GOVERNMENT OF NATIONAL CAPITAL TERRITORY OF DELHI
HEALTH & FAMILY WELFARE DEPARTMENT
9th LEVEL, A-WING, DELHI SECRETARIAT, IP ESTATE, NEW DELHI – 110 002
Ph: 011-23392017, Fax: 011-23392464, email: pshealth@nic.in

No. 52/ DGHS/ PH-IV/COVID-19/2020/prsecyhfwi/7676-7775 Date: 16/05/2020

ORDER

All Health Care Facilities operating in NCT of Delhi, including hospitals, nursing homes, dispensaries, AAMC, clinics and Covid Care Centers etc. run by Government of NCT of Delhi or in private sectors are hereby directed to follow guidelines issued by Ministry of Health and Family Welfare, Government of India dated 15.05.2020 for rational use of Personal Protective Equipments (PPEs) in accordance with the risk involved

Copy of the guidelines issued by Ministry of Health and Family Welfare Government of India is enclosed.

To

  1. All MSs/MDs/Directors of all GNCTD Hospitals
  2. All District Magistrates, GNCT of Delhi
  3. DGHS, Govt. of NCT of Delhi
  4. Dr R N Das to circulate it to all private health care facilities

Copy to:

  1. Addl. CS (Home), Govt. of NCT of Delhi
  2. Pr. Secretary to Hon’ble LG, Delhi
  3. Pr. Secretary (Revenue), Govt. of NCT of Delhi
  4. Pr. Secretary (Health & FW/UD), Govt. of NCT of Delhi
  5. Addl. Secretary to Hon’ble CM, Govt. of NCT of Delhi
  6. Secretary to Hon’ble Minister of Health, GNCT of Delhi
  7. OSD to CS, Govt. of NCT of Delhi
  8. PA to Spl. Secretary (H&FW)

Padmini Singala

Secretary(Health & Family Welfare)

Ministry of Health and Family Welfare
Directorate General of Health Services
[Emergency Medical Relief]

Novel Coronavirus Disease 2019 (COVID-19): Additional guidelines on rational use of Personal Protective Equipment (setting approach for Health functionaries working in non-COVID areas)

  1. About this guideline

This guideline is for health care workers and others working in Non COVID hospitals and Non- COVID treatment areas of a hospital which has a COVID block. These guidelines are in continuation of guidelines issued previously on ‘Rational use of Personal Protective Equipment’ (https://www.mohfw.gov.in/pdf/GuidelinesonrationaluseofPersonalProtectiveEquipment.pdf). This guideline uses “settings” approach to guide on the type of personal protective equipment to be used in different settings.

  • Rational use of PPE for Non COVID hospitals and Non-COVID treatment areas of a hospital which has a COVID block

The PPEs are to be used based on the risk profile of the health care worker. The document describes the PPEs to be used in different settings.

2.1. Out Patient Department

S.No.SettingActivityRiskRecommended PPERemarks
1Help desk/ Registration counterProvide information to patientsMild riskTriple layer medical mask Latex examination glovesPhysical distancing to be followed at all times
2Doctors chamberClinical managementMild riskTriple layer medical mask Latex examination glovesNo aerosol generating procedures should be allowed.
3Chamber of Dental/ENT doctors/ Ophthalmology doctorsClinical managementModerate riskN-95 mask Goggles Latex examination gloves + face shieldAerosol generating procedures anticipated. Face shield, when a splash of body fluid is expected
4Pre- anesthetic check-up clinicPre-anesthetic check-upModerate riskN-95 mask Goggles* Latex examination gloves* Only recommended when close examination of oral cavity/dentures is to be done
5Pharmacy counterDistribution of drugsMild riskTriple layer medical mask Latex examination glovesFrequent use of hand sanitizer is advised over gloves.
6Sanitary staffCleaning frequently touched surfaces/ FloorMild riskTriple layer medical mask Latex examination gloves

#All hospitals should identify a separate triage and holding area for patients with Influenza like illness so that suspect COVID cases are triaged and managed away from the main out-patient department.

