Communication Chaos from Discrepancies in Personal Protective Equipment and Preoperative Guidelines.

Wang, Nancy; Xu, Mary Jue; House, Adrian E; Strohl, Madeleine P; Goldberg, Andrew N; Murr, Andrew H

OBJECTIVES To compare personal protective equipment (PPE) guidelines, specifically respirator use, among international public health agencies, academic hospitals, and otolaryngology-head and neck surgery (OHNS) departments in the United States for the care of coronavirus-19 (COVID-19) patients. METHODS Review of publicly available public health and academic hospitals guidelines along with review of communication among otolaryngology departments. RESULTS Among 114 academic institutions affiliated with OHNS residencies, 20 (17.5%) institutions provided public access to some form of guidance on PPE and 73 (64%) provided information on screening or diagnostic testing. PPE guidelines were uniquely described based on several variables: location of care, COVID-19 status, involvement of aerosol generating or high-risk procedures, and physical distance from the patient. Six hospital guidelines were highlighted. Across these 6 institutions, there was agreement that N95 respirators were needed for high-risk patients undergoing high-risk procedures. Variations existed amongst institutions for scenarios with low-risk patients. Definitions of the low-risk patient and high-risk procedures were inconsistent amongst institutions. Three of the highlighted institutions had OHNS departments recommending higher level of airway protection than the institution. CONCLUSION OHNS departments typically had more stringent PPE guidance than their institution. Discrepancies in communicating PPE use were frequent and provide inconsistent information on how healthcare workers should protect themselves in the COVID-19 pandemic. Identification of these inconsistencies serves as an opportunity to standardize communication and develop evidence-based guidelines. This article is protected by copyright. All rights reserved.