Protocols for Personal Protective Equipment in a COVID-19 Medical Shelter

Abstract

The coronavirus (COVID-19) has greatly impacted healthcare systems worldwide, leading to an unprecedented rise in demand for healthcare resources. In anticipation of an acute strain on established medical facilities in Dallas, Texas, federal officials worked in conjunction with local medical personnel to convert a convention center into a Federal Medical Station capable of caring for patients affected by COVID-19. A 200,000 square foot event space was designated as a direct patient care area, with surrounding spaces repurposed to house ancillary services. Given the highly transmissible nature of the novel coronavirus, the donning and doffing of personal protective equipment (PPE) was of particular importance for personnel staffing the facility. Furthermore, nationwide shortages in the availability of PPE necessitated the reuse of certain protective materials. This article seeks to delineate the procedures implemented regarding PPE in the setting of a COVID-19 disaster response shelter, including workspace flow, donning and doffing procedures, PPE conservation, and exposure event protocols.

Emergency Department Changes to Combat COVID-19 in Oman

“…Our study showed a significant drop in the total number of patients, as evidenced in many other studies, like Hartnett et al, Thornton et al, and Santana et al studies (see Figure 7). [14][15][16] The main difference in our setup from other studies like Li Juan 5,17,18 The nursing staff rota is similar in our and Quah et al's studies. 17…”

“…Ideally, donning and doffing should be at the entrance and exit of staff, respectively. 5 We are not following any specific doffing guidelines, but other studies have shown the adherence to specific doffing guidelines as shown in the Hockaday et al's study. 5,19,20 Reuse of N95 masks with hydrogen peroxide is questioned in some studies.…”

“…4 The donning and doffing of PPE are vital for maintaining the health of health care workers and in preventing the spread of infection. 5 The staff using PPE in exposed areas includes doctors, nurses, paramedics, emergency medical services staff, medical orderlies, housekeeping, and food serving staff.…”

“…Most of the hospitals have made alterations in their present floor plan setup or acquired other departments of the hospital to expand the ED, like a surgery department as in Lin Juan Joy Quah et al's study, whereas others have made temporary field hospital expansions to expand their ED, like Hockaday et al's study. 5,17 Our setup includes a whole new ED for C19 patients in a new building, which also includes a dedicated resuscitation room (see Figure 3).…”

Coping with COVID-19 in United Nations peacekeeping field hospitals: increased workload and mental stress for military healthcare providers

“… 8 9 In facilities where medical resources are relatively sufficient, a comprehensive precaution strategy, including a proper layout of the hospital, full personal protective equipment (PPE) sets and enhanced training on the medical staff, could be applied. 10 In peacekeeping field hospitals, however, the shortage of PPE and the difficulty in its resupply has imposed a huge strain on the healthcare service. In an effort to consume PPE rationally, we applied a new ‘appointment–triage–disinfection’ protocol in the hospital, which allowed us to flexibly adjust the number of healthcare workers on duty, depending on the appointment of patients.…”