Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey

J Crit Care. 2020 Oct:59:70-75. doi: 10.1016/j.jcrc.2020.06.005. Epub 2020 Jun 13.

Abstract

Purpose: To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU).

Materials and method: A web-based survey distributed worldwide in April 2020.

Results: We received 2711 responses from 1797 (67%) physicians, 744 (27%) nurses, and 170 (6%) Allied HCW. For routine care, most (1557, 58%) reportedly used FFP2/N95 masks, waterproof long sleeve gowns (1623; 67%), and face shields/visors (1574; 62%). Powered Air-Purifying Respirators were used routinely and for intubation only by 184 (7%) and 254 (13%) respondents, respectively. Surgical masks were used for routine care by 289 (15%) and 47 (2%) for intubations. At least one piece of standard PPE was unavailable for 1402 (52%), and 817 (30%) reported reusing single-use PPE. PPE was worn for a median of 4 h (IQR 2, 5). Adverse effects of PPE were associated with longer shift durations and included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%).

Conclusions: HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.

Keywords: COVID-19; Health care workers; Intensive care; Personal protective equipment; Safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Africa
  • Allied Health Personnel
  • Asia
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / transmission*
  • Europe
  • Eye Protective Devices
  • Female
  • Gloves, Protective
  • Headache / etiology
  • Health Personnel*
  • Hot Temperature
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Intensive Care Units
  • Male
  • Masks / adverse effects
  • Masks / supply & distribution
  • Middle Aged
  • North America
  • Nurses
  • Occupational Health*
  • Oceania
  • Pandemics
  • Personal Protective Equipment / adverse effects
  • Personal Protective Equipment / supply & distribution*
  • Personnel Staffing and Scheduling
  • Physicians
  • Pneumonia, Viral / transmission*
  • Respiratory Protective Devices / adverse effects
  • Respiratory Protective Devices / supply & distribution
  • SARS-CoV-2
  • South America
  • Surgical Attire
  • Surveys and Questionnaires
  • Thirst