New Mexico Department of Health (NMDOH) Interim Guidance for Personal Protective Equipment (PPE) for the 2009/2010 Infl

1. New Mexico Department of Health (NMDOH) Interim Guidance for Personal Protective Equipment (PPE) for the 2009/2010 Influenza Season David Selvage, MHS, PA-C NMDOH, Infectious Disease Epidemiology Bureau

2. Healthcare Workers (HCWs) School Settings Day Care Settings Jails and Prisons Long-term Care Facilities (LTCFs) Emergency Medical Services Business and Community Settings Case Managers and Social Workers conducting Home Visits Occupations and Settings

3. Transmission by droplets Most transmission will occur in the community not acute care facilities PPE has an important but limited role PPE resources are limited Vaccination is key to prevention Other prevention strategies ( frequent hand washing, covering cough, early illness identification, isolation of the sick) very important Assumptions

4. HCWs • Standard precautions (guided by risk assessment): • hand hygiene • gloves • respiratory hygiene/cough etiquette • gown if risk of contact with body fluids • Droplet precautions: surgical masks upon room entry and when within 6 feet of a suspect case • N95 respirator when conducting aerosol generating medical procedures (AGMPs) • Wear eye protection with surgical mask or N95 respirator if anticipate exposure to body fluids/splash

5. School Settings • If school HCW or HCW proxy, follow general guidance for HCWs • Identify sick students/staff & get them out of class • Isolate & place surgical mask on ill person (if tolerated) until sent home • N95 mask if open-suctioning required

6. Day Care Settings • If school HCW or HCW proxy, follow general guidance for HCWs • Identify sick attendees/staff & get them out of class • Isolate & place surgical mask on ill person (if tolerated) until sent home • N95 mask if open-suctioning required

7. Jails & Prisons • If HCW, follow general guidance for HCWs • Identify sick staff, give surgical mask and send home • Isolate or cohort sick residents; restrict movement in or out of facility until 24 hours afebrile • Place mask on ill resident (if tolerated) during transport • N95 respirator if conducting AGMPs

8. Long-term Care Facilities (LTCFs) • If HCW, follow general guidance for HCWs • Identification of even a single resident with ILI warrants a call to NMDOH to coordinate testing, prophylaxis and other control measures within the facility • 505-827-0006

9. Emergency Medical Services (EMS) • If dispatcher identifies ILI case for transport, don PPE before entering the scene • If ILI identified at scene, don PPE • Place surgical mask on patient (if tolerated) • Standard precautions and accompanying PPE (gloves, eye/face shields) • N95 if performing AGMPs

10. Home Visiting Occupations (Social Workers, Case Managers) • Call ahead. If ILI in the home, delay visit (if possible) until everyone is well • If visit necessary & ILI in the home, have ill person isolated during the visit • If need to interact with the ill person, maintain separation of 6 feet & have them don a surgical mask (if tolerated) • If ill person can’t wear surgical mask, case worker should wear surgical mask

11. Upcoming Guidance • Mortuary Workers • Police & Law Enforcement • Churches & Synagogues Please find the NMDOH interim guidance at http://nmhealth.org/H1N1/provider.shtml Thank You.