The use of PPE and the protection of HCWs against highly infectious diseases was (and is) a topic of major importance, around the globe. The recent Cochrane review by Verbeek et al. was probably hoping to offer this “vital” information.
Unfortunately, they found no studies on the effects of goggles, face shields, long-sleeved gloves or taping on the risk of contamination. All they found was very low quality evidence, with high risk of bias and uncertain estimates of effect, that:
- More breathable types of PPE offer more comfort without increasing the risk of contamination
- Double gloving and CDC doffing guidance appear to decrease the risk of contamination, and
- Active more than passive training in PPE use may reduce PPE and doffing errors.
Their conclusions are obvious: we need high-quality studies of the materials, their use and protective effects, safe ways of doffing, and the most adequate training to achieve safe use of PPE for HCWs in the presence of highly infectious diseases or those (even less infectious) that may cause severe harm to HCWs.
But what to do until than? My personal opinion is that we should only use PPE, we are used to and know how to use. First-time users, even if supplied with the best available products, will inevitably fail to remove the PPE without error. Consequently, institutions should have a stable selection of PPE, and in the case of preventing highly infectious diseases, a selected group of HCWs with continuous active training, as it is too late to start when the next epidemic is hitting our healthcare centers.
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Hello Andreas – FYI back in October 2014 we worked with Royal Free Ebola Team and now NHS stock a RF specifically designed suit supplied by Integritex Europe and manufactured in Italy. Glad to discuss further if you are interested. We also supplied 100’s of 1000’s of our so-called European made Ebola Hood to teams working in the ETU’s in Sierra Leone. This hood was fabricated using same material as the RF suit and was, in fact, a Cat III Type 4-b EN14126 certified balaclava with integral Type IIR surgeons mask. This item was used with a FFP2 mask inside as additional safeguard.