Summary for Healthcare Facilities: ​Strategies for Optimizing the Supply of PPE during Shortages

All PPE

• Use physical barriers and other engineering controls
• Limit number of patients going to hospital or outpatient settings
• Use telemedicine whenever possible
• Limit all HCP not directly involved in patient care
• Limit face-to-face HCP encounters with patients
• Limit visitors to the facility to those essential for patients’ physical or emotional well-being
• Cohort patients and/or HCP

• Selectively cancel elective and non-urgent procedures and appointments for which PPE is typically used by HCP
• Decrease length of hospital stay for medically stable patients with an infectious diagnosis for whom PPE use is recommended during their care

• Cancel all elective and non-urgent procedures and appointments for which PPE is typically used by HCP

N95 Respirators

• Implement just-in-time fit testing
• Limit respirators during training
• Implement qualitative fit testing
• Use alternatives to N95 respirators such as other filtering facepiece respirators, elastomeric respirators, and powered air purifying respirators
• Additional guidance

• Temporarily suspend annual fit testing
• Use N95 respirators beyond the manufacturer-designated shelf life for training and fit testing
• Extend the use of N95 respirators by wearing the same N95 for repeated close contact encounters with several different patients
• Additional guidance on contingency capacity strategies

• Use respirators beyond the manufacturer designated shelf life for healthcare delivery
• Use respirators approved under standards used in other countries
• Implement limited re-use of N95 respirators. During times of crisis, it may be needed to practice limited re-use on top of extended use
• Use additional respirators beyond the manufacturer-designated shelf life that have not been evaluated by NIOSH
• Prioritize the use of N95 respirators and facemasks by activity
• Additional guidance on crisis capacity strategies
• Additional guidance on re-use

Facemasks

• Use facemasks according to product labeling and local, state, and federal requirements
• In healthcare settings, facemasks are used by HCP as 1) PPE to protect their nose and mouth from exposure to splashes, sprays, splatter, and respiratory secretions (e.g., for patients on Droplet Precautions) and 2) source control to cover their mouth and nose to prevent spread of respiratory secretions when they are talking, sneezing, or coughing.
• Additional guidance

• Remove facemasks from facility entrances and other public areas
• Implement extended use of facemasks as PPE
• Restrict facemasks for use only by HCP when needed as PPE. Patients and HCP requiring only source control may use a cloth mask
• Additional guidance

• Use facemasks beyond the manufacturer-designated shelf life during patient care activities
• Implement limited re-use of facemasks with extended use
• Prioritize facemasks for HCP for selected activities such as essential surgeries, activities where splashes and sprays are anticipated, and contact with an infectious patient, for whom facemask use is recommended

When no respirators or facemasks are available:

• Use a face shield that covers the entire front (that extends to the chin or below) and sides of the face with no facemask
• Additional guidance

Gowns

• Use isolation gown alternatives that offer equivalent or higher protection including reusable (i.e., washable) gowns
• Note: In general, CDC does not recommend the use of more than one isolation gown at a time when providing care to confirmed or suspected COVID-19 patients
• Additional guidance

• Consider the use of coveralls
• Use gowns beyond the manufacturer-designated shelf life for training
• Use gowns or coveralls conforming to international standards
• Additional guidance

• Extend the use of isolation gowns
• Prioritize gowns for activities where splashes and sprays are anticipated, during high-contact patient care, and for patients colonized or infected with emerging highly-resistant organisms
• Consider using gown alternatives that have not been evaluated as effective
• Re-use of isolation gowns is not recommended (risks of transmission among HCP and patients likely outweigh any potential benefits)
• Additional guidance

Eye Protection

• Use eye protection according to product labeling and local, state, and federal requirements
• Shift eye protection supplies from disposable to re-usable devices
• Additional guidance

• Extend the use of eye protection
• Additional guidance

• Use eye protection devices beyond the manufacturer-designated shelf life
• Prioritize eye protection for activities where splashes and sprays are anticipated or prolonged face-to-face or close contact with a potentially infectious patient is unavoidable
• Consider using safety glasses that cover the sides of eyes
• Additional guidance

Gloves

• Continue providing patient care as in usual infection control practice
• Note: CDC does not recommend double gloves when providing care to suspected or confirmed COVID-19 patients.
• Additional guidance

• Use gloves past their manufacturer-designated shelf life for training activities
• Use gloves conforming to other U.S. and international standards
• Additional guidance

• Use gloves past their manufacturer-designated shelf life for healthcare delivery
• Consider non-healthcare glove alternatives
• Extend the use of disposable medical gloves
• Additional guidance