22 Mar COVID-19 FAQs: Personal protective equipment (PPE)
The following are recommendations for re-use and conservation of personal protective equipment from the AVMA based on FDA and CDC information. Read the full information on the AVMA website.
- May disposable, single use PPE be re-used when supply levels are adequate (conventional capacity strategies)? Generally, no. Most PPE is designed to be used only once by a single person prior to disposal. However, there are exceptions in limited situations identified by FDA, CDC, and OSHA which include gowns, surgical masks, N95 respirators, reusable face shields or goggles. Details for each are briefly mentioned below.
- Can we use expired gowns and surgical masks? Do they offer the protection needed? These products were designed to serve as protective barriers and thus FDA believes they may still offer some protection even when they are used beyond the manufacturer’s designated shelf life or expiration date. The user should visibly inspect the product prior to use and if there are concerns (such as degraded materials or visible tears) the product should be discarded.
- Can we use surgical masks and gowns on more than one procedure? Gowns may be worn to see multiple patients with the same infectious disease diagnosis or exposure when they are maintained in a common area. Gowns may be worn for multiple surgeries where the surgical procedure has a low risk of contamination. In all cases, if the gown becomes contaminated, replace it. Surgical masks may be worn for extended periods (re-used) during care for multiple patients where they are used to protect the patient from droplets from the surgeon. If the mask becomes wet or contaminated, replace it.
- Can reusable cloth gowns be used in a shortage? FDA cleared or approved reusable cloth gowns can be used. Adequate laundering, or sterilization if available, can reduce the level of pathogen contamination to a negligible level, thus lowering the overall risk of disease.
- What is an N95 respirator and what do I need to know to use one properly? An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. The ‘N95’ designation means that when subjected to careful testing, the respirator blocks at least 95 percent of very small (0.3 micron) test particles. If properly fitted, the filtration capabilities of N95 respirators exceed those of face masks. However, even a properly fitted N95 respirator does not completely eliminate the risk of illness or death. N95 respirators are rarely used in veterinary medicine and most veterinarians are unfamiliar with how they are to be used. AVMA is not recommending the routine use of N95 respirators however there may be specific situations where it may be considered (e.g. house call veterinarian under extreme circumstances needing to enter the home of a positive COVID-19 patient). If you find yourself in a situation where an N95 mask is needed, please refer to the additional information section below for further information on proper use.
- What does reuse mean? CDC defines reuse as:1 the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient. When N95 respirator reuse is practiced or recommended, restrictions are in place which limit the number of times the same respirator is reused, this is “limited reuse”. Limited reuse has been recommended and widely used as an option for conserving respirators during previous respiratory pathogen outbreaks and pandemics.(2, 3, 10-12)
- How do I minimize the need to reuse N95 respirators? CDC recommends the following steps to minimize use of N95 respirators:
- Minimize the number of individuals who need to use respiratory protection through the preferential use of engineering and administrative controls;
- Use alternatives to N95 respirators (eg, other classes of filtering facepiece respirators, elastomeric half-mask and full facepiece air purifying respirators, powered air purifying respirators) where feasible;
- Implement practices allowing extended use and/or limited reuse of N95 respirators, when acceptable; and
- Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection.
- How may I reuse N95 respirators? If reuse of N95 respirators is permitted in the locality, healthcare facilities should provide staff with clearly written procedures to:
- Follow the manufacturer’s user instructions
- Conduct a user seal check
- Only reuse for up to five donnings (unless the manufacturers label recommendation explicitly states another number)
- Follow recommended inspection procedures
- Discard any respirator that is obviously damaged or becomes difficult to breathe through
- Pack or store respirators between uses so that they do not become damaged or deformed.