Table 5 Infection control procedures
From: COVID-19 multidisciplinary high dependency unit: the Milan model
Dressing and undressing procedures for healthcare providers in COVID-19 high-dependency unit [34, 88, 89]. | |
Dressing | Undressing |
• Remove all personal items | • Remove the disposable gown and dispose of it |
• Practice hand hygiene with soap and water or alcoholic solution | • Remove the first pair of gloves and dispose of them |
• Wear a first pair of gloves | • Remove the glasses and sanitize them |
• Wear the disposable gown over the uniform | • Practice hygiene of gloves with alcoholic solutions |
• Wear FFP2/FFP3 covering the nose and mouth to minimize the space between the face and mask | • Remove FFP2/FFP3 by handling it from the rear and dispose of it in the container |
• Wear protective full face shield or glasses | • Remove the second pair of gloves |
• Put on a second pair of gloves | • Practice hand hygiene with alcoholic solutions or with soap and water |
• Shower including disinfection of the ears and mouth | |
Protective equipment and recommendations for respiratory devices [34, 90, 91, 89, 92] | |
Procedures and/or device | Recommendation |
Aerosol-generating procedures (airway suction, bronchoscopy) | • Should be performed in negative pressure rooms • FFP3 mask for operator |
NIV | • Use a double-limb circuit with a non-vented mask • Place three filters per ventilator: between the expiratory port and the ventilator; between the inspiratory port and the ventilator; near the patient’s mask • The interface with the lowest risk of aerosol emission is the helmet equipped with an inflatable neck cushion |
Conventional oxygen therapy | • Do not use humidifiers • The patient has to wear the surgical mask to reduce contamination risk |
HFNC | • The patient has to wear the surgical mask to reduce contamination risk • Nasal cannula must be completely inserted in the nostrils and secured with the elastic bands on the patient’s head to minimize lateral losses |