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PPE Levels during patient care

Concept ambulance NTK

FRSMs must continue to be worn for all patient contacts by patients and staff.

Standard infection control precautions (SICPS)/ Level 1) - will apply for all asymptomatic patients. Universal wearing of FRSM is required for all staff and patients in all health and social care settings.

Staff should apply patient screening/triaging as appropriate and adhere to good IPC standard precautions in all areas, applying transmission-based precautions (TBP) (in addition to FRSM wearing) as required. Based on the level of exposure and the risk assessment consideration of additional PPE should be as follows:

Droplet /transmission-based precautions (TBP) - Level 2 PPE must be worn following a risk assessment e.g. risk of blood and body fluids/ suspected/ confirmed respiratory infections.

Airborne /transmission-based precautions (TBP) - Level 3 PPE must be worn following dynamic risk assessment:

  • for all known or suspected respiratory infectious patients where AGPs are required –i.e., witnessed arrest where patient history can be clinically assessed.
  • When undertaking AGPs or AGP is predicted to be required and there is an unacceptable risk of transmission of an infection following rigorous application of the hierarchy of controls i.e., known cardiac arrest where patients respiratory infectious status is unknown.

Level 3 is no longer required for all AGPs only those where there is known airborne exposure i.e., suspected or confirmed respiratory infection.

Due to the increased risk of blood and body fluid and/ or respiratory droplets when in cardiac or respiratory arrest PPE is now recommended as a minimum to be as follows:

  • Gloves
  • FFP3/PAPR if patient status is unknown or respiratory/airborne infection is suspected/confirmed – OR Facemask (FRSM) if patient status is known and no suspected infection present.
  • Eye protection
  • Apron (coveralls can be used where dynamic risk assessment determines this necessary, e.g a confirmed/suspected infectious case and/or AGPs performed in a poorly ventilated area)

Published 27th August 2022