Official PPE

What do you mean by "official"?

Uhhh "official"... well good luck with this.. We have PAPR now, and N95. Personally I wear PAPR, most of the nurse I'm with do as well but some wear the N95 with head scarf... I don't think it will be official until they figure it all out...

9 hours ago, EDNP100x said:

[...]

Currently, what we are doing is a surgical mask in ED. We aren't getting any positive covid or rule outs, that is all taken care of outside in the tent.

[...]

A surgical mask is all we are wearing in the PICU for non COVID 19 positive and rule out.

Do you think you you should be wearing more?

We wear full PPE in the tent, except when we are just the "gatekeeper" asking screening questions (from 6ft away) we don't have gown and gloves. We are wearing a surgical mask all day (one per shift) in every pt room/hallways, etc. Rule outs and positives, full PPE (with N95, PAPR, whichever you use). You should be using airborne precautions for rule outs in case they are positive.

CDC is the best resource for this. As you will see, your hospital becomes more and more lenient with the "new" guidelines according to factors such as: how many Covid patients and how much PPE they can access or have on hand. Unfortunately, these considerations don't always line up with the best interest of each worker. Here is what I have seen on a Covid unit, I assume this should be for ED also? Would you want to be less protected considering the # of asymptomatics? But I suppose supplies are an even bigger issue considering the patient turnover in ED. One of the reasons I left ED 9 years ago was how often you find out a patient had something you didn't PPE for I.e.:) TB, scabies and now there is this. Hopefully a current ED nurse will chime in but here is what I have seen on the Covid unit.

Ideally for all Rule out/positive C19:

Full PPE (N95/PAPR, face shield, gown, gloves, scrubs provided by hospital or disposable scrubs, foot covers and disposable hair net ( if not in PAPR), negative pressure room. Most items must be disposed at each room exit.

Realistically for all Rule out/positive C19:

Hopefully a N95 or PAPR (which is likely under re-use guidelines cleaned with special peroxide method), face shield (Reusable helmet version/not disposable), gown, hospital scrubs, from home cap/scarf for hair, door closed ( if there is a door ), negative pressure created with in room machines and makeshift duct work if available. Most items reused.

This is a common de-evolution seen from what was given and worn initially to what is available now. Since there's back and forth arguments for airborne or not, the most restrictive should be in place for the safety of workers, ideally.

I would go to this website to verify what you think, because not all hospitals are providing the "the most appropriate" items. You can see nurses on the news fighting for N95 masks for Covid +/rule out, and I wouldn't accept anything less. Those nurses won, by the way, and now get the N95s vs surgical mask. I also agree that Unions are the way to go, they help fight for these possibly life or death rights. I am on a Covid unit with N95 masks and I wouldn't work anywhere I didn't have a N95, personally. You never know who is asymptomatic, who the hospital has deemed not covid. Testing isn't even 100%. I have seen too many Covid (-) turn into (+) on the next test for whatever reason. But I suppose risk is one of the many reasons ED nurses get paid more.

Strategies for Optimizing the Supply of N95 Respirators

-SW?

16 hours ago, chare said:

A surgical mask is all we are wearing in the PICU for non COVID 19 positive and rule out.

Do you think you you should be wearing more?

Not sure, this is what they were doing up on the floors where I work but when the r/o came back positive all hell broke out because the nurses had already been exposed wearing just the surgi mask. Now the r/o go to a different floor where the nurses are wearing N95.

16 hours ago, Schweet said:

Ideally for all Rule out/positive C19: Full PPE (N95/PAPR, face shield, gown, gloves, scrubs provided by hospital or disposable scrubs, foot covers and disposable hair net ( if not in PAPR), negative pressure room. Most items must be disposed at each room exit.

Yes this is us complete disposable scrubs face shield and all. I wear the PAPR tho becuase you can breathe and it covers your hair bun...

Keep in mind those r/o's come back positive and some come to us struggling...that's all I'm saying.

15 hours ago, Schweet said:

This is a common de-evolution seen from what was given and worn initially to what is available now. Since there's back and forth arguments for airborne or not, the most restrictive should be in place for the safety of workers, ideally.

and, This should be a no-brainer for the HIGHER UPS!!!

28 minutes ago, HiddenAngels said:

17 hours ago, chare said:

A surgical mask is all we are wearing in the PICU for non COVID 19 positive and rule out.

Do you think you you should be wearing more?

Not sure, this is what they were doing up on the floors where I work but when the r/o came back positive all hell broke out because the nurses had already been exposed wearing just the surgi mask. Now the r/o go to a different floor where the nurses are wearing N95.

Thank you. After I posted this I realized it was not well written. We place all COVID rule out patients in a negative pressure room, and wear the all of the recommended PPE.