PPE FAQs and Guidance from Chief Optometric Adviser

Sent on behalf of the Chief Optometric Advisor
Optometry Practice Services: Guidance for the use of Personal Protective
Equipment (PPE)
On 2 April 2020, the UK Government and NHS leaders from a range of medical and
nursing royal colleges published new guidance about personal protective equipment
(PPE) for NHS teams who are likely to come into contact with patients with
coronavirus. For the first time, the guidelines featured advice for primary care, eye
care practitioners with appropriate guidance regarding the type of PPE required for a
number of clinical scenarios.
Whilst it is important for all practitioners to follow the attached guidance, the prudent
use of resources is essential during this time; therefore, practitioners working with
their local health boards, should only order PPE that is relevant to the examinations
being undertaken, and in a quantity that is proportionate to the number of patients
seen. By following these steps, we can continue to ensure the limited stock is
available to all front line NHS staff to protect both patients and the workforce.
Dear Colleagues,
Optometry Practice Services: Personal Protective Equipment (PPE)
On 2 April 2020, the UK Government and NHS leaders from a range of medical and
nursing royal colleges published new guidance about personal protective equipment
(PPE) for NHS teams who are likely to come into contact with patients with
coronavirus.
The guidance has been agreed by the four Chief Medical Officers and Chief Nursing
Officers and is applicable in all parts of the UK.
For the first time, the guidelines featured advice for primary care, eye care
practitioners. The guidelines state:
Primary care, ambulatory care, and other non- emergency outpatient and other
clinical settings e.g. optometry, dental, maternity, mental health For direct patient
care of possible or confirmed cases (within 2 meters)
Any setting Direct patient/resident care assessing an individual that is not currently
a possible or confirmed case (within 2 meters) Performing an aerosol generating
procedure on an individual that is not currently a possible or confirmed case.
The following link and associated tables provide guidance regarding the type of PPE
required for each clinical scenario, and should be adopted with immediate effect by
all primary eye care practitioners.
https://www.gov.uk/government/publications/wuhan-novel-coronavirusinfectionprevention-and-control
Further advice will follow from local health board Optometric Advisers regarding the
distribution and safe disposal of PPE. The advice will be for all practices remaining

open as part of the health boards agreed cluster service arrangements. Practices
operating outside of the agreed health board agreed cluster service arrangement
would need to make separate arrangements to source and dispose of PPE safely.
Working in reception / communal area with possible or confirmed case(s) and
unable to maintain 2 meters social distance
Rydym yn croesawu derbyn gohebiaeth yn Gymraeg. Byddwn yn ateb gohebiaeth a
dderbynnir yn Gymraeg yn Gymraeg ac ni fydd gohebu yn Gymraeg yn arwain at
oedi.
We welcome receiving correspondence in Welsh. Any correspondence received in
Welsh will be answered in Welsh and corresponding in Welsh will not lead to a delay
in responding.
Please note, whilst it is important for all practitioners to follow the attached guidance,
the prudent use of resources is essential during this time; therefore, practitioners
should only order PPE that is relevant to the examinations being undertaken, and in
a quantity that is proportionate to the number of patients seen. By following these
steps, we can continue to ensure the limited stock is available to all front line NHS
staff to protect both patients and the workforce.
It is imperative that practitioners using PPE understand how to use the equipment
properly and safely. The local health board Optometric Advisers will be available to
provide further information and guidance for optometry practitioners required to use
PPE, and all practitioners should ensure that they have completed the WOPEC
distance learning lecture ‘COVID 19 : A central information point for Optometry
practices in Wales’. The lecture access details will be emailed to all EHEW
practitioners by 9am Monday 6 April 2020.
The documents contained in the following links provides essential information, and
should be read in conjunction with the new guidelines.
1. https://www.gov.uk/government/publications/covid-19-personalprotectiveequipment-use-for-non-aerosol-generating-procedures
2. https://www.gov.uk/government/publications/covid-19-personalprotectiveequipment-use-for-aerosol-generating-procedures
3. https://phw.nhs.wales/topics/latest-information-on-novel-coronaviruscovid19/information-for-healthcare-workers-in-wales/
Coronavirus Q&A – personal protective equipment

Q What is personal protective equipment?
Personal protective equipment (PPE) has been designed to help protect a person
against health or safety risks at work and to prevent the spread of infection from
person to person via a heath or social care professional.
It includes a wide range of items, including safety helmets, gloves, eye protection,
highvisibility clothing, safety footwear and safety harnesses. It also includes
respiratory protective equipment.
PPE should be put on and removed in a specific order. The order for PPE removal is
– gloves, apron or gown, eye protection, surgical facemask or FFP3 respirator. Hand
hygiene must always be performed following removal of PPE.
PPE is important to help stop the spread of coronavirus and to protect frontline
healthcare workers. Coronavirus is spread primarily between people through close
contact and droplets, not by airborne transmission.
Q Are there different types of PPE?
PPE comes in a number of different forms depending on where it is being used, for
example for doctors and nurses, ambulance staff, maternity staff.
Different types of PPE are used, according to the level of risk a person is exposed to
in a particular setting or the procedure they are carrying out. For example, inserting a
tube through a patient's mouth and into their airway and nebuliser treatments – a
machine that delivers medicated mist to the lungs – poses a greater risk of exposure
to the virus.
Q What is the new guidance for PPE in relation to coronavirus?
Updated guidance was published on 2 April 2020, following a rapid review by Public
Health England and the Academy of Medical Royal Colleges.
The update has simplified the guidance in some places and reflects the fact
coronavirus is now widespread in the community, meaning NHS and social care staff

are more likely to care for people with the virus, some of who will not yet have
symptoms.
The guidance states any clinician working in a hospital, primary care or community
care setting who is within two metres of someone with suspected or confirmed
coronavirus should wear PPE – an apron, gloves and a surgical mask, based on the
risk.
Q What are the changes in the new guidance?
Three new tables have been added to clearly explain the PPE required for different
common clinical scenarios – one table for hospitals and one for primary care,
outpatient and community care and one for ambulance and first responders.
A fourth table describes when to use PPE for all patient encounters – not just people
with suspected or confirmed coronavirus – at a time when there is sustained
community transmission and the likelihood of anyone having coronavirus infection is
raised.