Guidelines for PPE use as veterinary facilities resume providing normal services

Updated on June 12, 2020

As states begin to transition back to resuming normal services in veterinary facilities, veterinarians should thoughtfully consider personal protective equipment (PPE) usage and needs. Some jurisdictions are requiring that veterinary facilities create a written emergency plan that includes demonstrating how performing non-urgent/elective procedures will not cause the practice to revert to “crisis capacity” standards of care or result in a draw down on federally provided PPE supplies in human healthcare.

Veterinary facilities may be able to rely on PPE order histories as rationale if required to develop a written emergency plan. Alternatively, the CDC has created a spreadsheet and the National Institute for Occupational Safety and Health (NIOSH) has created a smartphone app to help healthcare facilities anticipate their PPE consumption rate and needs.

The CDC COVID-19 online resources includes Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response that gives recommendations for PPE use in companion animal practice during the COVID-19 pandemic. A section on PPE Extended Use and Reuse has been added to this guidance document that provides strategies to optimize PPE supplies and explains differences among facemasks, single-use respirators, and reusable respirators.

To preserve surgical and N95 masks, cloth face coverings may be worn by veterinary personnel when social distancing in the clinic is unable to be maintained.  Cloth face coverings should not replace the appropriate use of N95 masks and eye protection for aerosol-generating procedures.

Employers have the obligation to provide their employees with PPE needed to keep them safe while performing their jobs. The type of PPE required will be based on the risk of being infected or exposed to hazardous materials while working and the job tasks performed that could lead to exposure. In addition, the General Duty Clause, Section 5(a)(1) of the Occupational Safety and Health (OSH) Act, requires employers to provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm.

As restrictions that had been enacted to limit the rate of transmission of COVID-19 begin to ease, a wider range of PPE may again be used in veterinary facilities for a variety of reasons, including but not limited to the following:

  • To prevent contamination of sterile surgical sites (e.g., spays/neuters, orthopedic surgeries)
  • To protect veterinary personnel during aerosol-generating procedures (e.g., dental procedures, endoscopy)
  • To keep from spreading infectious pathogens among patients (e.g., parvovirus)
  • To protect veterinary personnel from zoonotic pathogens that may be transmitted from patients (e.g., psittacosis, salmonella)
  • To protect veterinary personnel from pathogens that may be transmitted from clients and co-workers (e.g., SARS-CoV-2)
  • To comply with ongoing local orders when social distancing cannot be maintained in the work environment (e.g., requirement to wear cloth or other type of face mask)

Guidance has been developed to control personnel exposure to occupational hazards, utilizing a hierarchy to achieve feasible and effective controls. Multiple control strategies may be implemented concurrently, sequentially, or both to minimize exposure. This hierarchy is frequently represented as:

Hierarchy of Controls Chart Image
(adapted from CDC)

Elimination (physically removing the hazard) and substitution (replacing the hazard) are not typically options in the healthcare setting to prevent infectious disease transmission. However, engineering and administrative controls and PPE can often be used to reduce or avoid exposures to transmissible pathogens in healthcare facilities. Prompt detection, effective triage, and isolation of potentially infectious patients are essential control measures to prevent unnecessary pathogen exposures of patients, healthcare personnel (HCP), and visitors in a given facility.

The best way to prevent disease transmission is to use a combination of interventions from across the hierarchy of controls. This results in a greater degree of protection than a single method and provides backup in the event one control intervention fails, becomes less effective, or even unavailable.


This content is not intended or offered, nor should it be taken, as legal or other professional advice. The content on this webpage is subject to frequent updates and revisions. Please make sure you check back regularly and confirm all information with the relevant jurisdiction.

The AVMA provides this content for informational purposes only and not as a substitute for appropriate professional advice based on specific circumstances. You should always consult with your own professional advisors (e.g., attorney, accountant, insurance carrier). AVMA provides the content on this webpage “as is” with no representations or warranties. Any links to third party websites or content implies no endorsement or affiliation.

  

The use of PPE in veterinary medicine for protection of the wearer (e.g., infectious disease) is much less common than the use of PP to protect the patient (e.g., surgery).