The hottest debate these days is not in politics, it’s all about what appropriate face covering to wear to keep Healthcare Providers and the general public healthy and free from COVID-19. Some experts prefer face shields to cloth masks. Others say face shields have no effects. Experts are torn. So, what’s a healthcare provider, working with the patients in an in person setting on a daily basis, to do?
The Centers For Disease Control (CDC) is recommending cloth face coverings for the general public as a simple barrier to protect from droplet spread from traveling in the air and onto other people. COVID-19 spreads among people who are in close contact with each other (with in 6 feet). A simple surgical mask can also prevent droplet spread.
Many people in the general public are making DYI face shields (Do It Yourself) from recycled plastic bottles. But do these really work? And should our patients be wearing them?
Plastic face shields in health care are nothing new. Healthcare providers have been wearing them for many years. A study in the journal of Occupational health found that healthcare providers can inhale infectious airborne particles when a patient cough. Face shields can substantially reduce the short-term exposure to healthcare workers to large infectious aerosol particles, but smaller particles can remain airborne and flow around the face shield more easily to be inhaled. The study further recommends that face shields be used in adjunct to proper respiratory protection when needed. Face shields are generally not used alone, but in conjunction with other protective equipment like cap, mask, goggle, and are therefore classified as adjunctive personal protective equipment.
Important Facts To Consider When Using Face Shield’s For Healthcare Providers
–Snug fit: The face shield must be snugly fitting around head without any gaps between forehead and shield. The readymade plastic bands are not tight fitting and may fall off with repeated use. Use of sponge in between forehead and face shield gives good comfort, but such face shields should be used as disposable as sterilization of sponge is incomplete.
Disposable/Reusable: Disposable face masks should be disposed of in the appropriate location. Reusable face shields must be removed carefully and disinfected with the utmost care.
Methods of handling: Never touch the front of the face shield. Remove face shield with gloved hands. Dispose along with gloves.
Methods Of Sterilization:
1% Sodium Hypochlorite solution for minimum of 10 min.
Drying in Sun light and cleaning with Sanitizers with gloved hands.
2% Glutaraldehyde for 10 min, wash it with normal saline, again dry it.
Healthcare Providers Who Are Testing Patients for COVID-19
Healthcare providers interacting with ill or suspected to be ill with COVID-19 patients, need professional respirators such as N95 respirators which are designed for medical use. N95 respirators fit snuggly around the face and filter air to further stop transmission of droplets from person to person. Face shields and eye goggles should also be worn.
Guidance on the use of face shields vs. face masks remains unclear. When in doubt, it’s always best to consult the hospital or facilities policies that any healthcare provider may be working at. As a rule of thumb, always err on the side of causation and protect yourself as best as possible.