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October 16, 2020
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AAP updates interim COVID-19 guidance

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The AAP updated its interim guidance on when and how to test children for SARS-CoV-2 infection and added a new type of mask — the elastomeric mask — to its guidance on personal protective equipment.

New charts can help pediatricians make decisions about when and how to test patients, which tests to use and whether they should be testing in their practice.

Steve Krug, MD, FAAP, chair of AAP’s Council on Children and Disasters and co-author of the PPE guidance, said that the elastomeric mask was not included on the original guidance but is offered as an option now because it offers more protection than other masks, such as the N95.

Steve Krug

“If you can imagine a soldier wearing a gas mask, they look kind of like that,” Krug told Healio. “They are a different type of a mask that can be useful. For example, if you've got a lot of facial hair, the N95 masks really don't fit very well. For certain people with certain face shapes and sizes, they also may not get a very good feel. So, if you're looking for that level of protection, that's where the elastomeric masks may actually be able to better.”

The AAP recommends that health care personnel to be properly trained in the use of N95 and elastomeric masks, but does not recommend that professionals are required to wear them over surgical masks.

“We don’t believe that they need that level of protection,” Krug said.

Although the AAP did not provide new testing guidance, it did add pro and con charts for COVID-19 tests, testing strategies and testing in pediatric offices to help pediatricians make better decisions in performing these assessments. Those charts can be found here.

In addition to children who are symptomatic or who have been in close contact with a confirmed or probable case of COVID-19, the AAP said children also may need to be tested if they are scheduled to have an invasive medical procedure, such as elective surgery. It also recommends testing patients who are suspected or confirmed to have influenza, and to test as soon as possible using either PCR or antigen tests.

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