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COVID-19
Proper Donning/Duffing
*Scrub Nurse/CVOR
04/2020.. C P E Ñ A C S T / F A ~ A O R T I C _ T E A M
What.
Who.
Where.
Why.
How.
2018
2019
2020
2*COVID-19 DURING SURGERY *
What ?.. Coronavirus Disease
2019 (COVID-19)
Reported illnesses have ranged from mild symptoms to severe illness and
death for confirmed coronavirus disease 2019 (COVID-19) cases.
These symptoms may appear 2-14 days after exposure (based on the
incubation period of MERS-CoV viruses).
Fever
Cough
Shortness of breath
3*COVID-19 DURING SURGERY *
COVID-19 | Corona Virus: Epidemiology, Pathophysiology,
Diagnostics
https://youtu.be/PWzbArPgo-o
https://youtu.be/5DGwOJXSxqg
https://youtu.be/AWxyy8LkMVo
https://youtu.be/FkF9Tl2CR14
https://youtu.be/cKfWj8Az00A
https://youtu.be/BiOdBW6m0mw
4*COVID-19 DURING SURGERY *
Who?...
HEALTHCARE / PUBLIC HEALTH
Workers who perform critical clinical research,
development, and testing needed for COVID-19
response.
Healthcare providers and Caregivers including
physicians, dentists, psychologists, mid-level
practitioners, nurses and assistants, infection control
and quality assurance personnel, pharmacists, physical
and occupational therapists and assistants, social
workers, optometrists, speech pathologists,
chiropractors, and diagnostic and therapeutic
technicians and technologists.
Hospital and laboratory personnel (including
accounting, administrative, admitting and discharge,
engineering, epidemiological, source plasma and blood
donation, food service, housekeeping, medical
records, information technology and operational
technology, nutritionists, sanitarians, respiratory
therapists, etc.).
Workers in other medical and biomedical facilities
(including Ambulatory Health and Surgical, Blood
Banks, Clinics, Community Mental Health,
Comprehensive Outpatient rehabilitation, End Stage
Renal Disease, Health Departments, Home Health care,
Hospices, Hospitals, Long Term Care, Nursing Care
Facilities, Organ Pharmacies, Procurement
Organizations, Psychiatric Residential, Rural Health
Clinics and Federally Qualified Health Centers, and
retail facilities specializing in medical good and
supplies).
Manufacturer workers for health
manufacturing (including biotechnology companies),
materials and parts suppliers, logistics and warehouse
operators, distributors of medical equipment
(including those who test and repair), personal
protective equipment (PPE), isolation barriers, medical
gases, pharmaceuticals (including materials used in
radioactive drugs), dietary supplements, blood and
blood products, vaccines, testing materials, laboratory
supplies, cleaning, sanitizing, disinfecting or
sterilization supplies, and tissue and paper towel
products.
Public health / community health workers, including
those who compile, model, analyze and communicate
public health information.
5*COVID-19 DURING SURGERY *
Who?... Cont..
HEALTHCARE / PUBLIC HEALTH
Public health / community health workers,
including those who compile, model,
analyze and communicate public health
information.
Blood and plasma donors and the
employees of the organizations that
operate and manage related activities.
Workers who manage health plans, billing,
and health information, who cannot
practically work remotely.
Workers who conduct community-based
public health functions, conducting
epidemiologic surveillance, compiling,
analyzing and communicating public health
information, who cannot practically work
remotely.
Workers performing information
technology and cybersecurity functions at
healthcare and public health facilities, who
cannot practically work remotely.
Workers performing security, incident
management, and emergency operations
functions at or on behalf of healthcare
entities including healthcare coalitions, who
cannot practically work remotely.
Pharmacy employees necessary to maintain
uninterrupted prescription filling.
Workers performing mortuary funeral,
cremation, burial, cemetery, and related
services, including funeral homes,
crematoriums, cemetery workers, and
coffin makers.
Workers who coordinate with other
organizations to ensure the proper
recovery, handling, identification,
transportation, tracking, storage, and
disposal of human remains and personal
effects; certify cause of death; and facilitate
access to mental/behavioral health services
to the family members, responders, and
survivors of an incident.
6*COVID-19 DURING SURGERY *
Who?
OSHA has divided job tasks into four risk exposure
levels:
Very High
 High
Medium
Lower Risk
as shown in the occupational risk pyramid, below.
The four exposure risk levels represent the probable
distribution of risk. Most American workers will
likely fall in the lower exposure risk (caution) or
medium exposure risk levels
7*COVID-19 DURING SURGERY *
Who? Cont...
Lower Exposure Risk (Caution)
Jobs that do not require contact
with people known to be, or
suspected of being, infected with
SARS-CoV-2. Workers in this
category have minimal occupational
contact with the public and other
coworkers. Examples include:
Remote workers (i.e., those working
from home during the pandemic).
