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The emergence of highly contagious diseases comprising Ebola, pandemic influenza, SARS and now COVID-19 has emphasized the demand of efficacious personal protective equipment (PPE) to guard healthcare workers (HCWs), visitors and patients from the infection.

PPE is an important aspect in the hierarchy of control measures utilized to save HCWs from infectious pitfalls like novel coronavirus (COVID-19). However, in this situation of global emergency, certain conflicts are arising regarding PPE safety and efficacy. Let’s find out what these conflicts are and how these can be solved. But first, let’s know about PPE kits.

Highlights

  • Components of PPE kit for HCW
  • Importance of PPE kit in COVID-19 pandemic
  • Conflicts associated with PPE kits
  • Criteria for choosing the right PPE kit

Components of PPE kit for HCW

A PPE kit for HCW must contain face mask, face shields, respirator, head cover, shoe cover, gown, gloves and eye protection. Absence of any protective wear or their malfunctioning can cause major faulty consequences.

Importance of PPE kit in COVID-19 pandemic

Why PPE kits are that important? Why it is very essential to do a careful donning and doffing of PPE, and why it is important to choose the right PPE kits as per provided guidelines?

The all answers are associated with rapid viral transmission and higher viral load. COVID-19 is transmitted via contact or droplets (large respiratory particles, which are contingent upon gravitational forces and can travel up to 1 meter from the patient). However, airborne transmission can also happen if any medical procedure or patient’s respiratory activity generates respiratory aerosols, which can travel up to long distances.

This is why the PPE kit is important for HCWs and these are in high demand during this pandemic. However, this high demand leads to certain conflicts.

Conflicts associated with PPE kits

Acute shortage and disrupt the quality of PPE kits are some of the major conflicts, which governments are facing. No doubt, efforts are taking place to deal with the shortage of these protective wears.

However, is the quality of these PPE kits are as per the given criteria? The news which is spread all over the media these days regarding faulty gowns or PPE kits that failed the quality test is proof that the quality of PPE kits is in danger.

These faulty PPE kits are not the solution. Because of these, the health of HCWs is at the stake of getting the infection. Along with improper donning and doffing, the use of a faulty kit is also one of the biggest reasons behind the increasing number of COVID-19 infections among HCWs.

That is why it is very important to choose the right and proper PPE suits.

Criteria for choosing the right PPE kit

WHO has provided guidelines on how and when to use PPE kits.

WHO set technical specifications of PPE kits as well, which can help you to select the correct set of PPE gears?

1) Specifications for gown

-The gown should be disposable, fluid-resistant, single-use with a mid-calf length that can cover the tops of the shoes.
-Elastic cuff or finger/thumb loops to secure sleeves in place.
-The gown either can be bloodborne pathogens penetration resistant (AAMI PB70 Level 4 performance, or (EN 14126-B) and partial body protection (EN 13034 or EN 14605), or equivalent), or can be fluid penetration resistant (EN 13795 high performance, or AAMI PB70 level).

2) Specifications for apron

-The apron should be made of 100% PVC or rubber or polyester with PVC coating and waterproof.
-Neck strap should be adjustable.
-Covering size: Standard adult size or 70-90 cm (width) X 120-150 cm (height).
-Base weight: 250g/m2 (minimum)

3) Specifications for medical mask

-Design of surgical or medical mask should be of cup or duckbill shape.
-Masks must have good breathability, high fluid resistance with Filtration efficiency: ASTM F2101, EN14683 annex B, or equivalent.
-The fluid resistance at minimal 120 mmHg pressure premised on ASTM F1862-07, ISO 22609, or equivalent and Breathability: MIL–M-36945C, EN 14683 annex C, or equivalent.
-External and internal faces of the mask should be clearly defined.

4) Specifications for respirator

-Duckbill or cup-shaped “FFP2” according to EN 149N95 or “N95” respirator according to US NIOSH with good breathability.

5) Specifications for gloves

Sterile gloves
-Gloves should be made of nitrile, single-use, powder-free, have long cuffs, and should be mid-forearm (EU standard directive 93/42/EEC Class I, EN 455, ANSI/ISEA 105-2011, ASTM 6319-10 or equivalent.

Non-sterile gloves
-Should be made of nitrile, powder-free, non-sterile, mid-forearm length (sizes can be different: EU standard directive 89/686/EEC Category III, EN 374, EU standard directive 93/42/EEC Class I, EN 455, ANSI/ISEA 105-2011, ASTM D6319-10 or equivalent.

6) Specification for goggles

-Must be PVC frame, which is easy to fit and with even pressure.
Flexible, good seal, can cover eyes and surrounding areas, the clear plastic lens with scratch and fog-resistant treatments, accommodate wearers with prescription glasses, adjustable band and indirect venting to avoid fogging (EU standard
directive 86/686/EEC, EN 166/2002, ANSI/ISEA Z87.1-2010, or equivalent).
-Can be either re-utilized with proper decontamination or disposable.

7) Specification for face shield

-Must be made of clear plastic, with adjustable band, good visibility, good fit, fog-resistant and can completely cover the length and sides of the face (EU standard directive 86/686/EEC, EN 166/2002, ANSI/ISEA Z87.1-2010, or equivalent).
-Can be reused or disposable.

These are the specialized specifications recommended by WHO. The PPE kits made as per these guidelines are right and safe to use. So, follow these guidelines and choose the right and correct PPE kit.