IJCS | Volume 33, Nº3, May / June 2020

293 COVID-19 PUTTING ON AND REMOVING PPE FOR CCL PROCEDURES IN PATIENTS WITH SUSPECTED OR CONFIRMED COVID-19 PUTTING ON PPE CCL anteroom 9 Remove any personal items 9 Hair should be fully held back 9 Perform hand hygiene and use 70% alcohol 9 Put on hair cap, covering the ears 9 Put on the facial mask FFP2/N95, fit flexible band to nose bridge and fit snug to face and below chin 9 Put on the goggles and face shield, placing them on top of hair cap and over face and eyes, adjusting to fit 9 Put on shoe covers 9 Put on protective lead apron or similar 9 Put on the impermeable gown 9 Perform hand disinfection with surgical scrubbing 9 Put on the first pair of gloves Procedure room 9 - Put on the impermeable and sterile apron 9 - Put on the second pair of gloves REMOVING PPE Procedure room (after patient has been transferred away) 9 Perform hand hygiene over the second pair of gloves with 70% alcohol 9 Peel off gown and second pair of gloves together and roll inside 9 Discard gown and gloves in a waste container marked with the biological hazard symbol and labeled as ‘COVID-19’ (avoid contact while removing the gown because of the contamination risk) 9 Perform hand hygiene over the first pair of gloves with 70% alcohol 9 Remove hair cap, shoe cover and goggles 9 Perform hand hygiene over the first pair of gloves with 70% alcohol CCL anteroom 9 Remove the first pair of gloves 9 Remove the respiratory PPE (surgical mask, facial shield, FFP2/N95 respirator) 9 Perform hand hygiene with 70% alcohol 9 Remove lead apron or similar 9 Perform proper hand hygiene Figure 3 – Steps for putting on and removing PPE for cardiac catheterization laboratory (CCL) procedures during the COVID-19 pandemic. 4,5,12-14,28 1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-4. 2. Oliveira GMM, Pinto FJ. COVID-19: A Matter Close to the Heart. Int J Cardiovasc Sci. 2020; ahead print. Epub Apr 17,2020. 3. Driggin E, MadhavanMV, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic, J Am Coll Cardiol. 2020 Mar 18, Pii:S0735-1097(20)34637-4 [Epub ahead of print] 4. Welt FGP, Shah PB,AronowHD, BortnickAE, Henry TD, SherwoodMW, et al., from the American College of Cardiology’s (ACC) Interventional Council and the Society of Cardiovascular Angiography and Intervention (SCAI), Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From ACC’s Interventional Council and SCAI. J AmColl Cardiol. 2020; doi: https://doi.org/10.1016/j. jacc.2020.03.031. 5. Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista. (SBHCI). Comunicado n° 04/2020. Posicionamento da Sociedade Brasleira de Hemodinâmica e Cardiologia Intervencionista sobre a Pandemia COVID-19. [Citado em 2020 Apr 30] Disponível em: sbhci.org/post/ comunicado 04-2020 www.sbhci.org.br 6. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China:Summary of a Report of 72314 Cases From the Chinese Center for Disease Control References Author contributions Conception and design of the research: Mariano GZ, Lenke V, Paiva MSM, Oliveira GMM. Acquisition of data: Mariano GZ, Lenke V, Paiva MSM, Oliveira GMM. Analysis and interpretation of the data: Mariano GZ, Lenke V, Paiva MSM, Oliveira GMM. Writing of the manuscript: Mariano GZ, Lenke V, Paiva MSM, Oliveira GMM. Critical revision of the manuscript for intellectual content: Mariano GZ, Lenke V, Paiva MSM, Oliveira GMM. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study isnot associatedwithanygraduationprogram. Mariano et al. Covid-19 and safety in the cath lab Int J Cardiovasc Sci. 2020; 33(3):288-294 Viewpoint