Personal Protective Equipment Guidelines for Health Care Facility Staff
Reaffirmed by the ACEP Board of Directors October 2009
Originally approved by the ACEP Board of Directors August 2003
The American College of Emergency Physicians (ACEP) believes that proper protection for hospital staff utilizing personal protective equipment (PPE) from chemical, biological, and radiological elements (CBRE) is a critical component of emergency preparedness. The critical decisions by each facility on what type of PPE and when they should be utilized should only be made after thorough analysis of all information available.
The only accepted standard for hospital PPE is that the facility should provide appropriate splash and respiratory protection. These standard precautions for blood-borne or respiratory pathogens do not necessarily protect against chemical exposures. At the present time, there is little available evidence to help determine the level of PPE needed for health care facility staff.
Essential protective measures depend heavily on the location of the decontamination area, the role of the health care facility in the community response to hazardous material (HAZMAT) incidents, and the hazard vulnerability analysis (HVA) conducted at the hospital and community levels. Critical priorities include: ensuring the safety of the health care facility staff; ensuring continuity of health care facility operations up to and including a possible determination for appropriate controlled hospital access; and providing initial treatment and triage for contaminated or exposed/potentially contaminated patients arriving at the health care facility seeking treatment.
Key elements in the selection process for appropriate PPE levels and decontamination facilities include:
Forming strategic partnerships with local response agencies, professional associations, accrediting bodies, governmental agencies, and others.
Performing a hospital hazard vulnerability analysis consistent with community threats.
Determining initial and on-going local training and equipment needs appropriate to the essential PPE level chosen.
ACEP encourages regionalized countermeasures developed through a continual process of community planning and health care worker education coupled with initial and on-going training. ACEP strongly encourages federal appropriations for adequate research to determine a scientific basis for PPE level and decontamination procedures at hospitals and health care facilities.