Personal Protective Personal Protective EquipmentEquipment

(PPE)(PPE)

Personal Protective Personal Protective EquipmentEquipment

Gloves – protect handsGloves – protect handsGowns/aprons – protect skin Gowns/aprons – protect skin

and/or clothing and/or clothing Masks and respirators– protect Masks and respirators– protect

mouth/nose mouth/nose Goggles – protect eyesGoggles – protect eyesFace shields – protect face, Face shields – protect face,

mouth, nose, and eyesmouth, nose, and eyes

GlovesGloves

Glove UseGlove Use

Limit opportunities for “touch Limit opportunities for “touch contamination” - protect yourself, contamination” - protect yourself, others, and the environmentothers, and the environmentDon’t touch your face or adjust PPE Don’t touch your face or adjust PPE

with contaminated gloveswith contaminated glovesDon’t touch environmental surfaces Don’t touch environmental surfaces

except as necessary during patient except as necessary during patient carecare

Glove Use (cont)Glove Use (cont)

Change glovesChange glovesDuring use if torn and when During use if torn and when

heavily soiled (even during use on heavily soiled (even during use on

the same patient)the same patient)

After use on each patientAfter use on each patient

Eye ProtectionEye Protection

GogglesGoggles

Face ShieldsFace Shields

Eye ProtectionEye Protection

Goggles – protect eyesGoggles – protect eyesShould fit snuggly over and around Should fit snuggly over and around

eyeseyes

Personal glasses not a substitute Personal glasses not a substitute

for gogglesfor goggles

Antifog feature improves clarityAntifog feature improves clarity

GownsGowns

GownsGowns

MasksMasks

MasksMasks

Masks – protect nose and mouthMasks – protect nose and mouthShould fully cover nose and mouth Should fully cover nose and mouth

and prevent fluid penetrationand prevent fluid penetration

Respiratory ProtectionRespiratory Protection

Purpose – protect from inhalation of Purpose – protect from inhalation of

infectious aerosols (e.g., infectious aerosols (e.g.,

Mycobacterium tuberculosis (TB))Mycobacterium tuberculosis (TB))

Respiratory protection equipment Respiratory protection equipment

varies depending on the degree of varies depending on the degree of

protection requiredprotection required

High Particulate Filter High Particulate Filter Masks (N95 / P2)Masks (N95 / P2)

Half Face RespiratorHalf Face Respirator

Powered Air Purifying Powered Air Purifying RespiratorRespirator

Powered Air Purifying Powered Air Purifying RespiratorRespirator

Elements of a Elements of a Respiratory Respiratory

Protection ProgramProtection Program

Fit testingFit testing

TrainingTraining

Fit checking before useFit checking before use

Key Points About PPEKey Points About PPE Don before contact with the patient, Don before contact with the patient,

generally before entering the roomgenerally before entering the room

Use carefully – don’t contaminate Use carefully – don’t contaminate self or othersself or others

Remove and discard carefully, either Remove and discard carefully, either at the doorway or immediately at the doorway or immediately outside patient room; remove outside patient room; remove respirator outside roomrespirator outside room

Immediately perform hand hygieneImmediately perform hand hygiene

Sequence* for Donning Sequence* for Donning PPEPPE

Gown firstGown first

Mask or respiratorMask or respirator

Goggles or face shieldGoggles or face shield

GlovesGloves

*Combination of PPE will

affect sequence – be practical

How to Don a GownHow to Don a Gown

Select appropriate type Select appropriate type and sizeand size

Opening is in the backOpening is in the back Secure at neck and Secure at neck and

waistwaist If gown is too small, use If gown is too small, use

two gownstwo gowns Gown #1 ties in frontGown #1 ties in front Gown #2 ties in backGown #2 ties in back

How to Don a GownHow to Don a Gown

Select appropriate type Select appropriate type and sizeand size

Opening is in the backOpening is in the backSecure at neck and Secure at neck and

waistwaist If gown is too small, If gown is too small,

use two gownsuse two gowns Gown #1 ties in frontGown #1 ties in front Gown #2 ties in backGown #2 ties in back

