National guidance on the appropriate use of PPE has been produced and adapted for RCR Fellows and members working in imaging and oncology services on our posters. We are aware in these times of great challenge that the appropriate use of PPE is a source of significant anxiety. The further guidance that follows aims to address some of the issues and concerns expressed by RCR Fellows and members.
The nature of PPE required depends on the background prevalence of COVID-19, whether the procedure being performed is aerosol generating (AGP) or if it is being performed in areas where AGPs are common. Please see the current list of PHE-recognised AGPs and information from Health Protection Scotland
The national guidance was updated on 27 April 2020 to include a recognition of individual and organisational risk assessment at local level to inform the use of PPE. Where there is concern of increased risk in performing a particular procedure in a patient at high risk of COVID-19 positivity, appropriate PPE should be requested and used. Naso-enteric tube insertions and image-guided lung biopsies, for example, are not nationally recognised AGPs, but Fellows and members should assess on a case-by-case basis whether there are specific features that would be judged as representing an increased risk.
Depending on the nature of the procedure, asking the patient to wear a mask during the procedure might be of benefit where feasible. Screening patients prior to the procedure, e.g. by temperature and symptom check lists, can be deployed to add to information on local background COVID-19 risk.
Fellows and members should, of course, also follow locally agreed policies in respect of the application of national guidance.