Office workers who do not have
frequent close contact with
coworkers, customers, or the public.
Manufacturing and industrial facility
workers who do not have frequent
close contact with coworkers,
customers, or the public.
Healthcare workers providing only
telemedicine services.
Long-distance truck drivers.
8*COVID-19 DURING SURGERY *
Who?
Cont...
Medium Exposure Risk
Jobs that require frequent/close contact with people who may be
infected, but who are not known to have or suspected of having
COVID-19. Workers in this category include:
Those who may have frequent contact with travelers who return
from international locations with widespread COVID-19 transmission.
9*COVID-19 DURING SURGERY *
Who?
Cont...
High Exposure Risk
Jobs with a high potential for exposure to known or suspected
sources of SARS-CoV-2. Workers in this category include:
Healthcare delivery and support staff (hospital staff who must enter
patients’ rooms) exposed to known or suspected COVID-19 patients.
Medical transport workers (ambulance vehicle operators) moving
known or suspected COVID-19 patients in enclosed vehicles.
Mortuary workers involved in preparing bodies for burial or
cremation of people known to have, or suspected of having, COVID-
19 at the time of death.
10*COVID-19 DURING SURGERY *
Who?
Cont...
Very High Exposure Risk
Jobs with a very high potential for exposure to known or suspected sources of
SARS-CoV-2 during specific medical, postmortem, or laboratory procedures.
Workers in this category include:
Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency
medical technicians) performing aerosol-generating procedures (e.g., intubation,
cough induction procedures, bronchoscopies, some dental procedures and exams,
exams, or invasive specimen collection) on known or suspected COVID-19
patients.
Healthcare or laboratory personnel collecting or handling specimens from known
or suspected COVID-19 patients (e.g., manipulating cultures from known or
suspected COVID-19 patients).
Morgue workers performing autopsies, which generally involve aerosol-generating
generating procedures, on the bodies of people who are known to have, or are
suspected of having, COVID-19 at the time of their deat
11*COVID-19 DURING SURGERY *
Where?
Job Duties Affect Workers’ Exposure Risk Levels
As workers’ job duties change or they perform different tasks in
in the course of their duties, they may move from one exposure
exposure risk level to another. Additional examples of workers
who may have increased risk of exposure to SARS-CoV-2 include
include those in:
12*COVID-19 DURING SURGERY *
Where? Cont...
Other types of healthcare positions (including pre-hospital and medical transport workers, allied
medical care professionals, and support staff)
Emergency response (e.g., emergency medical services workers, firefighters, and law
enforcement officers)
Other postmortem care positions (e.g., funeral directors)
Research or production laboratory workers
Airline operations
Retail operations, particularly those in critical and/or high-customer-volume environments
Border protection and transportation security
Correctional facility operations
Solid waste and wastewater management
Environmental (i.e., janitorial) services
In-home repair services
ü Travel to areas where
the virus is spreading
ü Pastoral, social, or
public health workers
in jobs requiring
contact with
community members
who may spread the
virus
ü Transit and delivery
drivers, depending on
their degree of close
contacts with the
public
13*COVID-19 DURING SURGERY *
Where?
Cont...
This list is not intended to be
comprehensive, and
employers should always rely
on thorough hazard
assessments to identify if
and when their workers are
at increased risk of exposure
to the virus on the job.
14*COVID-19 DURING SURGERY *
Why?..
15*COVID-19 DURING SURGERY *
How?
How Does COVID-19 Spread?
Although the pandemic possibly originated from humans exposed to infected animals, SARS-CoV-2—like other
coronaviruses—spreads between people and cause COVID-19. The CDC acknowledges that at this time, there is no
evidence that companion animals, including pets, can spread COVID-19 to people or that they might be a source of
infection in the United States.
According to the CDC, person-to-person transmission occurs during close (within 6 feet) contact with a person with
COVID-19, primarily from respiratory droplets produced when an infected person coughs or sneezes. These droplets,
particularly when aerosolized, can be deposited in the mouth, nose, or eyes of nearby people or be inhaled into the
lungs. Airborne transmission from person-to-person over long distances (including as a result of evaporating droplets that
leave behind infectious particles known as droplet nuclei) is believed to be unlikely.
People can also become infected with SARS-CoV-2 by touching surfaces or objects contaminated with the virus, and then
touching their mouths, noses, or eyes. Current evidence suggests that novel coronavirus may remain viable for hours to
days on a variety of surfaces. Frequent cleaning of visibly dirty and high-touch surfaces, followed by disinfection, can help
prevent SARS-CoV-2 and other respiratory pathogens (germs) from spreading in workplaces.
Person-to-person spread is likely to continue to occur under current pandemic conditions.
