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The waiting game

PHE recommends wide-ranging re-use of PPE items amid shortage

Public Health England (PHE) has published new guidance on the use of PPE 'when in short supply', recommending re-use of items including facemasks.

The temporary guidance applies only for 'urgent or emergency face-to-face contacts' in a 'health and social care setting'.

Its most recently updated guidance on PPE during the Covid-19 pandemic, published 2 April, had already recommended sessional use of PPE, but the new guidance, published this evening (17 April), goes further by recommending re-use.

It says, regarding fluid repellent surgical face masks (FRSM) - which are recommended in general practice - that these can be re-used if they have elastic ear hooks but not if they are tie-on. Inbetween uses they should be stored correctly and marked with the person's name.

The document further recommends healthcare providers 'consider shifting disposable gowns or coveralls to reusable options, retaining disposable gowns only for high risk aerosol-generating procedures'.

It does not recommend the re-use of gloves, but says healthcare professionals should 'not use double gloves for care of suspected or confirmed Covid-19'.

PHE said that the 'considerations are to ensure that health and care workers are appropriately protected from Covid-19, where items of PPE are unavailable, and should be considered as temporary measures until the global supply chain is adequate to meet the UK’s needs'.

PHE added that the document 'aligns with current evidence and Centers for Disease Control (CDC) and World Health Organization (WHO) guidance on optimising the supply of personal protective equipment (PPE) and the use of PPE when in short supply'.

BMA consultants committee chair Dr Rob Harwood said: 'If it’s being proposed that staff re-use equipment, this must be demonstrably driven by science and the best evidence – rather than availability – and it absolutely cannot compromise the protection of healthcare workers.

'Too many healthcare workers have already died.  More doctors and their colleagues cannot  be expected to put their own lives on the line in a bid to save others, and this new advice means they could be doing just that. It’s not a decision they should have to make.' 

Re-use of fluid repellent surgical face masks (FRSM) and disposable respirators (FFP3/ FFP2/ N95)

  • the mask should be removed and discarded if soiled, damaged, or hard to breathe through;
  • masks with elastic ear hooks should be re-used (tie-on face masks are less suitable because they are more difficult to remove);
  • hand hygiene should be performed before removing the face mask;
  • face masks should be carefully folded so the outer surface is held inward and against itself to reduce likely contact with the outer surface during storage;
  • the folded mask should be stored between uses in a clean sealable bag/ box which is marked with the person’s name and is then properly stored in a well-defined place;
  • hand hygiene should be performed after removing the face mask;
  • some models of PPE cannot be physically reused as they deform once being donned and do not go back to original condition (meaning it would be difficult to re-don and achieve a fit check). Fit checks should be performed each time a respirator is donned if it is reused.

Source: PHE: Considerations for acute personal protective equipment (PPE) shortages

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Readers' comments (15)

  • On PPE no See

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  • International PPE Shortage = PPE is now more expensive

    To keep our doctors, nurses and health workers alive the treasury may need to pretend they are bankers, and let the investment flow.

    While they are at it, the treasury could also release the Covid Fund so GP Surgeries don’t go bankrupt!

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  • What sort of bureaucartic hierarchy bends the rules, ignores evidence base or even the lack of evidence base and wilfully puts the workforce at risk to save face? The NHS.

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  • Took Early Retirement

    Weren't we being told, only about 2 weeks ago that there was NO SHORTAGE and the problem was simply about delivery? Then I heard Handjob saying something about "PPE being a precious resource" and I thought, "Aye, Aye. We've a REAL problem here". And wasn't it Jeremy Hunt who refused, on cost grounds, to let the NHS have a larger store of PPE? Manslaughter I'd say.

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  • We are one of the worlds largest economies and despite off-shoring everything that moves, there are still factories and engineers in the U.K. The Tories just spent a ton of cash on ventilators of questionable use but don’t seem willing to organise some gowns and masks. This is nothing to do with logistics, it’s about money and the lack of willingness to spend what it takes to keep healthcare workers safe. It’s cheaper to let doctors and patients die. It’s a crime.

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  • PHE has lost all credibility and should be mearged with the GMC/NMC and other such impotent organisations.

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  • Vinci Ho

    Simple question : Which side are you guys(PHE) on ?
    Helping the government to defend its utterly indefensible position or helping frontline colleagues to help and save their patients ?
    I have tried to be lenient in terms of criticising an authority like PHE from day one of this crisis . But I am sorry , enough is enough . And I wish you could still see your reflection when you look at your mirror today . One can accuse me of inappropriate sensationalism in times like these.
    Perilous, precarious and certainly ignominious.

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  • Another simple question that needs asking is " compared to other countries what was our standby stock levels prior to the pandemic?" There does appear a universal shortage and I suspect the procurement managers in the front line are doing their best however what will be criminal is failure of planning/provision of basic equipment required. When we on the frontline are scrutinised to the nth degree, pilloried by cqc for not having plans available for the most obscure scenarios it is rich that we have to endure the current situation. NHSE, GMC, CQC should really be reflecting on what their purpose is, when the chips are down who is deserving of their support- us on the front line or the political masters. Unfortunately, as most of us anticipate, when this dies down no doubt some cover up will be penned with some nebulous finger pointing, the same old status quo will continue! I get it that if you want to be a career Politician aka Matty then its part of the job to be fast and loose with facts/money and integrity however to be a doctor and to work for one of those collaborating departments that is hard to stomach!

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  • How does one report NHSE to the CQC ?

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