The Massachusetts Department of Public Health has released “Guidance on Prioritization of PPE in MA“. In the near term, given current supplies, PPE will be prioritized for medical facilities on the front lines. Please submit all requests for PPE via the channels shown on the illustrative diagram. The Commonwealth will coordinate your requests. For hospitals, nursing homes, community health centers, emergency medical services, local public health, and other health facilities, this means to request or report PPE shortages to your regional Health and Medical Coordinating Coalition (HMCC), which are listed below.
Nebulizer treatments As you may know nebulizer treatments are on the CDC’s list of interventions which are “likely to generate higher concentrations of respiratory secretions or aerosols.” (https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html accessed 3/25/2020). In the hospital setting Metered Dose Inhalers may be preferred to decrease the risk of aerosolization. In the office setting some providers have asked patients to perform nebulizer treatments in their automobiles utilizing nebulizer devices which plug into a car 12V auxiliary power outlet (aka car cigarette lighter). Concerns have also been expressed related to patient’s using their nebulizers at home when others at home are susceptible. Some folks have recommended that patients perform the neb treatment outdoors, perform the neb treatment alone in a room with the door closed and windows open, close off the room for 3 hours after the treatment, or use metered dose inhalers. After much searching there does not seem to be a clear answer regarding what to advise patients using home nebulizers.