COVID-19Returning to PracticeA practical discussion to easethe transition for OMF Surgeons

Are we really at risk?

ChinaEarly China experience, 23 health care worker deaths

50% physicians8 surgeons (70% of physicians)

Global

100 health care worker deaths in the UK

18,000 health care workers infected Spain, 11,000 + in

Italy

USA DOL

Risk calculations based on

contact, proximity,

procedure, frequency of

exposure

Us Dept of Labour

Canadian case numbers (May 6, 2020)

Ø Practice and train doffing PPE with observer/coach

Ø Be professionally N95 Mask Fit Tested with N95’s on hand

Ø Double Hair cover, Eye protection, n95 mask, contact gown, gloves

Ø Wash neck, and any parts of face that may have received splatter

Ø Protocols for Laundering of scrubs and reusable PPE

Ø Know PPE donning & doffing and Hand Hygiene Ø Post Donning & Doffing and Hand Hygiene PostersØ Practice donning/ doffing PPE with observer/coachØ Hair cover, Eye protection, Level 3 mask, contact gown,

gloves

Ø Intake - Scrubs, gowns, mask, eye protection, gloves Ø Physical distancing, or level 1 mask protection in admin/ waiting roomsØ Admin - Physical barrier installation Ø Staff avoid personal clothing, change at work,

PPE by scenario (= risk level )

During the COVID-19 pandemic staffing levels and patient flow has changed.

It is very important to make sure that you are appropriately staffed, and protections for patients, admin, and clinical team are in place.

Ensure staff is aware of changes to PPE

Intake/ admin/ PPE

Contact PPE/ Droplet PPE

AGMP PPE

COVID-19 Definitions

Aerosol Generating

Medical Procedure

Secretions from the

upper aerodigestive

tract are partitioned

into small droplets and

particles that can be

suspended in the air

Anything that uses:

� Handpiece, power

instrumentation

� Harmonic scalpels

� Irrigation / Suction

� Laser /Cautery

� Cough /spit /gag

Personal Protective Equipment

� PAPR respirators

� N95 respirator (AGMP)

� Hair cover (double)

� Face shield or Goggles

� Gown

� Gloves (surgical /double)

AGMP OMFS AGMPs PPE

Safety PPE required for all Non-AGP’sFace Shield OR Safety Glasses PPE Required for AGP’s

COVID-19 – Medicolegal considerations• Do your protocols meet or exceed provincial hospital protocols for

IP&C and PPE, (and those of your dental regulator)• All staff must be provided protections • All Staff in the procedure room in the same level PPE• All respirators Health Canada approved and from distributor with

MDEL

Resources• https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html• https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/health-workers• https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe#ppe-guidance-by-healthcare-context• https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-aerosol-generating-procedures• https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/881489/COVID-19_Infection_prevention_and_control_guidance_complete.pdf