Table 5.

What PPE should be worn, and what steps done, by healthcare workers in different areas of the patient pathway (prehospital, emergency room, inpatient ward, OR, outpatients)

Sites	Prior to COVID-19 pandemic		During a COVID-19 pandemic	Specific advice/important knowledge
	No history of epidemic exposure	Epidemiological exposure history
On-site first aid	Level one	Level two	Level two	Beware: all body fluids can contain COVID-19 virus (vomit, urine, blood, sputum) When in a pandemic, all patients are suspected of having COVID-19
Ambulance	Level one	Level two	Level two	Beware: the ambulance environment receives a high level of aerosol Negative pressure ambulances are preferred
Emergency room	Level one	Level two	Level two	Test for COVID-19 ASAP CT scan chest for all (appearances of COVID-19 are different to traumatic wet lung) Infection staff needed as part of the trauma team
Patient transfer in hospital	Level one	Level two	Level two	Use special transfer, a special channel and a special lift
Operating room	Level one	Level two	Level three	Severe COVID-19 is a relative contra indication to emergency orthopedic surgery and critical COVID-19 is an absolute contra indication Level 3 PPE for all staff except runners who are level-two Label door with COVID-19 Minimal staff numbers in the OR Conversion of a positive pressure to a negative pressure of − 5 Pa should be confirmed prior to starting surgery All patients should have masks if awake or exhaust filters if under general anesthesia Remove the smoke from electrocautery quickly. Reduce irrigation. Minimize splashing of the patient’s body fluid Hand disinfection is done before removing PPE
Isolation wards	Level two	Level two	Level two	Beware: a high level of aerosol when performing high-risk procedures such as sampling from respiratory tract, intubation, tracheotomy, CPR, and etc., Level three PPE is required
General wards	Level one	Level one	Level one	Pay attention to body temperature, respiratory symptom, and screening when necessary Small probability that incubation period may be as long as 24 days
Outpatients	Level one	Level two	Level two	Online outpatient clinic is preferred Pay attention to body temperature, respiratory symptom and epidemiological exposure history Pay attention to the possibility of positive viral etiology test results in patients recovered from COVID-19