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Personal Protection Systems

There are two levels of personal protection required in caring for patients under SARS precautions. Standard protection for routine care of patients with SARS usually includes double gowning, double gloves, N95 mask, eye protection, face shield, and head covering (these recommendations are determined by provincial directive and in consultation with local infection control officials). Despite these standard precautions, certain high-risk procedures (e.g., intubation, cardiac arrest, bronchoscopy) have been associated with breakthrough transmission of SARS to health care workers. Adjunct protective equipment is recommended for these high-risk procedures in patients with SARS. Issues related to personal protection, including choices of adjunct protective equipment, are discussed on this site.

Report on Adjunct Protection Systems for High-Risk Critical Care Procedures for SARS Patients

  • There have been a number of incidents where clinical staff have been infected with SARS despite usual recommended precautions (N95 mask, goggles or eye shield, gown, gloves). A multidisciplinary group of experts gathered on April 25th, 2003 to consider the concept of adjunct protection systems for intubation, cardiac arrest and bronchoscopy in patients with SARS. General recommendations are provided along with evaluations of two adjunct protection systems (3M PAPR Hoods and Stryker T4 Personal Protection System).

Information on Respirators from the NIOSH Website

  • This website contains excellent information on the selection and use of personal protective equipment. Review of this material is helpful when deciding on purchase of personal protective equipment, including adjunct equipment such as PAPRs or other devices.

Stryker T4 Personal Protection System

  • Dr. Randy Wax, Dr. Laurie Mazurik, and Vagia Tsiaousidis Campbell RRCP have developed an online Powerpoint presentation that will help clinical staff learn how to use the Stryker T4 system following a step-by-step checklist with pictures. Stryker has produced a report on repeat testing of this system as performed by an independent laboratory.

3M PAPR Hood System

  • A checklist summarizes procedures for using the 3M PAPR Hood adjunct protective device used during high-risk procedures on patients with SARS. This reviews equipment check, donning of gear, room entry, and room exit with equipment removal. A video was created using the protocol at St. Michael's Hospital for the use of 3M PAPR systems as adjunct protection during high-risk SARS situations. Note that their protocol is different than that used at Mount Sinai Hospital, thus the checklist will differ from the video.

For further information contact: Dr. Randy Wax, Education Director
Room 1831, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5

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