Tier 1 PPE - current advice
Eye protection is no longer required for Tier 1 PPE. This applies to patient-facing healthcare workers who are providing care and/or treatment to patients assessed as low risk or no risk for coronavirus (COVID-19), against the clinical criteria for coronavirus (COVID-19).
This advice replaces the advice in Guide to the conventional use of PPE published on 21 October 2020.
Please note the Guide to the conventional use of PPE document is currently being updated.
Updated Conventional Use of PPE guide
The Guide to Conventional use of PPE has been updated as of 21 October 2020;
- Tier 0 is currently not applicable.
- Tier 1 – No change.
- Tier 2 – The definition of Tier 2 has been redefined. It is now only applicable to health care workers providing care to a person who is suspected to have coronavirus (COVID-19) (excluding suspected patients where an aerosol generating procedure is performed and/or there is a risk of aerosol generating behaviours).
- Tier 3 – The definition of Tier 3 has been expanded to include all scenarios where care is provided to probable and confirmed coronavirus (COVID-19) patients, regardless of the amount of time in contact.
A probable coronavirus (COVID-19) patient means a person who has a compatible clinical illness and meets one or more of the following epidemiological criteria.
In the 14 days prior to illness onset:
- Was a close contact of a confirmed or probable case
- Travelled internationally
- Lived in an area where outbreaks are present, including aged care
- Lived in or travelled through a geographically localised area with elevated risk of community transmission, as defined by public health authorities
Where a patient’s history cannot be obtained, they should be considered as a probable coronavirus (COVID-19) case until further screening information can be obtained.
A suspected coronavirus (COVID-19) patient means a person awaiting the results of a test, where they may have symptoms that could be consistent with coronavirus (COVID-19) but no epidemiological risk factors.
Download the updated Guide to the conventional use of PPE (Word).
All infection prevention and PPE guidance is currently being updated.
- Health care workers must wear a N95/P2 respirator
- at all times when providing care to probable and confirmed coronavirus (COVID-19) patients, regardless of the amount of time in contact.
- undertaking an aerosol generating procedure (AGPs) on a person with clinically suspected, probable or laboratory confirmed coronavirus (COVID-19).
- providing care to a person with suspected coronavirus (COVID-19) and there is a risk of aerosol generating behaviours.
- Use of N95/P2 respirators are not required for healthcare workers
- undertaking surgery or AGPs on patients who are not suspected, probable or confirmed to have coronavirus (COVID19) risk factors (Tier 1 PPE precautions)
- working at a coronavirus (COVID-19) testing site and/or undertaking testing for coronavirus (COVID-19) (Tier 2 PPE precautions)
- patients with aerosol generating behaviours who are not confirmed, probable or suspected of coronavirus (COVID-19) (Tier 1 PPE Precautions).
- If the risk of bodily fluid splash is low, staff may wear a non-fluid resistant P2/N95 respirator with a face shield.
- Do not use P2/N95 respirators with a valve. The air you exhale is likely to not be filtered and may expose other healthcare workers and patients.
- Health care workers who are directly involved in treating patients are required to wear eye protection. Eye protection options include; a face shield (where practical), goggles or safety glasses.
- Reusable face shields should be chosen over single-use face shields, where possible. For reusable face shields, a process needs to be in place to ensure appropriate decontamination and storage between uses (i.e. meal breaks) and at the end of a shift/use.
- All staff must wear (at a minimum) a level 1 or type 1 surgical mask while at work. This now includes non-public facing staff.
- Do not use cloth masks at work.
- Keep staffing in high-risk areas to the minimum required to provide appropriate care and ensure patient safety.
- Wherever possible, avoid situations where other staff attend these areas and/or use critical PPE (i.e. P2/N95 respirators).
- Unless damp or soiled, staff may wear a surgical mask, P2/N95 respirator for up to four hours.
- Isolation gowns may be used for extended periods in specific cohorting environments.
- Single-use goggles and face shields can be worn for an entire shift, if there is shortage of these items. However, eye protection must be replaced after assisting with an aerosol generating procedure.
- Where single-use face masks/face shields/goggles are used for extended periods and are needed to be removed to eat and/or drink, hand hygiene and sanitising should be maintained.
- For reusable face shields a process needs to be in place to ensure appropriate decontamination.
- Remove and dispose of all items before going on a break and replace before resuming work.
- Change gloves between every patient interaction.
Read Coronavirus disease 2019 infection prevention and control guidelines for more on extended use.
For health service PPE supply enquiries, please contact the following:
|Service type||Primary source of PPE|
|GPs, private allied health, community pharmacies||Private suppliers. Where no local commercial supply is available please contact your local Primary Health Network|
|NDIS||The Commonwealth Department of Health: NDISCOVIDPPE@health.gov.au|
|Private aged care services||The Commonwealth Department of Health: email@example.com|
|Private hospitals||Private suppliers|
Public Hospitals can request PPE through the Zycus online ordering portal. Other DHHS-funded services can request PPE through Covid19PPErequest@dhhs.vic.gov.au
What is the correct PPE use and when should PPE be used?
Take a look at our Guide to the conventional use of PPE (Word).
We also have other resources:
Further advice can be found in the COVID-19 infection control guidelines - Version 5.0 - 26 October 2020 (Word).
Infection control posters and signage for workplaces are also available:
What is the current advice on use of masks by the general population?
See the Chief Health Officer’s latest for Victorian communities advice.
Where can GPs gain access to gown supplies?
If you are having trouble sourcing single use fluid repellent gowns from your normal supplier, there are steps to consider:
Do I need to wear full PPE when examining a patient with an upper respiratory tract infection?
The current clinical criteria for testing for coronavirus (COVID-19) include an acute respiratory tract infection (for example, cough, sore throat, shortness of breath, runny nose or anosmia). For anyone who meets these clinical criteria, full PPE will be required to examine the patient.
Can we wear the same PPE and swab multiple people?
The use of some PPE can be extended for sessions such as swabbing multiple people in a testing clinic. Masks, protective eye wear and gowns can be used for an extended period in these circumstances.
Gloves must be changed, and hand hygiene performed between each patient. Masks may be worn for up to 4 hours or unless damp or soiled. Goggles and gowns may be used for a similar period but must be replaced if they become soiled.
When single-use PPE is removed it must be disposed of and not reused. If reusable, it must be cleaned and disinfected before reuse.
- Posters with the correct technique for how to put on and take off your PPE:
- A video created by the Melbourne Health demonstrates the use of Personal Protective Equipment (PPE) for contact and droplet precautions.
- Airborne and contact precautions – Gown and gloves removed separately (PDF)
- Airborne and contact precautions – Gowns and gloves removed together (PDF)
- Droplet and contact precautions - Gown and gloves removed separately (PDF)
- Droplet and contact precautions - Gowns and gloves removed together (PDF)
- Ensure that you are using the gowns in accordance with published guidance.
- Consider extending the use of the gowns that you have (so long as you believe it is reasonable and safe to do so).
- Consider using a reusable non fluid repelling cloth gown covered by a plastic single use apron.
- For low risk situations, consider using a plastic single use apron and bare below the elbows, with associated hand and forearm hygiene.
- Consider use of fluid repellent coveralls, ensuring that you are familiar with safe donning and doffing procedures.
- Consider use of non-fluid repellent, reusable coveralls in association with plastic single use apron, with safe donning and doffing procedures.
- Coronavirus (COVID-19) - Disposing clinical waste (PDF) - this fact sheet explains how to manage clinical waste from coronavirus (COVID-19), and arrange for collections in various workplace settings.