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ECRI: Video on setting up mechanical ventilator sharing.

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Other organizations have drawn different conclusions and have provided advice on how to set up systems to share ventilators in March/April 2020: However, SCCM’s Mechanical Ventilator Strategies page also included a section labeled “When You’re Out of Options” which provided links to resources for mechanically ventilating two patients with a single ventilator in crisis situations. …it is better to purpose the ventilator to the patient most likely to benefit than fail to prevent, or even cause, the demise of multiple patients” (March 2020). The Society of Critical Care Medicine, in partnership with several other organizations, advises clinicians to not attempt to share mechanical ventilators because it cannot be done safely: “Attempting to ventilate multiple patients with COVID-19…could lead to poor outcomes and high mortality rates for all patients cohorted. In such situations, we usually remain silent, but we think it is important to provide resources for those who might be facing this difficult decision. The Joint Commission does not endorse any position because there is not sufficient evidence to guide us. Experts have differing opinions about whether ventilator sharing can be done safely and effectively. If Shortages Occur Despite Mitigation StrategiesĮven with these mitigation strategies, the possibility remains that shortages will occur, and clinicians and healthcare leaders will face the decision of whether to place two patients with COVID-19 on a single ventilator.

JAMA: Sourcing Personal Protective Equipment During the COVID-19 Pandemic.

Recommendations for PPE Conservation and Management But the FDA states that alcohol is not recommended for cleaning vinyl gloves because it may degrade them.

It is safe to use alcohol-based hand rub on latex and nitrile gloves. Note: In reviewing FDA guidance on strategies to conserve gloves, you need to know what type of gloves you use in your facility (e.g., latex, vinyl and nitrile).

FDA Recommends Transition from Use of Decontaminated Disposable Respirators - Letter to Health Care Personnel and Facilities.

Surgical Mask and Gown Conservation Strategies - Letter to Healthcare Providers.

Use of Cloth Face Coverings to Help Slow the Spread of COVID-19įDA Guidance on Managing Critical Shortages.

Summary Strategies to Optimize the Supply of PPE during Shortages.

For example, if practicing extended use of N95 respirators (recommended by NIOSH) the organization should consider using face shields that will protect the respirator from splashes or splatters and prevent staff from inadvertently touching surfaces of the respirator while in use.ĬDC Guidance on Managing Critical ShortagesĬDC Guidance on Optimizing the Supply of PPE During Shortages It is essential that the instructions to employees take into account the specific PPE the facility is using (e.g., reusable versus disposable gown, N95, PAPR, or surgical mask, goggles, glasses with side shields, or faces mask) being used as well as the physical layout (e.g., ante-room, no ante-room, multiple patient room) and how the organization is utilizing the PPE (e.g., single use, reuse, or extended use).Ĭombinations of PPE should be considered. These videos provide an example using disposable gowns.

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Airborne Plus Droplet plus Eye Protection when performing aerosol generating procedures on known or suspected COVID-19 patients.Contact Plus Droplet plus Eye Protection when providing routine care to known or suspected COVID-19 patients.Rush University Medical Center: Step by Step Donning and Doffing: Reusable Gown, N95 Respirator, Goggles or Face Shield.Rush University Medical Center: Step by Step Donning and Doffing: Disposable Gown, Face Mask and Goggles.The Joint Commission: Removing (Doffing) a Disposable Gown and Gloves with Rationale.Videos Consistent with CDC recommendations as of March 24, 2020 Infographic – Aerosol Generating Procedures.Infographic – Do’s and Don’ts for Health Care Staff Wearing Face Masks.Poster - Wear a Mask (black and white, printer friendly).