PPE guidance for cardiology during COVID-19 pandemic operating in a “vacuum” in UK

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Simon Ray

Simon Ray, president of the British Cardiovascular Society (BCS), has told the COVID-19 Cardiovascular Conference that a lack of consistency in national guidance around personal protective equipment (PPE) during COVID-19 had led to a “vacuum” which has had to be filled by individual societies and membership organisations. This, he said, has created “a piecemeal approach, which does not necessarily join up”.

He was speaking as part of the live webinar, hosted by The Imperial College Network of Excellence in Vascular Science at Imperial College London (London, UK).

Ray told the online audience: “We need a robust PPE supply through a robust supply chain that is readily available for all appropriate use—that has not happened in the UK. We have also been lacking unambiguous national guidance on the use of PPE based on established and evolving science.” As a result, he indicated, professional confidence in the guidance that has been given has been low. Ray expressed sympathy for the difficulties involved for policy makers, given “there is little hard science on which to base recommendations on”.

He also revealed difficulties with reaching consensus on PPE within cardiology “because there is such a wide discrepancy of views within healthcare”. Public Health England is expected to update guidance imminently, and Ray said he is hopeful that this will be “consensus based, and put things into context for cardiology”.

During the same session, Ricardo Petraco (Imperial College Healthcare Trust, London, UK) looked at issues around PPE in the cath lab, advising on how to ensure that staff are protected “whilst offering excellence in cardiology care”. He said: “The risk of exposure to acute specialties, including cardiology, is very high.” His recommendations included full PPE (“full body kit with no millimetre of skin exposed”) in confirmed or suspected cases, and basic PPE (goggles, a mask, a visor, gloves and a gown) for patients who are very unlikely to be positive for COVID-19. He also advocated masks for all patients, and emphasised the importance of training staff carefully on how to use PPE and remove it safely after a cath lab procedure.

Bushra Rana (Imperial College Healthcare Trust) offered suggestions on protection in echocardiography. “An echo exam is an intimate exam,” she said. “It takes about 20 minutes, it is face-to-face, and you are sharing the same breathing space.” Her three-step principle was to assess the infection status of patients; clarify the indication for an echo (“Is it likely to change the immediate management strategy?”); and deliver appropriate imaging.


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