How is your hospital handling PPE with GA's?

[MP RN]

Hey everyone,

Hope everyone is doing well and keeping safe.

Just wanted to compare/contrast what everyone's OR's are doing through the COVID pandemic?

My hospital is relatively small, with 4 OR theaters. We do a decent variety of cases normally- OB/gyne, general, eyes, endoscopy and a few others. We have currently suspended all our elective cases, with the exception of limited/select time-sensitive cases- ie, known bowel Ca's which can't wait long, known breast Ca's.

Currently every Pt in the hospital is being treated as droplet precautions. We have some Covid in our community- ppl isolating @ home and the like, but the storm hasn't hit us yet. Every day more and more Diagnoses though, so it's coming.

Here, any GA is being intubated across the hall in an ICU negative pressure room. They are then brought to the OR for their surgery. Once the case is finished, we bring them tubed, back to the negative pressure ICU room- with Anaesthetist and 1 PACU RN, both in full Covid PPE (boots, gown, N95, gloves, goggles, hood, faceshield). There Pt gets extubated. 30 minutes after extubation, the staff can doff/remove the full PPE and go back to regular droplet precs (gown/gloves, surgical mask with eye protection).

I feel bad for anyone in/around the epicenters. Just wondering what everyone elses OR practices have been during this trying time?? Are you intubating in the OR's? What precautions/changes have been implemented?

Trying to stay ahead of the curve in terms of prevention and safe practice.

Stay safe everyone, and support each other.

[MP RN, RN]

On 4/9/2020 at 9:32 AM, Rose_Queen said:

They are to wait the full 3 minutes for an air exchange to occur then are entering the room with standard PPE for a surgical case per our infection control experts.

On 4/9/2020 at 10:26 AM, MP RN said:

So your OR has the typical 20 air exchanges/hr then.

Guidelines reveal at that rate of air exchange, it would take 14 minutes for the air to be considered 99% "clean" of airborne pathogen such as Covid. 21 minutes for 99.9%.

Curious how your workplace settled on 3 minutes, or a single air exchange. Very little airborne pathogen would theoretically be removed from circulation at that point. 

???

[Rose_Queen, BSN, MSN, RN]

You’d have to ask our infection prevention and infectious diseases docs. They are the ones responsible for creating the plan.

[MP RN, RN]

Ah, yes. I can't do that obviously. Did you ?

They didn't lay out their own rationale to the staff impacted by this it looks like.