The issue of adequate Personal Protective Equipment (PPE) and the uncertainty of infectious phases and conditions of this Coronavirus is certainly a contentious and important matter to our first responders and those we interact with.
In this section we look at various links to PPE studies and resources and discuss some options that are being discussed.
There have been many studies and reports on the spread of COVID-19 and appropriate PPE for many in the health care industry.
This section will serve to discuss PPE minimum standards as well as some options should it become necessary to deviate from the recommended PPE.
If you didn't know it a while ago, you know it now, SOCIAL DISTANCING. Practice it everywhere! In your workplace and when you must go into the public, distance is a great form of PPE. If you are involved in first response, maintaining crew members at a distance until the Person Under Investigation (PUI) has been assessed will reduce exposures and reduce unnecessary use of PPE if no patient intervention is required. We should always be ready to go, but can do so in a calculated manner to reduce our overall risk.
The minimum standard for PPE for known COVID-19 calls is detailed in this interview with the IAFF's Jim Brinkley. In general terms, the full PPE for assessment of a COVID-19 patient is N95, medical gloves, impervious gown, goggles or face shield and distance are recommended. WATCH THE MSNBC VIDEO
Please remember that the PPE recommended is the MINIMUM STANDARD, they are the floor, the OPFFA will never recommend decreasing the level of PPE, you should always INCREASE. We will provide some suggestions for preserving PPE stock.
Contact with a COVID-19 patient, while wearing this full compliment of PPE would be considered a no risk exposure. It would not result in any immediate isolation requirements by the fire fighter/first responder but the filing of an exposure report would be recommend.
We know that there are fire departments that encourage the use of bunker gear pants or both coats and pants to medical calls. Various pieces of your gear provide varying levels of protection and they will also hold contaminants until properly doffed and decontaminated. The IAFF has provided this document summarizing some of this information, CLICK HERE TO SEE IT.
N95 vs Surgical Masks
The Center for Disease Control in the US and a memo from The Associate Chief Medical Officer of Health (Ontario) both stated it was permissible to reduce the level of PPE from N95 mask to 'surgical mask'. The OPFFA and the IAFF takes exception to this and have stated our disagreement with this stance. Please see the ONTARIO MEMO HERE. You can view General President Schaitberger's LETTER TO THE CDC HERE. AS STATED, WE OBJECT to this recommendation and the reduction to PPE for the reasons listed in GP's letter, this information has been communicated to the Ministry of the Solicitor General during our regular phone conversations. A letter is following this conversation up.
It is your employer's responsibility to provide PPE. In the field, a N95 or stepped up to a P100, Air Purifying Respirator (APR) or SCBA should be the ONLY ACCEPTABLE respiratory protection for fire department medical first response. You can read this EVIDENCE BRIEF from Public Health Ontario.
Preserving N95 and Other Stock
We can share a few options available to minimize the use of some PPE in SOME INSTANCES. It must be remembered that at no time should personal safety be compromised to 'save PPE'. This should not be foremost, your own personal protection should always be top of list.
- You can review PPE Information FAQ #6 at the IAFF web page BY CLICKING HERE, about situations where uncontaminated N95's can be re-used. Another IAFF document can be FOUND HERE.
- You can use strategies such as only having one rescuer initially start patient assessment with other fire fighters positioned at a safer distance away or outside of the area of the patient.
- Face shields, if they are designed as reusable, may be decontaminated using proper products and procedures and re-used.
In conversation with the Ministry of the Solicitor General's Office there are discussions on testing and appropriate use of expired N95 masks that are apparently in large supply. It is believed that the expiry date is only due to the degradation of the elastic straps, but that has yet to be fully determined. I will keep you posted on the status of this.