Required Precautions and Procedures (extracted from Directives #5)

-          A point-of-care risk assessment (PCRA) must be performed by every health care worker before every patient interaction in a public hospital or long-term care home.

-          If a health care worker determines, based on the PCRA, and based on their professional and clinical judgement, that health and safety measures may be required in the delivery of care to the patient, then the public hospital or long-term care home must provide that health care worker with access to the appropriate health and safety control measures, including N95 respirator. The public hospital or long-term care home will not unreasonably deny access to the appropriate PPE.

-          At a minimum, for health care workers and other employees in a hospital or a long-term care home, contact and droplet precautions must be used by health care workers and other employees for all interactions with suspected, presumed or confirmed COVID-19 patients. Contacts and droplet precautions includes gloves, face shields or goggles, gowns and surgical/ procedure masks.

- All health care workers or other employees who are within two metres of suspected, presumed or confirmed COVID-19 patients shall have access to appropriate PPE. This will include access to: surgical/ procedure masks, fit tested NIOSH- approved N-95 respirators or approved equivalent or better protection, gloves, face shields with side protection (or goggles) and appropriate isolation gowns.

- The PCRA by the health care worker should include the frequency and probability of routine or emergent Aerosol Generating Medical Procedures (AGMPs) being required. N95 respirators, or approved equivalent or better protection, must be used by all health care workers in the room where AGMPs are being performed, are frequent or probable.

AGMPs include but are not limited to: Intubation and related procedures (e.g. manual ventilation, open endotracheal suctioning), cardio pulmonary resuscitation during airway management, bronchoscopy, sputum induction, non-invasive ventilation (i.e. BiPAP), open respiratory/airway

suctioning, high frequency oscillatory ventilation, tracheostomy care, nebulized therapy/ aerosolized medication administration, high flow heated oxygen therapy devises (e.g. ARVO, optiflow) and autopsy. The list may be amended from time to time as per Public health Ontario.

Click on the respective PDF below for details. (The Directives from Chief medical Officer of Health; Updated IPAC Recommendations for use of PPE for Care of individuals with Suspect or Confirmed COVID-19 from Public health Ontario; the PPE use during the COVID-19 Pandemic from Ontario health)

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CMOH Directive #5 (Revised 2020-04-10)
Ontario Health Personal Protective Equipment Use During the COVID-19 Pandemic_rev10May20 PDF.pdf

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