HIV and Oral Health: Personal Protective Equipment Optimization
By: Mark Schweizer, DDS MPH
Director of Development and Special Projects
Dental Director Southeastern AIDS Training and Education Center
Nova Southeastern University College of Dental Medicine
[email protected]
With the number of Coronavirus cases surpassing 7.3 million and 210,000 deaths in the United States, dental offices continue to be faced with shortages of personal protective equipment (PPE).
Surge capacity refers to the ability to manage a sudden increase in patient volume that would severely challenge or exceed the present capacity of a facility. While there are no commonly accepted measurements or triggers to distinguish surge capacity from daily patient care capacity, surge capacity is a useful framework to approach a decreased supply of PPE during the COVID-19 response. To help healthcare facilities plan and optimize the use of PPE in response to COVID-19, CDC has developed a Personal Protective Equipment (PPE) Burn Rate Calculator. Three general strata have been used to describe surge capacity and can be used to prioritize measures to conserve PPE supplies along the continuum of care.
- Conventional capacity: measures consisting of engineering, administrative, and personal protective equipment (PPE) controls that should already be implemented in general infection prevention and control plans in healthcare settings.
- Contingency capacity: measures that may be used temporarily during periods of expected facemask shortages. Contingency capacity strategies should only be implemented after considering and implementing conventional capacity strategies. While current supply may meet the facility’s current or anticipated utilization rate, there may be uncertainty if future supply will be adequate and, therefore, contingency capacity strategies may be needed.
- Crisis capacity: strategies that are not commensurate with U.S. standards of care but may need to be considered during periods of known facemask shortages. Crisis capacity strategies should only be implemented after considering and implementing conventional and contingency capacity strategies. Facilities can consider crisis capacity strategies when the supply is not able to meet the facility’s current or anticipated utilization rate. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
Below are some general recommendations:
- Calculate your monthly usage of PPE including gowns, masks, face shields, gloves, disinfectants, and other PPE supplies.
- Keep one-month supply in your inventory
- Only work with reputable vendors
- Respirator masks should be approved by National Institute for Occupational Safety and Health (NIOSH) https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html
- Gown should be surgical and approved by the Food and Drug Administration (FDA), American National Standards (ANSI) or Association for the Advancement of Medical Instrumentation (AAMI) https://www.halyardhealth.com/media/538845/Guide-to-Gown-Guidelines.pdf
- Disinfectants used to address the Coronavirus and their usage can be found on the Environmental Protection Agency (EPA) N-List. https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19
