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Pune, October 12: Meenkashi S, a nurse working with civic-run YCM hospital, moves around in the isolation wards, tending to the COVID-19, patients. She was among the those spotted wearing masks and gloves and not PPE suits. “PPE suits are highly inconvenient and makes one sweat profusely. It is impossible to keep them on for seven hours and perform your duty,” the nurse said when asked as to why she was not wearing PPE suit. Her views are echoed by the other nurses in the ward.
Not just nurses even doctors working in isolation wards prefer face masks and face shields over PPE suits. “I think an N-95 and a faceshield provide strong protection against COVID-19. There is no need to wear a PPE suit,” said Dr Aniket Lathi, who is part of the team that provides plasma therapy to COVID-19 patients at YCM hospital, The Indian Express reported today.
Dr Lathi said PPE suits are mandatory in intensive care units where invasive and and non-invasive ventilators function. “But in isolation wards, there is no need for PPE suits. If a patient is on an oxygenated bed, he too can wear a mask. There is problem with gloves too. If they are not handled properly, they too can transmit the virus. Therefore, instead of gloves, we believe frequent hand hygiene is effective enough to keep the virus at bay.”
Pointing out that even the central government has issued guidelines as to where PPE suits should be used as well as face masks and faceshields, Dr Lathi said,”If the medical staff uses a face mask and covers it with faceshield, then need not wear PPE suits. In fact, faceshields are an invention of Indians and is now being used by the medical community worldwide.”
Dr Lathi said PPE suits needs meticulous training. “There is a strict procedure to be followed while wearing and removing PPE suits. If it is not followed strictly, then chances of virus transmission is high.”
Dr Sharmila Gaikwad, physician handling COVID-19 patients at government District Hospital, Aundh, said,”Our staff uses PPE suit for a maximum period of two to two and hours when they enter the hospital wards or an ICU. Once they come out of ward or ICU, they can remove it.”
Dr Gaikwad said their medical staff handles COVID-19 patients closely, a face mask topped by faceshields provide effective protection. “Our staff has to feed the patients by removing their facemask. When such patients cough, the faceshields provides the protection from the virus coming out of the patient’s mouth. Here, just mask would not suffice, faceshields are mandatory,” she said.
Dr Shrikrishna Joshi of Lokmanya Hospital said,”Medical staff complaints of inconvenience after wearing PPE kits, but if the staffers are handling patients closely, PPE offers them protection against droplets. Anyways, PPE kits come with faceshields and face masks. Facesheilds are equally important if the patient is coughing, to keep droplets away.”
Dr Joshi added,”While those who handle patients closely should wear PPE suits, those who do not have to go close should wear face masks and faceshields.” Dr Joshi himself ensures that he is donning a faceshield when moving around the hospital.
Dr Rajendra Wable, dean, YCM Hospital and Medical College, said as per the central government’s directives, medical staff which are required to perform necessary procedure on COVID-19 patients should mandatorily wear PPE suits, face masks and faceshields. “In every ward at YCM hospital, there are four staffers. Two of them have to wear PPE suits as they are required to handle patients. Other two should wear facemask and faceshields.”
Dr Wable said even if a staffer is not handling patient closely, he or she should wear face mask and faceshield. “Both these provide strong protection against the virus,” he said.
Doctors however point out medical professionals should be careful about use of face masks and face shields. “When choosing a facemask, one should be carefully. Valved mask are absolutely dangerous. They should never be used,” said Dr Sanjay Pathare of Ruby Hall clinic.
Yash Lunavat, CEO, Bluemark Promotions, which has come up with SmartGuards said,”There are currently two kinds of face shields in the market. First are the ones made with plastic film which are fragile and not convenient in outdoor environments. The second are the ones offered by helmet companies which are heavy and not convenient to use all day.
We have designed Smartguards which are in a solid durable material, keeping it’s weight below 100 grams making it convenient to use all day and in all environments. The Smartguard’s ergonomic design provides an all-round protection against droplet splash and also resists the user from touching their face eliminating the risk of infection.” He said not only medical professionals but even people from other fields are preferring faceshields.
Dr Sushrut Ganpule, consultant, chest physician, Jupiter Hospital, Pune said,” Face shield is an important part of personal protective equipment. Even for medical professionals it works really well as it keeps larger aerosols at bay and reduce the chances of getting an infection. It’s role as a substitute to face masks is not clear. We should be careful enough while using face shields and should not touch face or nose while wearing or removing them. Disposable face shields should be worn for a single use and disposed of according to manufacturer instructions and reusable face shields should be cleaned and disinfected after each use.”
Meanwhile,
the Ministry of Health and Family Welfare has issued guidelines regarding use of personal protective equipment.
- Contamination of mucous membranes of the eyes, nose and mouth is likely in a scenario of droplets
generated by cough, sneeze of an infected person or during aerosol generating procedures carried out
in a clinical setting…Hence protection of the mucous membranes of the eyes/nose/mouth by using face
shields/ goggles is an integral part of standard and contact precautions.
@ There are two types of masks which are recommended for
various categories of personnel working in hospital or community settings.
A triple layer medical mask is a disposable mask, fluid-resistant, provide protection to the wearer
from droplets of infectious material emitted during coughing/sneezing/talking.
@ N-95 Respirator mask
An N-95 respirator mask is a respiratory protective device with high filtration efficiency to airborne
particles.
Since these provide a much tighter air seal than triple layer medical masks, they are designed to
protect the wearer from inhaling airborne particles. (with inputs from Indian one news)
