PPE recommendations (Table 1)
Appropriate use of standard PPE was sufficient in preventing infection
spread to HCWs during SARS, and is also likely to be sufficient during
the era of COVID-19. (4, 5) However, enhanced PPE is recommended to
minimise the risk of transmission to HCWs. Beyond that, medical
personnel should be familiar with procedure guidelines, with all PPE
available for immediate usage, hence minimising risk of acquiring the
infection during airway management.
P100/N100 masks are not recommended in standard PPE due to their
cumbersome nature, and can be substituted by N95 masks in enhanced PPE
when used simultaneously with powered air purifying respirators (PAPR).
Whole-body barrier suits may be used in enhanced PPE due to additional
neck and lower leg coverage, but difficulty in removal leading to
improper doffing increases risk of cross-contamination of surroundings
and infection of HCWs. All HCWs should be trained to don and doff PPE
carefully without contaminating hands or clothes, with careful hand
washing before and after.
In enhanced PPE, the risk of leakage with PAPRs is negligible. Unlike
reusable elastomeric respirators and N95 masks, there is no need for a
fit test or additional eye protection as the head is completely
enclosed.