PPE recommendations (Table 1)
Appropriate use of standard PPE was sufficient in preventing infection spread to HCWs during SARS, and is also likely to be sufficient during the era of COVID-19. (4, 5) However, enhanced PPE is recommended to minimise the risk of transmission to HCWs. Beyond that, medical personnel should be familiar with procedure guidelines, with all PPE available for immediate usage, hence minimising risk of acquiring the infection during airway management.
P100/N100 masks are not recommended in standard PPE due to their cumbersome nature, and can be substituted by N95 masks in enhanced PPE when used simultaneously with powered air purifying respirators (PAPR). Whole-body barrier suits may be used in enhanced PPE due to additional neck and lower leg coverage, but difficulty in removal leading to improper doffing increases risk of cross-contamination of surroundings and infection of HCWs. All HCWs should be trained to don and doff PPE carefully without contaminating hands or clothes, with careful hand washing before and after.
In enhanced PPE, the risk of leakage with PAPRs is negligible. Unlike reusable elastomeric respirators and N95 masks, there is no need for a fit test or additional eye protection as the head is completely enclosed.