Abstract
Background: Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, a need for precise donning and doffing protocols for personal protective equipment (PPE) among healthcare infrastructures is paramount. Procedures involving the cardiac catheterization laboratory (CCL) are routinely non-aerosolizing but have the potential for rapid patient deterioration, creating the need for aerosolizing generating procedures. Multiple societal and governmental guidelines on the use of PPE during medical procedures are available on Internet websites; however, there is limited literature available in peer-reviewed formats in this context. This study aims to provide an overview of current PPE donning and doffing protocols specific to the catheterization laboratory.Methods: A series of internet searches regarding donning and doffing of PPE in the CCL including published articles and internet protocols were compiled and compared using Pubmed.gov, Google.com, www.twitter.com, and www.youtube.com.Results: Most institutions used N95 masks, shoe covers, at least one head covering, face shield or goggles, two pairs of gloves, and inner and outer gowns. Doffing variation was greater than donning. Doffing has the potential to contaminate the healthcare worker (HCW), and therefore, this step of PPE management requires further study. Common steps in temporal priority included cleaning of gloved hands, removal of outer (or only) gown, removal of outer gloves, repeat gloved hand cleaning, removal of facial PPE last, and a final non-gloved hand cleaning.Conclusions: This analysis provides a summary of commonly used practices that may be considered when designing CCL-specific PPE protocols. Analysis of consistent steps from the literature led the authors to formulate a suggested protocol for CCL HCWs when performing procedures on patients with confirmed or suspected/unknown COVID-19.
Highlights
As the coronavirus disease 2019 (COVID-19) pandemic continues to evolve, there is an increased need for healthcare systems to manage personal protective equipment (PPE) resources [1]
The protocol we describe is invoked for patients with COVID19, suspected COVID-19, or those who have an unknown status of infection
healthcare workers (HCWs) can significantly reduce their risk of acquiring the virus by adhering to society/guideline recommendations, during the donning and doffing of PPE
Summary
As the coronavirus disease 2019 (COVID-19) pandemic continues to evolve, there is an increased need for healthcare systems to manage personal protective equipment (PPE) resources [1]. The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus requires healthcare workers (HCWs) to follow protocol driven use and removal of PPE. Proper donning and doffing of PPE is paramount to reducing HCW exposure to the SARS-CoV-2 virus. Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, a need for precise donning and doffing protocols for personal protective equipment (PPE) among healthcare infrastructures is paramount. This study aims to provide an overview of current PPE donning and doffing protocols specific to the catheterization laboratory
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