Emergency Planning

Swine Flu Update - 17 July 2009

Swine Flu Update - 17 July 2009

  

Leicester, Leicestershire and Rutland

Guidance on PPE For Use During a Flu Pandemic

 

Issued on behalf of LLR LRF

Date 17/07/2009

1. The occurrence of cases of swine flu in this country has raised the issue in a number of staff groups about whether they should be wearing personal protective equipment (PPE). In these circumstances PPE means a surgical mask, gloves and a plastic apron.

 

2. There is separate national guidance for use by clinical staff. This guidance is for use by non-health service staff.

 

3. At this stage we are no longer swabbing and testing patients due to the numbers of cases involved. Anyone with flu like symptoms is assumed to have swine flu and should be treated as such with regard to the use of PPE and other infection control processes.

 

4. The main point to remember is that PPE is only necessary for people who are providing personal care to individuals who are likely to have swine flu. At this stage this means anyone who has flu like symptoms. Personal care includes washing, bathing and dressing. It does not include shopping or cleaning or general social contact. The vast majority of staff will not need to worry about wearing PPE as they will not have sufficiently close contact with individual to pose a risk to themselves.

5. There is insufficient evidence of benefit to advise members of the public or members of staff to routinely wear a face mask during a flu pandemic

 

6. It is important to remember that keeping more than 1 metre away from a person is an effective way of reducing the risk of transmission of flu viruses. Work practices should be reviewed to ensure that this is achieved wherever possible.

 

7. Wearing PPE should not be seen as a substitute for other means of avoiding transmission of flu viruses. These include:

 

  • Use a tissue to cover your nose and mouth when coughing and/or sneezing and encourage others to do them same. Dispose of tissues promptly and then wash your hands
  • Clean hands frequently with soap and water, especially after coughing, sneezing and using tissues. An alcohol hand rub could be used as an alternative for cleaning hands
  • Avoid touching your mouth, eyes and/or nose, unless you have recently cleaned your hands.
  • Use normal household detergent and water to clean surfaces frequently touched by hands
  • Before you leave work you should wash your hands with soap and water, and then wash them again soon after you arrive home.
  • If you attend someone's house as part of your work you should wash your hands before you leave.
  • Increase social distancing to more than 1 metre where possible

8. On the occasions that the use of PPE is appropriate it is important that it is used and disposed of properly.

 

  • Wash hands prior to putting on PPE
  • Fresh PPE should be used for each contact with an infected person
  • When removing masks avoid touching the front of the mask
  • Dispose of PPE in a tied bag within the normal household waste
  • Wash hands after removal of PPE

    9 Members of staff of all organisations and school pupils should stay at home if they have a flu like illness.

     

    10 More detailed guidance has been produced nationally for a variety of staff groups and can be accessed via the following link:

     

    http://www.dh.gov.uk/en/Publichealth/Flu/PandemicFlu/DH_085433|

     

    Questions and Answers

     

    Q1 Do meals on wheels volunteers need to wear PPE if delivering food to a flu patient?

    A1 No, but they should avoid getting within 1 metre of a patient with flu like symptoms.

     

    Q2 I am a social worker in a hospital, should I be wearing PPE?

    A2 Patients in hospital who are thought to have swine flu will be barrier nursed. All staff attending such patients will need to wear PPE. This will be made clear by the hospital staff and PPE will be provided.

     

    Q3 I am a teacher, a pupil in my school has got flu like symptoms, should I wear PPE?

    A3 Any child (or member of staff) with flu like symptoms should be sent home. PPE does not need to be worn.

    Q4 I am a home care worker providing services to someone with flu like symptoms, do I need to wear PPE?

    A4 If you are providing personal care such as washing, dressing bathing etc then you should already be using gloves and an apron as part of standard infection control practice. If the patient has flu like symptoms you should wear a surgical face mask in addition. If you are providing shopping, cleaning etc then you do not need to wear any special PPE. You should wash your hands with soap and water before leaving the house and avoid touching your face with your hands whilst in the house.

