PPE
Please find the latest guidelines on PPE
Guidelines are continually evolving please keep in touch with your service manager for the latest guidelines.
• Sites undertaking only non-AGP procedures will require Level 2 PPE.
• Sites undertaking AGPs will require Level 3 PPE.
• Sites delivering AGP and non-AGP will require Level 2 and Level 3 PPE
Available via www.themedstock.com
FFP2/ FFP3
FFP2/ FFP3 respirators are high grade filtration masks that protect against airborne particles.
They must be fit tested on all healthcare staff who may re required to wear an FFP2/3 to ensure adequate seal fit according to the manufacturers guidanc
FFP2/3 masks cannot be worn without fit testing by a trained fit tester. We now have four members of Night dental who have been on an accredited hands on Fit2Fit accredited course and are trained to able to carry outfit test
All respirators should:
- be well fitted, covering both nose and mouth
- not be allowed to dangle around the neck of the wearer after or between each use
- not be touched once put on
- be removed outside the patient room or cohort area or COVID-19 ward
Respirators can be single use or single session use (disposable) and fluid-resistant OR re-usable.
Respirators should be compatible with other facial protection used (protective eyewear) so that this does not interfere with the seal of the respiratory protection.
It is also important to ensure that facial hair does not cross the respirator sealing surface and if the respirator has an exhalation valve, hair within the sealed mask area should not impinge upon or contact the valve. See the Facial hair and FFP3 respirators guide.
Respirators are for single use or single session use and then are to be discarded as healthcare (clinical) waste (hand hygiene must always be performed after disposal) or if re-usable cleaned accorded manufacturer’s instructions. It is important that the respirator maintains its fit, function and remains tolerable for the user.
The manufacturers’ guidance should be followed in regard to the maximum duration of use.
Staff must adhere to the strict guidelines of FP3 use including be fully clean shaven and down the mask in the exact way that they were trained if anyone wants refresher reminder please contact your service manager a repeat fit testing will be needed for new FFP2/3 masks introduced.
Any change in weight above 10% should be reported to the service manager
If an FFP2/3 is used and worn for a session they can be shielded from splatter with a fluid resistant surgical mask or visor to protect the respirator from droplets.
Masks should be removed if breathing becomes difficulty the respirator is damaged or distorted or the respirator becomes obviously contaminated by respiratory secretions or other body fluids. they should then be disposed of or in the case of reusable face mask they should be decontaminated according to manufacturers guidance
The HSE has stated that FFP2 and N95 respirators (filtering at least 94% and 95% of airborne particles respectively) offer protection against COVID-19 and may be used if FFP3 respirators are not available.
Other respirators can be utilised by individuals if they comply with HSErecommendations.
Reusable masks with appropriate filters are available, however, it is important that doffing and disinfection of these masks is carried out following a strict protocol to prevent contamination in line with manufacturers guidance.
Respirators should not be removed within a surgery where a high risk AGE has occured.
Those who are unable to wear a FFP2/FFP3 mask either due to a failure of fit testing as a result of having a beard and are unable to shave for either religious or cultural reasons have the option of wearing a powered air purifying respirator (PAPR) hood.
One of the limitations of the PAPR is that expired air is not filtered, like valved FFP2/FFP3 masks which allow unfiltered exhaled air through a port. Non-valved masks filter expired air through the mask. The use of a simple fluid resistant mask over a valved FFP2/ FFP3, in addition to the visor, may offer additional protection for a vulnerable patient.
Eye protection
Is an essential part of the barrier component of PPE. Evidence suggests that conjunctivae could be exposed to infective droplets during close contact. A full-face visor will reduce the amount of exposed skin on the face and neck that may be subject to splash or droplet contamination.
Gowns
Evidence to support the use of fluid repellent gowns in preventing transmission of disease is inconclusive. However, for alert levels 3-5 and high AGE risk it is advisable to wear a long-sleeved fluid repellent gown. It is important that all team members are trained in the correct procedures for safe doffing of all PPE including gowns. Reusable washable gowns may confer some benefits in terms of cost and environmental sustainability.
The use of full gowns in high risk situations will protect scrubs worn under the gown, therefore, it will not be necessary to change scrubs between sessions in one day. Scrubs should be changed daily and washed at a minimum of 60 degrees. In low risk situations the policy of “bare below the elbow” can be used with diligent hand hygiene for disease prevention including washing and drying the forearms and wrists.
It may be appropriate to wear head and shoe covers when a risk assessment indicates. Those who wear turbans, hijabs or other head covering as part of their faith are advised to wear protective covering in high risk situations. Wipeable indoor shoes covering the toes should be worn. The risk of contamination of shoes in a dental practice setting is low.
Uniform Instructions
The appropriate use of PPE will protect staff uniform from contamination
>Follow BDA “Stay Safe in Urgent Dental Centres”
- Bare below elbows when not in PPE and under PPE
- Scrubs only
- Bring 2 pillowcases and a wipeable bag
- Do not wear Uniform or PPE before coming into site wear clean clothes
- Wash hands on arrival
- Change into scrubs on arrival, put clean clothes in 1 pillow case and all belongings in wipeable bag
- Put all belongings away into your locker
- Wash hands up to elbow
- Follow dothing and doffing guidelines for PPE throughout the day
- Remove scrubs at the end of the day and put into 2nd pillow case
- On arrival at home wipe down all surfaces contacted, shower and wash scrubs in a separate wash
APPROPRAITE PPE
• Sites undertaking only non-AGP procedures will require Level 2 PPE.
• Sites undertaking AGPs will require Level 3 PPE.
• Sites delivering AGP and non-AGP will require Level 2 and Level 3 PPE.
Recommended PPE in [order from suppliers e.g The Medstock ]
• Scrubs
• Fluid repellant gown [reusable gowns must have an expiry date and be laundered in a suitable environment such as healthcare laundry]
• Surgical gloves
• FFP3 mask fit tested [resusable masks must be tested and disinfected inline with manufacturers guidance]
• Ear loop / hand tie Type IIR face mask
• Wrap around goggles or Visor
• Hair net (as available)
• Protective shoe covers (as available)
• In addition, a fluid resistant mask or visor can be used over the FFP3 mask which can then be discarded after each contact to allow the FFP3 mask to remain in situ this protects against splatter and droplets however care must be taken on removal to avoid contamination
• For all PPE, please keep updated as to current guidance
DONNING
There should be a dedicated donning station in a clean area: VIDEO LINK
DOFFING
Dedicated doffing station
This may be outside the clinical room however where space is a limiting factor the clinical room can be used as a doffing station however respirators and eye protection should not be removed in surgery during or following an AGP this should be removed outside the room.
Clear doffing instructions should be made available to all staff please see below
