American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Personal Protective Equipment (PPE)

The ACS Issues Statement on PPE

The ACS issued a statement on Wednesday, April 1 noting that many health care facilities are facing shortages of personal protective equipment (PPE), including face masks, gowns, and respirators. The ACS strongly supports the ability of surgeons to use their own masks or PPE, but this option does not obviate the hospital’s responsibility to provide adequate PPE to all their health care workers. In these extraordinary times, the ACS encourages institutions to adapt and be flexible so that health care personnel continue to feel safe. Read the full statement.

Universal Masking of Health Care Personnel During COVID-19: Should It Be Implemented?

A thoughtful perspective piece in the New England Journal of Medicine discusses the advantages and risks of universal masking of health care workers who have no direct interactions with symptomatic patients. The article weighs the possible reduction of transmission from asymptomatic and minimally symptomatic health care workers with COVID-19 to other providers and patients against issues of mask availability and the risk of diverting attention from more fundamental infection-control measures.

University of Kansas Health System Updates PPE Recommendations

The University of Kansas Health System has issued an updated personal protective equipment (PPE) recommendation graphic (which previously appeared in Bulletin: ACS COVID-19 Updates issue #3). The updated graphic, available on the American College of Surgeons website, includes a new recommendation stating that if an interaction between a health care worker and a suspected or COVID-19 positive patient requires being within three feet, the patient should also wear a surgical mask. The graphic also recommends reading the extended and re-use guidelines for N95 respirators.

AHA 100 Million Mask Challenge Asks Manufacturers to Produce PPE

The COVID-19 pandemic has created severe PPE shortages in the U.S. and throughout the world, and health care workers are running low on PPE to protect their own health as they treat patients with the disease. Building off an initiative launched in Washington State that asked the local community to help produce PPE for hospitals, the American Hospital Association (AHA) is expanding the 100 Million Mask Challenge nationwide to harness the manufacturing and business community’s collective desire to help by asking them to rapidly produce surgical masks and face shields for health care workers on a broad scale. The challenge aims to enable new relationships between hospitals and health systems in need of surgical masks and manufacturers with the capacity to produce them.

The AHA plans to expand the scope of this effort as the needs of the nation’s health care workers grow. Visit the AHA website or follow #100MillionMasks on social media for more information.

Additional PPE Highlights

Following are a few recently posted educational materials regarding personal protective equipment that surgeons may find useful:

  • Based on the American College of Surgeons (ACS) recommendation that surgeons curtail the performance of elective surgical procedures, the ACS has created a list of guidelines from various health care facilities and resources. The website also includes some overarching principles for all cases mentioned in the list of specialty guidelines.
  • The Association of periOperative Registered Nurses (AORN) website offers frequently asked questions (FAQs) to support the perioperative community during the COVID-19 pandemic.
  • The Association for the Advancement of Medical Instrumentation Protective Barriers Committee developed a technical information report (TIR) that assists health care personnel in the selection and use of surgical gowns, other protective apparel, and surgical drapes. Intended to help prevent wound infections by providing a barrier between nonsterile and sterile areas, the TIR focuses on the protection of health care personnel and the enhancement of patient care practices. The report is available here.

Assessment of Filtering Ability of Homemade Cloth Surgical Masks: Summary of Findings

Investigators subjected 13 different homemade cloth surgical masks to rigorous testing to see how they compare with standard surgical mask and N95 respirators, in partnership with the Manufacturing Development Center at the Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC. Masks varied widely in their ability to remove particles approximating the size of viruses and bacteria. N95 masks filtered 97 percent of particles 0.3 microns (thousandths of a millimeter) in diameter, surgical masks filtered 62−65 percent, and homemade cloth masks varied widely. The investigators note that more research is needed. 

PPE Resources

A number of organizations and companies are providing protective eyewear and other PPE to hospitals and health care professionals, including:

Goggles for Docs