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HAZARD ALERT

California’s health care workers must have immediate access to respirators in case of a sudden emergency involving patients who are suspected or confirmed cases of COVID-19.

Cal/OSHA received allegations that some California hospitals do not have respirators immediately available to health care workers for emergency aerosol-generating procedures involving suspected or confirmed COVID-19 patients. Respirators for emergency care have allegedly been unavailable because of inventory control policies that did not ensure immediate on-demand availability of respirators for emergency procedures. While these allegations are still under investigation, they raise serious concerns that require an immediate hazard alert to ensure the availability of respirators when health care workers need them for emergency procedures.

Health care providers cannot implement inventory control strategies that impede immediate access to respiratory protection for health care workers who must respond to sudden emergencies such as cardiac or respiratory arrest in patients who are suspected or confirmed cases of COVID-19.

California’s Aerosol Transmissible Diseases (ATD) Standard (California Code of Regulations title 8 section 5199) requires California hospitals to provide powered air-purifying respirators (PAPRs) and other personal protective equipment for aerosol-generating procedures involving patients who are suspected or confirmed cases of COVID-19. Aerosol generating procedures must be performed in an airborne infection isolation room. For life saving emergency care, where transfer of a patient to an isolation room or obtaining a PAPR would interfere with the successful completion of the procedures, or where PAPRs and/or isolation rooms are not available due to a surge in COVID-19 cases, hospitals must provide approved respirators to, and ensure that such respirators are used by, all employees in the area where the life-saving emergency care is performed. Inventory control measures cannot interfere with immediate availability of respirators for emergency procedures.

June 2020