Use of Personal Protective Equipment (PPE) for Massage Therapists

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COVID-19 Updates

for the Massage Profession

By Karrie Osborn

The use of personal protective equipment (PPE) will be central to moving forward and reopening your practice when the time comes. There is currently a shortage of PPE, with most supplies being redirected—rightly so—to frontline workers and health assistance staff (nursing homes, home health aides, etc.) who are still operating without the proper supply of equipment they need to work safely. ABMP believes it’s professionally unethical to divert supplies from this delicate supply chain for non-emergency equipment requests at this time. Consider other options for face coverings for you and your clients in the interim.

Following is more information about PPE from the Centers for Disease Control and Prevention (CDC). For ABMP's full overview of guidelines and considerations, go to www.abmp.com/back-to-practice.

Facial Protection

There are three types of facial protection, as defined by the CDC:

1. Cloth face covering. “Textile (cloth) covers that are intended to keep the person wearing one from spreading respiratory secretions when talking, sneezing, or coughing. They are not PPE, and it is uncertain whether cloth face coverings protect the wearer.”

2. Face mask. “Face masks are PPE and are often referred to as surgical masks or procedure masks. Use face masks according to product labeling and local, state, and federal requirements. FDA-cleared surgical masks are designed to protect against splashes and sprays and are prioritized for use when such exposures are anticipated, including surgical procedures.”

3. Respirator. “A respirator is a personal protective device that is worn on the face, covers at least the nose and mouth, and is used to reduce the wearer’s risk of inhaling hazardous airborne particles (including dust particles and infectious agents), gases, or vapors. Respirators are certified by the CDC/National Institute for Occupational Safety and Health, including those intended for use in health care.”

• The much-talked-about N95 face mask is in this category and is necessary, and currently scarce, equipment for those treating COVID-19 patients in medical settings.

• In a massage or bodywork setting, if a client is asymptomatic but unknowingly has COVID-19, then wearing an N95 face mask should protect a therapist. However, N95 masks are not available to the general public at this time.

Gloves

Nonsterile, disposable gloves, which are used for routine patient care in health-care settings, are appropriate for use in your facility. Gloves can be used to make taking payments safer for clients and practitioners. You might also consider using them during sanitation protocols and if administering any facial work during your sessions with clients.

Gowns

Disposable gowns are used to protect health-care providers when working with patients in isolation, when delivering aerosol-generating procedures, and when delivering high-contact patient care activities like dressing, bathing, or transferring patients.

For hands-on modalities, having a standard uniform top, or scrub-like attire that can be changed between clients is a logical approach while working with clients during this time.

Eye Protection

For health-care providers, this category would include goggles and face shields. According to the CDC, “Personal eyeglasses and contact lenses are NOT considered adequate eye protection.” If using eye protection in a massage or bodywork setting, remove the goggles before leaving the client room or care area. According to the CDC, “Reusable eye protection (e.g., goggles) must be cleaned and disinfected according to manufacturer’s reprocessing instructions prior to re-use. Disposable eye protection should be discarded after use unless following protocols for extended use or reuse.”

“Donning and Doffing” of PPE

The value of wearing PPE is only as good as the protocols and quality control around putting it on and taking it off. The CDC offers very regimented guidance on these procedures. Following are some aspects of those protocols to be aware of:

• Per the CDC, a reusable cloth mask should be washed after each wearing, whether that’s per client or per day. Have several cloth masks available for use throughout the day for yourself and clients.

• Once your face covering or face mask is on, don’t touch it. According to the CDC, if you must touch or adjust your cloth face covering, you should perform hand hygiene immediately before and after.

• When you take off your mask, fold it in half to contain the inner secretions and deposit it into the lidded laundry bin, if you aren’t able to wash it immediately. These can be washed and dried with other laundry.

• Protocols for reusing single-use surgical masks are crisis-based; health-care workers are storing their masks in paper bags and then reusing them. Conserve any PPE you might have stored in your practice and reuse until supply chains return to normal. This advice from the Food and Drug Administration (FDA) gives governance on PPE conservation strategies.

Additional PPE Information

• Here are CDC guidelines for cleaning PPE

Here is your risk, with and without wearing PPE: It is important to understand the risks you are taking, even when wearing PPE. The CDC offers this risk assessment with various PPE scenarios, and assuming that health-care personnel are working with COVID-19 patients.

• PPE for employees: Guidelines from the Occupational Safety and Health Administration state that employers are obligated to provide their workers with PPE needed to keep them safe while performing their jobs. Find the document here.

Here is information from the CDC on how to make a mask.

This is information you can share with clients regarding the use of homemade masks and directions on how to easily make your own. Make sure homemade face masks cover both your nose and mouth in alignment with updated CDC guidelines.

For more information, visit the CDC at www.cdc.gov/coronavirus/2019-nCoV/index.html.

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Comments

I like how the information gave me how to make the mask and additional information by just clicking on the highlight give a lot more details

The mask and gloves I can understand, the way I massage they eyewear and the surgical dress would get in the way. I wear glasses and I wear short sleeves when I massage

I have read reports that state the COVID-19 virus may have circulated though heating and A/C ducts. If this is so wouldn't some extra filtering be necessary for individual treatment rooms?

I ordered an air purifier for my small treatment room. I also plan on trying to buy a far UV-c sanitizing unit. I just hope I can afford it. The hospital grade ones are thousands of dollars.

Thank you, excellent article.

One thing that isn't really clear from the article: Cloth masks are inferior protection. They don't protect the wearer, but may prevent the spread to others, per the CDC. The reason they are being promoted is that real PPE masks, like the N95 ones, are very scarce right now. For protection of BOTH the client and practitioner, it is essential that both people wear masks if they are cloth.

I recently purchased a hand held forehead thermometer for future use.

At some point when larger events (stage 4) in California becomes a reality, we massage therapists (stage 3).

The guidelines are very helpful. Because I purchased my N95 masks back in February, it is also good to know the cleaning protocol on cloth N95 masks.

Will I need to wear disposable gloves for all massages?