2.2. In-patient Department (Non-COVID Hospital &Non-COVID treatment areas of a hospital which has a COVID block)

S.No.SettingActivityRiskRecommended PPERemarks
1Ward/individual roomsClinical managementMild riskTriple layer medical mask Latex examination glovesPatients stable. No aerosol generating activity.
2ICU/ Critical careCritical care managementModerate riskN-95 mask Goggles Nitrile examination gloves +Face shieldAerosol           generating activities performed. Face shield, when a splash of body fluid is expected
3Ward/ICU /critical careDead body packingLow RiskTriple Layer medical mask Latex examination gloves 
4Ward/ICU/ Critical care (Non-COVID)Dead body transport to mortuaryLow RiskTriple Layer medical mask Latex examination gloves 
5Labor roomIntra-partum careModerate RiskTriple Layer medical mask Face shield Sterile latex gloves Coverall N-95 mask*Patient to be masked in the Labor room, if possible. *If the pregnant woman is a resident
6Operation TheaterPerforming surgery, administering general anaesthesiaModerate RiskTriple Layer medical mask Face shield (- wherever feasible) Sterile latex gloves + Gogglesof containment zo Already OT staff shall be wearing For personnel involved in aerosol generating procedures
N-95 mask**If the person being operated upon is a resident of containment zone
7SanitationCleaning frequently touched surfaces/ floor/ changing linenLow RiskTriple Layer medical mask Latex examination gloves

2.3. Emergency Department (Non-COVID)

S.No.SettingActivityRiskRecommended PPERemarks
1EmergencyAttending emergency casesMild riskTriple Layer medical mask Latex examination glovesNo aerosol generating procedures are allowed
2Attending to severely ill patients while performing aerosol generating procedureHigh riskFull complement of PPE (N-95 mask, coverall, goggle, Nitrile examination gloves, shoe cover) 

2.4. Other Supportive/ Ancillary Services

S.No.SettingActivityRiskRecommended PPERemarks
1.Routine LaboratorySample collection and transportation and testing of routine (non- respiratory) samplesMild riskTriple layer medical mask Latex examination gloves 
Respiratory samplesModerate riskN-95 mask Latex examination gloves 
2Radio- diagnosis, Blood bank, etc.Imaging services, blood bank services etc.Mild riskTriple layer medical mask Latex examination gloves 
3CSSD/LaundryHandling linenMild riskTriple layer medical mask Latex examination
gloves
 
4Other supportive services incl kitchenAdministrative Financial Engineering** and dietary** services,etc.Low riskFace cove** Engineering and dietary service personnel visiting treatment areas will wear personal protective gears appropriate to that area

2.5. Pre-hospital (Ambulance) Services

S.No.SettingActivityRiskRecommended PPERemarks
1Ambulance Transfer to designated hospitalTransporting patients not on any assisted ventilationLow riskTriple layer medical mask Latex examination gloves 
Management of SARI patientHigh riskFull complement of PPE (N-95 mask, coverall, goggle, latex examination gloves, shoe cover)While performing aerosol generating procedure
Driving the ambulanceLow riskTriple layer medical mask Latex examination glovesDriver helps in shifting patients to the emergency

Points to remember while using PPE

  1. Standard precaution to be followed at all times
  2. PPEs are not alternative to basic preventive public health measures such ashand hygiene, respiratory etiquettes which must be followed at all times.
  3. Always follow the laid down protocol for disposing off PPEs as detailed in infection prevention and control guideline available on website of MoHFW.

In addition, patients and their attendants to be encouraged to put on face cover.

In case a COVID-19 patient is detected in such Non-COVID Health facility, the MoHFW guidelines for the same has to be followed (Available at: https://www.mohfw.gov.in/pdf/GuidelinestobefollowedondetectionofsuspectorconfirmedCOVID19ca  se.pdf)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s