     

    Q5 I work providing frontline customer services behind a counter. I deal directly with many members of the public every day, some of whom cough and sneeze. Should I be wearing PPE?

     

    A5 No, there is no need to wear PPE, but your work practices should be reviewed to ensure you have at least 1 metre between you and members of the public.

    Q6 I provide maintenance services to housing association accommodation, I am due to carry out repairs in a house in which someone has flu. Should I wear PPE

     

    A6 If the maintenance is not urgent it may be worth considering rescheduling the work until after the person has recovered. If the work is urgent you should aim to keep at least 1m away from anyone with flu like symptoms. If possible, anyone who is ill should stay in a different room in the house whilst the work is being carried out. You should not touch your face with your hands whilst in the house. You should wash your hands with soap and water before leaving the house. You do not need to wear PPE.

     

    Signs And Symptoms Of Flu

    (taken from Pandemic Flu – Guidance for Businesses1)

     

    It is likely that the signs and symptoms of pandemic flu will be similar to those of seasonal flu, but they may be more severe and cause more serious complications.

    The most significant symptoms are the sudden onset of:

     

    • fever
    • cough or shortness of breath.

     

    Other symptoms may include:

     

    • headache
    • tiredness
    • chills
    • aching muscles
    • sore throat
    • runny nose
    • sneezing
    • loss of appetite.

     

    The incubation period (time between contact with the virus and the onset of symptoms)

     

    The range is from one to four days, though for most people it will be two to three days.

     

    The infectious period (how long you are infectious to others)

     

    People are most infectious soon after they develop symptoms. They can continue to spread the virus, for example in coughs and sneezes, for up to five days (seven days in children). People become less infectious as their symptoms subside, and once symptoms are gone, they are considered no longer infectious to others.

    1 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/

    PublicationsPolicyAndGuidance/DH_097137

      

    Guidance On The Use Of Face Masks

    (taken from Pandemic Flu – Guidance for Businesses1)

     

    Broadly speaking, the only circumstances where face masks may play a part in reducing the risk of infection would be a situation where a healthy individual was unavoidably in close (less than 1 metre) contact with an individual with symptoms consistent with a flu like illness

     

    If close proximity (less than a metre) with an individual with symptoms consistent with a flu like illness is inevitable, then consideration might be given to using a face mask. If face masks are worn, staff must follow the procedures for their safe use, paying particular attention to how they are both removed and disposed of. Staff may expose themselves to additional risk of infection if they fail to use or dispose of face masks correctly. The use of a face mask must not decrease the strict application of other, more relevant, infection control measures.

     

    Without appropriate advice on the proper use of face masks, there is a risk of users contaminating themselves from the outside of the mask after use.

    General Advice On The Use Of A Face Mask

     

    Putting on a face mask

     

    A face mask should be put on before coming into contact with an individual with symptoms consistent with a flu like illness. Hands should be washed thoroughly before handling the mask.

     

    • secure ties or elastic bands at middle of head and neck.
    • fit flexible band to the bridge of the nose. 
    • fit snug to face and below chin.

    Removing a face mask

     

    The face mask should be removed once there is no longer any likelihood of close contact with an individual with symptoms consistent with a flu like illness. Once removed, the mask should be bagged and may be disposed of in domestic waste. Hands should be washed thoroughly after the mask has been removed and disposed of.

     

    • assume that the front of the face mask is contaminated.
    • untie or break the bottom ties, followed by the top ties or elastic, and remove the mask by handling the ties only.
    • discard appropriately.
    • Wash hands thoroughly after touching the mask.

     

    Other points to keep in mind

     

    Face masks should:

     

    • cover the nose and mouth
    • not be allowed to dangle around the neck after or between each use
    • not be touched once put on
    • be worn once only and then discarded.

     

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