There is still more to learn about the transmissibility, severity, and other features associated with SARS-CoV-2.
16*COVID-19 DURING SURGERY *
Head Covering
17*COVID-19 DURING SURGERY *
Shoe Covering
18*COVID-19 DURING SURGERY *
N95-
19*COVID-19 DURING SURGERY *
*COVID-19 DURING SURGERY * 20
REFERENCES
https://www.who.int/
https://www.nih.gov/health-information/coronavirus
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/early-
investigations
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
https://www.who.int/publications-detail/protocol-for-assessment-of-potential-risk-factors-for-2019-novel-
coronavirus-(2019-ncov)-infection-among-health-care-workers-in-a-health-care-setting
https://www.jointcommission.org/covid-19/
https://www.cms.gov/outreach-education/partner-resources/coronavirus-covid-19-partner-toolkit
21*COVID-19 DURING SURGERY *

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Proper PPE for COVID-19 Surgery

  • 1. COVID-19 Proper Donning/Duffing *Scrub Nurse/CVOR 04/2020.. C P E Ñ A C S T / F A ~ A O R T I C _ T E A M
  • 3. What ?.. Coronavirus Disease 2019 (COVID-19) Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. These symptoms may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses). Fever Cough Shortness of breath 3*COVID-19 DURING SURGERY *
  • 4. COVID-19 | Corona Virus: Epidemiology, Pathophysiology, Diagnostics https://youtu.be/PWzbArPgo-o https://youtu.be/5DGwOJXSxqg https://youtu.be/AWxyy8LkMVo https://youtu.be/FkF9Tl2CR14 https://youtu.be/cKfWj8Az00A https://youtu.be/BiOdBW6m0mw 4*COVID-19 DURING SURGERY *
  • 5. Who?... HEALTHCARE / PUBLIC HEALTH Workers who perform critical clinical research, development, and testing needed for COVID-19 response. Healthcare providers and Caregivers including physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, social workers, optometrists, speech pathologists, chiropractors, and diagnostic and therapeutic technicians and technologists. Hospital and laboratory personnel (including accounting, administrative, admitting and discharge, engineering, epidemiological, source plasma and blood donation, food service, housekeeping, medical records, information technology and operational technology, nutritionists, sanitarians, respiratory therapists, etc.). Workers in other medical and biomedical facilities (including Ambulatory Health and Surgical, Blood Banks, Clinics, Community Mental Health, Comprehensive Outpatient rehabilitation, End Stage Renal Disease, Health Departments, Home Health care, Hospices, Hospitals, Long Term Care, Nursing Care Facilities, Organ Pharmacies, Procurement Organizations, Psychiatric Residential, Rural Health Clinics and Federally Qualified Health Centers, and retail facilities specializing in medical good and supplies). Manufacturer workers for health manufacturing (including biotechnology companies), materials and parts suppliers, logistics and warehouse operators, distributors of medical equipment (including those who test and repair), personal protective equipment (PPE), isolation barriers, medical gases, pharmaceuticals (including materials used in radioactive drugs), dietary supplements, blood and blood products, vaccines, testing materials, laboratory supplies, cleaning, sanitizing, disinfecting or sterilization supplies, and tissue and paper towel products. Public health / community health workers, including those who compile, model, analyze and communicate public health information. 5*COVID-19 DURING SURGERY *
  • 6. Who?... Cont.. HEALTHCARE / PUBLIC HEALTH Public health / community health workers, including those who compile, model, analyze and communicate public health information. Blood and plasma donors and the employees of the organizations that operate and manage related activities. Workers who manage health plans, billing, and health information, who cannot practically work remotely. Workers who conduct community-based public health functions, conducting epidemiologic surveillance, compiling, analyzing and communicating public health information, who cannot practically work remotely. Workers performing information technology and cybersecurity functions at healthcare and public health facilities, who cannot practically work remotely. Workers performing security, incident management, and emergency operations functions at or on behalf of healthcare entities including healthcare coalitions, who cannot practically work remotely. Pharmacy employees necessary to maintain uninterrupted prescription filling. Workers performing mortuary funeral, cremation, burial, cemetery, and related services, including funeral homes, crematoriums, cemetery workers, and coffin makers. Workers who coordinate with other organizations to ensure the proper recovery, handling, identification, transportation, tracking, storage, and disposal of human remains and personal effects; certify cause of death; and facilitate access to mental/behavioral health services to the family members, responders, and survivors of an incident. 6*COVID-19 DURING SURGERY *
  • 7. Who? OSHA has divided job tasks into four risk exposure levels: Very High  High Medium Lower Risk as shown in the occupational risk pyramid, below. The four exposure risk levels represent the probable distribution of risk. Most American workers will likely fall in the lower exposure risk (caution) or medium exposure risk levels 7*COVID-19 DURING SURGERY *
