emerging severe acute respiratory infection(esari)-including … › wp-content › uploads › 2020...

emerging Severe Acute Respiratory

Infection(eSARI)-including MERS and

Covid-2019 (Wuhan)

Personal Protective Equipment (PPE) training

Infection Prevention and Control Team

Infection prevention and Control Team February 2020

Examples eSARI

Previously SARs – CoV

Avian Flu

MERS- CoV

2019- nCoV (Wuhan)

Future emerging Respiratory Viruses

Common clinical Features 2019-nCoV (Wuhan)

Recent relevant 14 day Travel History to mainland China

Contact with a known infectious person

Incubation period usually 2-14 days.

Clinical features can range from asymptomatic, fever, cough/coryza shortness of breath to severe Pneumonia (N.B. fever not always present).

Transmission

Droplet transmission occurs

when the virus travel large

respiratory droplets that people

sneeze, cough, drip, or exhale.

They travel short distances before

settling, usually less than 2m.

These droplets are loaded with

infectious particles.

Mainly transmitted by respiratory droplets or indirect contacts with secretions

Environment

There is evidence for widespread environmental contamination of patient rooms so effective cleaning and decontamination is essential.

Coronaviruses and Influenza are fairly fragile, surviving outside the body 24/48 hours.

They are easily destroyed by detergents and cleaning agents.

Cleaning environmental surfaces with water and detergent and applying commonly used disinfectants (such pericitic acid/DiffX) is effective.

When the patient is discharged a UV clean is recommended.

Waste and linen to follow the clinical infectious waste/linen streams

eSARI PPE

The following slides will cover the safe Donning and Doffing – safety check lists

The process has been kept similar to the VHF/HCID with limited changes which will

be discussed

PPE with FFP3 mask

7

• Scrubs to be worn

underneath (ease of

laundering).

• FFP3 mask

• Face Visor

• Fluid repellent gown

• Gloves

• Tape

Preparing the area - gather all equipment needed

8

Preparing the area; ensure donning/doffing

checklist and staff log sheet available

9

Donning

Ensure staff are fit tested/ remove

jewellery/ tie hair back/ hydrated/wearing

scrubs

1. Hand hygiene- wash and

alcohol gel hands.

2. Put on mask criss-cross band

+ fit check.

10

Donning

3. Put on visor and gloves

11

4. Put on gown - ensure gown is secured

12

Donning

13

Donning

5. Put on second pair of gloves and tape to gown

Ensure you are safe

14

Donning summary

Get yourself ready – remove jewellery, tie hair

Staff member entering the patients room must wear scrubs

underneath the PPE

Prepare the area: PPE, staff log sheet,

Wash and gel hands

Put on the mask & visor

Put on first pair of gloves

Put on long sleeved gown

Put on 2nd pair of gloves and tape to gown

Check this is correct

Complete log sheet

15

1. Unfasten and pull away the gown inside the isolation room and

dispose of it in the clinical waste bin

By doing this, pull away removing the top pair of gloves – gel

remaining gloved hands.

16

2. Remove the visor inside the isolation room pulling it

away from you and placing it in the bin, gel gloved hands

17

3. Remove the remaining pair of gloves inside the

room – Keep your facemask on

18

4. Remove the FFP3 mask outside the isolation room with top band

followed by bottom, bin mask in clinical waste and gel hands. (This can

be removed in the ante- room if there is demarcation but this is not

required for eSARI.

Gel hands and the wash hands with soap

19

Doffing summary

Avoid touching face, eyes, mouth with contaminated

hands/gloves

Gel gloved hands

Remove gown and top gloves, gel gloves hands –

in isolation room

Remove visor and remaining gloves in isolation room

Remove mask, gel hands outside isolation room

Remove bottom gloves- wash hands and follow with

alcohol gel

20

PPE with respirator

21

• Scrubs to be worn

underneath (ease of

laundering).

• Respirator

• Fluid repellent gown

• Gloves

• Tape

Preparing the area - gather all equipment needed

22

Preparing the area; ensure donning/doffing

checklist and staff log sheet available

23

Donning

Ensure staff are fit tested/ remove

jewellery/ tie hair back/ hydrated/wearing

scrubs

1. Hand hygiene- wash and

alcohol gel hands.

2. Continue as per FFP3

protocol regarding gowns and

gloves

24

Donning

Ensure your:

Respirator has a fully

charge battery

Has a filter attached

3. Put on respirator.

Attached the filter and battery

pack using the waist belt.

25

Donning summary

Get yourself ready – remove jewellery, tie hair

Staff member entering the patients room must wear scrubs

underneath the PPE

Prepare the area: PPE, staff log sheet,

Wash and gel hands

Put on first pair of gloves

Put on long sleeved gown

Put on 2nd pair of gloves and tape to gown

Put on the respirator

Check this is correct

Complete log sheet

26

Doffing (you will need a buddy system) 1. Apply hand sanitizer over gloved hands

2. Detach the hood from the battery pack

3. Unfasten the battery pack belt and remove the battery pack

27

Doffing

3. Place the battery pack in a orange clinical waste bag held by the

buddy outside of the door

(The buddy needs to be wearing apron and gloves)

28

4. Unfasten and pull away the gown inside the isolation room and

dispose of it in the clinical waste bin

By doing this, pull away removing the top pair of gloves – gel

remaining gloved hands.

29

5. Clean the respirator tubing with green clinell wipes

30

6. Remove the remaining pair of gloves inside the

room – Keep your respirator on

31

7. Gel hands outside of the room

8. Remove the respirator (from the back away from the face)

9. Place in orange clinical waste bag

10. Gel hands and then wash hands with soap

32

Decontamination of respirator hood

The respirator must be taken in the clinical waste bag to

the sluice and clean with green Clinell® wipes.

For the cleaning process staff must wear apron, gloves and

surgical mask to avoid touching their face whilst cleaning.

After cleaning and removal of PPE staff must wash their

hands with soap and water.

33

Doffing summary

Avoid touching face, eyes, mouth with contaminated

hands/gloves

Gel gloved hands

Remove battery pack in isolation room

Remove gown and top gloves, gel gloves hands –

in isolation room

Clean the Respirator tubing in isolation room

Remove gloves and gels hands in isolation room

Remove respirator, gel hands outside isolation room

Clean respirator in the sluice after use.

34

Don’t panic

If it doesn’t happen in this order, don’t panic.

Remember:

Protect your mucus membranes (eyes, nose and mouth)

Clean your hands

35

Any questions?

36