Personal protective equipment during the COVID-19 pandemic – a narrative review

Cook, T. M.

Summary Personal protective equipment has become an important and emotive subject during the current coronavirus (COVID-19) epidemic COVID-19 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately one metre from the patient Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from COVID-19 cross-infection Appropriate use significantly reduces risk of viral transmission Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care ? contact, droplet, or airborne Recommendations from international organisations are broadly consistent, but equipment use is not Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol-generating procedures Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment