Last updated: 2 March 2020 Infection Control Branch Recommended Personal Protective Equipment (PPE) in hospitals/clinics under Serious/ Emergency Response Level Coronavirus disease (COVID-19) (Interim) 衞生防護中心乃衞生署 轄下執行疾病預防 及控制的專業架構 The Centre for Health Protection is a professional arm of the Department of Health for disease prevention and control Recommended Personal Protective Equipment for routine patient care and performing aerosol-generating procedures in hospitals/clinics under Serious / Emergency Response Level. Apply Standard Precautions +/- transmission based precautions for all patients Areas High-risk patient areas I. Triage stations of Out-patient Clinics and AEDs Activities Routine Serious Response Level Recommended PPE Surgical mask Surgical mask eye protection (d) eye protection (d) gown gown gloves gloves cap(optional) cap(optional) patient care and aerosolgenerating procedures High-risk patient areas II. Designated clinics III. Isolation rooms (including isolation rooms in ICU and AEDs) (a,b) Use N95 respirator when performing aerosolgenerating procedures. N95 respirator eye protection (d) gown gloves cap(optional) Routine patient care and aerosolgenerating Use N95 respirator when performing aerosolgenerating procedures. N95 respirator eye protection (d) gown gloves cap(optional) Use N95 respirator when performing aerosolgenerating procedures. Use N95 respirator when performing aerosolgenerating procedures. No patient contact (e.g. outside patient room) Surgical mask Surgical mask Routine patient Surgical mask, Standard Precautions +/- transmission based precautions Surgical mask, Standard Precautions +/- transmission based precautions procedures (a,c,e) N95 respirator eye protection (d) gown gloves cap (optional) N95 respirator eye protection (d) gown gloves cap (optional) No patient contact Surgical mask is required in patient areas Surgical mask is required in ALL areas procedures (a,b) care Other patient areas Emergency Response Level Aerosolgenerating 2 Non patient areas Surgical mask is required in patient areas No patient contact Surgical mask is required in ALL areas Remarks: a. b. c. d. e. Aerosol-generating procedures with documented increased in risk of respiratory infection transmission are endotracheal intubation, cardiopulmonary resuscitation, bronchoscopy, open suctioning of respiratory tract (including tracheostomy care), autopsy and non-invasive positive pressure ventilation (BiPAP & CPAP). Aerosol-generating procedures with controversial/ limited studies evaluating the risk of respiratory infection transmission are highfrequency oscillatory ventilation, nebulizer therapy and sputum induction. Nasopharyngeal aspiration (NPA) and high flow oxygen are theoretically at risk of dispersal of infectious respiratory droplets, therefore they should be performed in conditions as required for aerosol-generating procedures in highrisk patient areas. Other procedures should be assessed on discretion of hospital Infection Control Officers. In high risk patient areas, place patient in a negative pressure airborne infection isolation room (AIIR) before performing aerosol generating procedures. In other patient areas, place patient in a well-ventilated area (e.g. at least minimum overall 6 air changes per hour (ACH) or use portable HEPA filter e.g. IQ Air if indicated) before performing aerosol generating procedures. Eye protection refers to full face shield or goggles or eye-visors. Taking into consideration of patient’s factors under OT setting, where the patient has undergone pre-operative screening and under sedation, staff is advised to follow Standard Precautions or transmission based precautions (if indicated) when performing intubation for elective surgery. 17 January 2020 (Last update on 2 March 2020) The copyright of this paper belongs to the Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region. Contents of the paper may be freely quoted for educational, training and non-commercial uses provided that acknowledgement be made to the Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region. No part of this paper may be used, modified or reproduced for purposes other than those stated above without prior permission obtained from the Centre. 3