Department of Ophthalmology, United Christian Hospital.
Department of Ophthalmology, Tseung Kwan O Hospital, Hospital Authority, Hong Kong SAR.
Curr Opin Ophthalmol. 2020 Sep;31(5):435-446. doi: 10.1097/ICU.0000000000000691.
The use of nonpharmaceutical interventions can prevent viral spread in COVID-19 pandemic and PPE forms a crucial part of this strategy. However, there are discrepancies in existing guidelines and a lack of consensus among ophthalmic communities. This review aims to identify general consensus and provides recommendation of PPE for most common ophthalmological scenarios. With a global shortage of PPE, extended use and reuse strategies are also discussed.
In this review, guidelines and resources were selected, based on a three-tier process. The first-tier resources were from international infection control organizations. The second-tier resources were from ophthalmological professional associations and colleges. The third-tier resources involved a PubMed search using the keywords 'COVID-19; coronavirus; personal protective equipment' performed on 1 May 2020. Non-English guidelines and literatures were excluded.
On the basis of our methodology, we included a total of 30 documents, including 5 resources from tier 1, 14 resources from tier 2 and 15 from tier 3. Different levels of protection are necessary. Whenever performing an aerosol generating procedure, maximum protection should be ensured, this includes FFP3 respirator, fluid resistant gown, goggles or face-shield and disposable gloves. Similar protection should be used for handling COVID-19-positive/suspected case but the use of FFP2 respirator is acceptable. During routine outpatient clinic in cases of negative triage, it is recommended to use ASTM III surgical mask, plastic apron, disposable gloves and eye protection with goggles or face-shield. Lastly, patients should be encouraged to wear surgical masks whenever possible.
在 COVID-19 大流行期间，非药物干预措施的使用可以阻止病毒传播，个人防护装备是该策略的关键组成部分。然而，现有的指南存在差异，眼科界也缺乏共识。本综述旨在确定一般共识，并为大多数常见的眼科情况提供个人防护装备的建议。鉴于个人防护装备全球短缺，还讨论了延长使用和重复使用策略。
在本综述中，根据三级流程选择了指南和资源。一级资源来自国际感染控制组织。二级资源来自眼科专业协会和学院。三级资源涉及 2020 年 5 月 1 日使用关键字“COVID-19；冠状病毒；个人防护装备”在 PubMed 上进行的搜索。排除了非英语指南和文献。
根据我们的方法，我们共纳入了 30 篇文献，包括 1 篇来自一级资源、14 篇来自二级资源和 15 篇来自三级资源。需要不同级别的保护。进行任何产生气溶胶的操作时，都应确保最高级别的保护，包括 FFP3 呼吸器、防流体长袍、护目镜或面罩和一次性手套。处理 COVID-19 阳性/疑似病例时应使用类似的保护措施，但可接受使用 FFP2 呼吸器。在常规门诊中，如果分诊结果为阴性，建议使用 ASTM III 手术口罩、塑料围裙、一次性手套和护目镜或面罩进行眼部保护。最后，应鼓励患者尽可能佩戴外科口罩。
