March 19 – DAILY COVID-19 UPDATE (PM)

March 19, 2020  //  FOUND IN: Updates & Resources

NEW TODAY: Here’s the latest information about Michigan Medicine’s management of the COVID-19 pandemic:

  • NEW PPE RECOMMENDATIONS
  • HR STAFFING

As this global pandemic has rapidly evolved, we have gained a better understanding of the transmission of COVID-19, in response we are implementing new recommendations for personal protective equipment use.

Currently available evidence indicates COVID-19 is spread through person-to person transmission during close exposure to a person infected via droplet spread and direct contact. Airborne transmission may occur with aerosol generating procedures. 

These updated recommendations are in line with the World Health Organization (WHO) and have already been implemented in many other health care institutions around the country, and have been found to be effective in protecting health care workers.

Updated PPE Recommendations effective 3/19/20:

Patients with respiratory symptoms of unknown etiology and who are not being tested for COVID should be managed in droplet precautions until a clear etiology is determined.

Regular facemask, eye protection, gown, gloves are recommended for care of all non-ICU suspected or confirmed COVID-19 patients.

N95 masks or PAPRs (PAPR only if not fit tested for N-95) in place of regular facemasks should only be used for care during aerosol generating procedures (AGP) and for one hour after the AGP in non-ICU patients and used for all care of ICU patients (see list of AGP below). Aerosol generating procedures should be performed in a negative pressure isolation room.   View PPE guidance here.

Aerosol-generating procedures are:

  • Tracheal intubation
  • Bronchoscopy
  • Oropharyngeal or tracheotomy suctioning
  • Non-invasive positive pressure ventilation
  • Cardiopulmonary resuscitation (CPR)
  • Nebulizer treatment
  • Bag valve mask (BVM) ventilation
  • High-flow supplemental oxygen therapy
  • Sputum induction or cough assist treatments

Nasopharyngeal or oropharyngeal swab collection are not considered aerosol-generating procedures.

Facemasks protect the wearer from splashes and sprays that could occur. Respiratory (N95s or PAPRs), which filter inspired air, offer respiratory protection against airborne transmission that could occur during aerosol generating procedures.

In addition:

  • General care patients with negative COVID testing should be removed from Special Pathogens precautions and placed in droplet precautions. 
  • ICU patients with negative COVID testing should prompt a discussion with the clinical team and infection prevention or the infectious diseases consult service following the patient to discuss if removal of special pathogens precautions is appropriate.

See a graphic algorithm here.

Evidence suggests that health care workers are more likely to make mistakes with new or unfamiliar PPE equipment/techniques. Please don’t hesitate to ask questions. As usual, avoid touching your face or mask.

The safety of our health care staff remains of paramount importance. We appreciate your dedication to our efforts to minimize the spread of this disease.

HR Staffing

The HR Staffing Team has developed a new process to request additional staffing. If you have staff available to be redeployed to another assignment, please ask them to submit this form. If you or your department needs additional staffing support, contact the HR Staffing Team at (734) 647-5798 or email at HR-Pandemic-Staff@med.umich.edu.

Still have questions?

An FAQ is posted in Headlines and updated frequently. If you have specific questions about COVID19 and your work at Michigan Medicine, go to the Infection Prevention & Epidemiology page for updates.

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