Episode 169: PPE and Modified Difficult Airway Algorithm for COVID

In this episode I introduce Dr. Christina Miller’s video, linked below, that goes through PPE considerations including how to safely don and doff, and suggestions for how to handle a difficult airway in COVID patients.

Video: https://drive.google.com/file/d/1AFYIouqGVLRlstU3xXSOJTHbtorWvQ7L/view

4 Replies to “Episode 169: PPE and Modified Difficult Airway Algorithm for COVID”

  1. Great instructional video on donning and doffing. It does seem even with the surgical gown, that her backside is exposed and vulnerable to contamination. I would still recommend putting the surgical gown on first, but wear it backward, so more of the posterior chain and back are covered.

  2. I mentioned this on Doximity already (which had a link to this page): the chin of her PAPR is potentially contaminated, and could contaminate her scrubs and chest after the gown is removed. There is no mention of either covering or decontaminating her entire neck and the parts of her scrub top neckline that are visible while she is fully gowned. I would relay this directly, only I can’t figure out how to contact her.

    1. Here is her response:

      We do have access to PAPR hoods that also have a “shroud” or collar that covers the neck and these are preferred for high risk situations although not everyone has access to this. When you remove any hood, grasp above the ears and pull up and away from you to avoid contaminating your chin. As for the exposed neck, some have developed work arounds such as using a blue towel or taping the surgical gown up along the lower border of the PAPR. Use caution to make sure that any work around you use also does not introduce additional opportunity for self contamination. If there is any visible contaminant on the neck or PAPR surface, I would advise removing this with sanitary wipes prior to the doffing process. This method (not of my own devising) is designed to reduce the bio-burden at each step and focus on heavily contaminated areas like the hands and front of the gown, but by no means makes you sterile or virus free. Remember that this disease is transmitted primarily by inhaled droplets, not through contact with surfaces. In a negative pressure environment, little of what aersolizes will have an opportunity to settle on clothing but does remain a potential concern. Thank you for your feedback and stay well.

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