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Table 1 Sars-CoV-2 related personal protection management. Adapted from the WHO guidance for rational use of personal protective equipment for COVID-19 [6]. FFP2/3 = Filtering Facepiece Particles. aThe screening procedure refers to prompt identification of patients with signs and symptoms of COVID-19. b AGP: tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy.c: This category includes the use of no-touch thermometers, thermal imaging cameras, and limited observation and questioning, all while maintaining a spatial distance of at least 1 m. d: the number of visitors should be restricted. If visitors must enter a COVID-19 patient’s room, they should be provided with clear instructions about how to put on and remove PPE and about performing hand hygiene before putting on and after removing PPE; this should be supervised by a health care worker

From: Recommendations from the Italian Society of Pediatric Orthopaedics and Traumatology for the management of pediatric orthopaedic patients during the COVID19 pandemic and post-pandemic period in Italy

Setting (healthcare facilities) Target (personnel or patients) Activity Type of PPE or procedure
Inpatient facilities
Screeninga
Clinical triage for prioritization of care according to severity should be performed in separate area for individuals with symptoms and signs
Health care workers Preliminary screening not involving direct contactc • Maintain physical distance of at least 1 m.
• Ideally, build glass/plastic screens to create a barrier between health care workers and patients.
• No PPE required.
• When physical distance is not feasible and yet no patient contact, use mask and eye protection.
Patients with symptoms suggestive of COVID-19 Any • Maintain physical distance of at least 1 m.
• Provide medical mask if tolerated by patient.
• Immediately move the patient to an isolation room or separate area away from others; if this is not feasible, ensure spatial distance of at least 1 m from other patients.
• Perform hand hygiene and have the patient perform hand hygiene.
Patients without symptoms suggestive of COVID-19 Any • No PPE required.
• Perform hand hygiene and have the patient perform hand hygiene.
Patient room/ward Health care workers Providing direct care to COVID19 patients, in the absence of aerosol generating procedures • Medical mask.
• Gown.
• Gloves.
• Eye protection (goggles or face shield).
• Perform hand hygiene.
Health care workers Providing direct care to COVID19 patients in settings where aerosol generating procedures are frequently in placeb • Respirator N95 or FFP2 or FFP3 standard, or equivalent.
• Gown.
• Gloves.
• Eye protection.
• Apron.
• Perform hand hygiene.
Cleaners Entering the room of COVID-19 patients • Maintain physical distance of at least 1 m.
• Medical mask.
• Gown.
• Gloves.
• Perform hand hygiene.
Visitorsd Entering the room of COVID-19 patients • Maintain physical distance of at least 1 m.
• Medical mask.
• Gown.
• Gloves.
• Perform hand hygiene
Areas of transit where patients are not allowed (e.g. cafeteria, corridors) All staff, including healthcare workers. Any activity that does not involve contact with COVID-19 patients • Maintain physical distance of at least 1 m.
• No PPE required.
• Perform hand hygiene
Laboratory Lab technician Manipulation of respiratory samples.
Specimen handling for molecular testing would require BSL-2 or equivalent facilities.
Handling and processing of specimens from cases with suspected or confirmed COVID19 infection that are intended for additional laboratory tests, such as haematology or blood gas analysis, should apply standard precautions.
• Maintain physical distance of at least 1 m.
• Medical mask.
• Eye protection.
• Gown.
• Gloves.
• Perform hand hygiene.
Administrative areas All staff, including health care workers. Administrative tasks that do not involve contact with COVID-19 patients. • Maintain physical distance of at least 1 m. No PPE required.
• Perform hand hygiene.
Outpatient facilities
Screeninga/triage Health care workers Preliminary screening not involving direct contactc • Maintain physical distance of at least 1 m.
• Ideally, build glass/plastic screens to create a barrier between health care workers and patients.
• No PPE required.
• When physical distance is not feasible and yet no patient contact, use mask and eye protection.
• Perform hand hygiene
Patients with symptoms suggestive of COVID-19 Any • Maintain spatial distance of at least 1 m.
• Provide medical mask if tolerated.
• Perform hand hygiene.
Patients without symptoms suggestive of COVID-19 Any • No PPE required.
• Perform hand hygiene
Waiting room Patients with symptoms suggestive of COVID-19 Any • Provide medical mask if tolerated.
• Immediately move the patient to an isolation room or separate area away from others; if this is not feasible, ensure spatial distance of at least 1 m from other patients.
• Have the patient perform hand hygiene.
Patients without respiratory symptoms Any • No PPE required.
• Perform hand hygiene.
Consultation room Healthcare workers Physical examination of patient with symptoms suggestive of COVID-19 • Medical mask.
• Gown.
• Gloves.
• Eye protection.
• Perform hand hygiene.
Healthcare workers Physical examination of patients without symptoms suggestive of COVID-19 • PPE according to standard precautions and risk assessment.
• Perform hand hygiene.
Patients with symptoms suggestive of COVID-19 Any • Provide medical mask if tolerated.
• Hand hygiene and respiratory etiquette
Patients without symptoms suggestive of COVID-19 Any • No PPE required.
• Have the patient perform hand hygiene.
Cleaners After and between consultationswith patients with respiratory symptoms • Medical mask.
• Gown.
• Heavy-duty gloves.
• Eye protection (if risk of splash from organic material or chemicals).
• Closed work shoes.
• Perform hand hygiene
Administrative areas All staff, including healthcare workers Administrative tasks • Maintain physical distance of at least 1 m
• No PPE required.
• Perform hand hygiene.