Lack of PPE with PUI/Covid19

[StIGMA]

Has anyone's residency articulated a guideline for what to do when there is a lack of personal protective equipment (gloves, masks) available with a person under investigation (PUI) / confirmed Covid19 case present?

We have had lapses in PPE availability in our clinic with PUI's. However, we have no formal policy that residents should be excluded from seeing these patients without PPE when other appropriate staffing is immediately available. It seems more of an issue of service/duty to see these patients when the resident is the only available medical personnel available even in the absence of PPE (say, on the floor during a code MET).

I have been looking for a formal ACGME or other guideline for resident rights (safety, etc) but wasn't able to locate one that was helpful. Happy to hear what some of the more affected centers are doing.

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[AMEHigh]

In our outpatient clinic non-residents are doing all the screening so in theory they shouldn’t be coming in contact with PUI. Sorry that’s probably not helpful if you don’t have enough staff. But I’m sorry that you’re already running out of PPE in general.

 

[thehundredthone]

Has anyone's residency articulated a guideline for what to do when there is a lack of personal protective equipment (gloves, masks) available with a person under investigation (PUI) / confirmed Covid19 case present?

We have had lapses in PPE availability in our clinic with PUI's. However, we have no formal policy that residents should be excluded from seeing these patients without PPE when other appropriate staffing is immediately available. It seems more of an issue of service/duty to see these patients when the resident is the only available medical personnel available even in the absence of PPE (say, on the floor during a code MET).

I have been looking for a formal ACGME or other guideline for resident rights (safety, etc) but wasn't able to locate one that was helpful. Happy to hear what some of the more affected centers are doing.

At my center residents are currently not allowed to care for PUIs or cases. However, increasingly, most PUMs are going to be PUIs and the difference is only in availability of testing. And as the numbers increase, they will eventually have to see patients because there just aren't enough attendings to go around.

But if there isn't PPE available, don't go into the room. Period. You are not saving anyone by exposing yourself and having to be isolated (or worse, exposing others).

 

[hallowmann]

They removed all PPE from almost all other contact precautions. The PUIs on our service are being seen with PPE (face shield, droplet mask, gloves, gown) for now, but I suspect we will be losing gowns soon. N95s are hidden and reserved only for confirmed cases.