  • 8. Who? Cont... Lower Exposure Risk (Caution) Jobs that do not require contact with people known to be, or suspected of being, infected with SARS-CoV-2. Workers in this category have minimal occupational contact with the public and other coworkers. Examples include: Remote workers (i.e., those working from home during the pandemic). Office workers who do not have frequent close contact with coworkers, customers, or the public. Manufacturing and industrial facility workers who do not have frequent close contact with coworkers, customers, or the public. Healthcare workers providing only telemedicine services. Long-distance truck drivers. 8*COVID-19 DURING SURGERY *
  • 9. Who? Cont... Medium Exposure Risk Jobs that require frequent/close contact with people who may be infected, but who are not known to have or suspected of having COVID-19. Workers in this category include: Those who may have frequent contact with travelers who return from international locations with widespread COVID-19 transmission. 9*COVID-19 DURING SURGERY *
  • 10. Who? Cont... High Exposure Risk Jobs with a high potential for exposure to known or suspected sources of SARS-CoV-2. Workers in this category include: Healthcare delivery and support staff (hospital staff who must enter patients’ rooms) exposed to known or suspected COVID-19 patients. Medical transport workers (ambulance vehicle operators) moving known or suspected COVID-19 patients in enclosed vehicles. Mortuary workers involved in preparing bodies for burial or cremation of people known to have, or suspected of having, COVID- 19 at the time of death. 10*COVID-19 DURING SURGERY *
  • 11. Who? Cont... Very High Exposure Risk Jobs with a very high potential for exposure to known or suspected sources of SARS-CoV-2 during specific medical, postmortem, or laboratory procedures. Workers in this category include: Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, exams, or invasive specimen collection) on known or suspected COVID-19 patients. Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19 patients (e.g., manipulating cultures from known or suspected COVID-19 patients). Morgue workers performing autopsies, which generally involve aerosol-generating generating procedures, on the bodies of people who are known to have, or are suspected of having, COVID-19 at the time of their deat 11*COVID-19 DURING SURGERY *
  • 12. Where? Job Duties Affect Workers’ Exposure Risk Levels As workers’ job duties change or they perform different tasks in in the course of their duties, they may move from one exposure exposure risk level to another. Additional examples of workers who may have increased risk of exposure to SARS-CoV-2 include include those in: 12*COVID-19 DURING SURGERY *
  • 13. Where? Cont... Other types of healthcare positions (including pre-hospital and medical transport workers, allied medical care professionals, and support staff) Emergency response (e.g., emergency medical services workers, firefighters, and law enforcement officers) Other postmortem care positions (e.g., funeral directors) Research or production laboratory workers Airline operations Retail operations, particularly those in critical and/or high-customer-volume environments Border protection and transportation security Correctional facility operations Solid waste and wastewater management Environmental (i.e., janitorial) services In-home repair services ü Travel to areas where the virus is spreading ü Pastoral, social, or public health workers in jobs requiring contact with community members who may spread the virus ü Transit and delivery drivers, depending on their degree of close contacts with the public 13*COVID-19 DURING SURGERY *
  • 14. Where? Cont... This list is not intended to be comprehensive, and employers should always rely on thorough hazard assessments to identify if and when their workers are at increased risk of exposure to the virus on the job. 14*COVID-19 DURING SURGERY *
  • 16. How? How Does COVID-19 Spread? Although the pandemic possibly originated from humans exposed to infected animals, SARS-CoV-2—like other coronaviruses—spreads between people and cause COVID-19. The CDC acknowledges that at this time, there is no evidence that companion animals, including pets, can spread COVID-19 to people or that they might be a source of infection in the United States. According to the CDC, person-to-person transmission occurs during close (within 6 feet) contact with a person with COVID-19, primarily from respiratory droplets produced when an infected person coughs or sneezes. These droplets, particularly when aerosolized, can be deposited in the mouth, nose, or eyes of nearby people or be inhaled into the lungs. Airborne transmission from person-to-person over long distances (including as a result of evaporating droplets that leave behind infectious particles known as droplet nuclei) is believed to be unlikely. People can also become infected with SARS-CoV-2 by touching surfaces or objects contaminated with the virus, and then touching their mouths, noses, or eyes. Current evidence suggests that novel coronavirus may remain viable for hours to days on a variety of surfaces. Frequent cleaning of visibly dirty and high-touch surfaces, followed by disinfection, can help prevent SARS-CoV-2 and other respiratory pathogens (germs) from spreading in workplaces. Person-to-person spread is likely to continue to occur under current pandemic conditions. There is still more to learn about the transmissibility, severity, and other features associated with SARS-CoV-2. 16*COVID-19 DURING SURGERY *