment (PPE), limited re-use of PPE