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

Summary for Healthcare Facilities: ​Strategies for Optimizing the Supply of PPE during Shortages
Updated Dec. 29, 2020

This quick reference summarizes CDC’s strategies to optimize personal protective equipment (PPE) supplies in healthcare settings and provides links to CDC’s full guidance documents on optimizing supplies which provide additional strategies and details. These strategies offer a continuum of options using the framework of surge capacity when PPE supplies are stressed, running low, or absent. When using these strategies, healthcare facilities should:

  • Consider these options and implement them sequentially
  • Understand their current PPE inventory, supply chain, and utilization rate
  • Train healthcare personnel on PPE use and have them demonstrate competency with donning and doffing any PPE ensemble that is used to perform job responsibilities
  • Once PPE availability returns to normal, promptly resume conventional practices

Conventional Capacity strategies that should already be in place as part of general infection prevention and control plans in healthcare settings. Contingency Capacity strategies that can be used during periods of anticipated PPE shortages. Crisis Capacity* strategies that can be used when supplies cannot meet the facility’s current or anticipated PPE utilization rate. *Not commensurate with U.S. standards of care

PPE Type

Conventional

Contingency

Crisis

PPE Type

All PPE

N95 mask facemasks eye protection gowns gloves

Conventional

  • 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

Contingency

  • 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

Crisis

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

PPE Type

N95 Respirators

N95 mask

Conventional

Contingency

Crisis

PPE Type

Facemasks

facemasks

Conventional

  • 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

Contingency

  • 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

Crisis

  • 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

PPE Type

Gowns

gowns

Conventional

  • 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

Contingency

Crisis

  • 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 organismspdf icon
  • 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

PPE Type

Eye Protection

eye protection

Conventional

  • 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

Contingency

Crisis

  • 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

PPE Type

Gloves

gloves

Conventional

  • 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

Contingency

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

Crisis

  • 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