16 Apr 2020

Seeking change to PPE guidance

The BDA is working with others as part of the AGP Alliance, and alongside organisations such as Fresh Air NHS, the Royal College of Nursing and British Medical Association to take action to ensure that our members are provided with appropriate PPE in all circumstances. This should include provision of FFP3 masks and other suitable PPE when interacting with COVID patients/spending time in indoor spaces with COVID-19 patients. 

Further information:

Aerosol Generating Procedures and wider PPE

The BDA believes that a wider range of procedures should be categorised as Aerosol Generating and makes one specific recommendation in addition to government guidance:

  • The insertion of Nasogastric Tubes (NGT) and Nasojejunal Tubes (NJT) should be treated as Aerosol Generating Procedures (AGP). As a result, any dietitian (or other healthcare professional) asked or required to undertake this role (in any setting where there is a risk of COVID-19 transmission), should be provided with appropriate PPE.

We make this further recommendation based on clinical experience of insertion of NGT/NJTs under adverse conditions such as those prevailing now. It is widely known that insertion of an NGT/NJT induces a cough or sneeze in many patients and that this could generate both droplets and aerosols within the range of 1-2 metres required for proximity to the patient during NGT/NJT insertion.

The BDA's opinion is shared by the British Association for Parenteral and Enteral Nutrition (BAPEN), RCN and the Intercollegiate General Surgery Guidance issued by the Royal Colleges of surgery in the UK and Ireland states that "Naso-gastric tube placement may be an aerosol generating procedure (AGP). AGPs are high risk and full PPE is needed."

Government advice

The government’s most recently updated PPE guidance can be accessed here. This guidance should be regarded as the minimum standard. You can access the tables explaining what equipment is required here:

We are here to help

If you are asked to undertake duties without sufficient PPE, you should refuse to do so and notify your Union Rep or our TU team. You may try to find an alternative healthcare professional with appropriate PPE to complete duties on your behalf. 

Risk assessment

It is also important to risk assess every situation. If direct patient contact can be avoided, it should be, with digital options utilised where possible. The BDA has issued a statement on this topic as well as guidance on using digital technologies to keep you and your patients safe.