How to Don a How to Don a Particulate RespiratorParticulate Respirator

Select a fit tested Select a fit tested respiratorrespirator

Place over nose, mouth Place over nose, mouth and chinand chin

Fit flexible nose piece Fit flexible nose piece over nose bridgeover nose bridge

Secure on head with Secure on head with elasticelastic

Adjust to fitAdjust to fit

HowHow to Don a Particulate to Don a Particulate Respirator (cont)Respirator (cont)

Perform a fit check – Perform a fit check – Inhale – respirator should collapseInhale – respirator should collapseExhale – check for leakage around Exhale – check for leakage around

faceface

How to Don Eye and How to Don Eye and Face ProtectionFace Protection

Position goggles over Position goggles over eyes and secure to the eyes and secure to the head using the ear head using the ear pieces or headbandpieces or headband

Position face shield over Position face shield over face and secure on face and secure on brow with headbandbrow with headband

Adjust to fit comfortablyAdjust to fit comfortably

How to Don GlovesHow to Don Gloves

Don gloves lastDon gloves lastSelect correct Select correct

type and sizetype and size Insert hands into Insert hands into

glovesglovesExtend gloves Extend gloves

over isolation over isolation gown cuffsgown cuffs

PPE SafetyPPE Safety

Keep gloved hands away from Keep gloved hands away from

faceface

Avoid touching or adjusting other Avoid touching or adjusting other

PPEPPE

Remove gloves if they become Remove gloves if they become

torn; perform hand hygiene torn; perform hand hygiene

before donning new glovesbefore donning new gloves

Limit surfaces and items touchedLimit surfaces and items touched

““Contaminated” and Contaminated” and “Clean” Areas of PPE“Clean” Areas of PPE

Contaminated – outside frontContaminated – outside frontAreas of PPE that have or are likely to Areas of PPE that have or are likely to

have been in contact with body sites, have been in contact with body sites, materials, or environmental surfaces materials, or environmental surfaces where the infectious organism may residewhere the infectious organism may reside

Clean – inside, outside back, ties on Clean – inside, outside back, ties on head and backhead and back

Areas of PPE that are not likely to have Areas of PPE that are not likely to have been in contact with the infectious been in contact with the infectious organismorganism

Sequence for Removing Sequence for Removing PPEPPE

GlovesGloves

Face shield or gogglesFace shield or goggles

GownGown

Mask or respiratorMask or respirator

Where to Remove PPEWhere to Remove PPE

At doorway, before leaving At doorway, before leaving

patient room or in anteroompatient room or in anteroom

Remove respirator outside Remove respirator outside

room, after door has been room, after door has been

closedclosed

How to Remove Gloves How to Remove Gloves (1)(1)

Grasp outside Grasp outside edge near wristedge near wrist

Peel away from Peel away from hand, turning hand, turning glove inside-outglove inside-out

Hold in opposite Hold in opposite gloved handgloved hand

How to Remove Gloves How to Remove Gloves (2)(2)

Slide ungloved Slide ungloved finger under finger under the wrist of the the wrist of the remaining gloveremaining glove

Peel off from Peel off from inside, creating inside, creating a bag for both a bag for both glovesgloves

DiscardDiscard

RemoveRemove GogglesGoggles oror FaceFace ShieldShield

Grasp ear or head Grasp ear or head pieces with pieces with ungloved handsungloved hands

Lift away from faceLift away from facePlace in designated Place in designated

receptacle for receptacle for reprocessing or reprocessing or disposaldisposal

RemovingRemoving GownGown Unfasten tiesUnfasten ties Peel gown away from Peel gown away from

neck and shoulderneck and shoulder Turn contaminated Turn contaminated

outside toward the outside toward the insideinside

Fold or roll into a Fold or roll into a bundlebundle

DiscardDiscard

Removing a Particulate Removing a Particulate RespiratorRespirator

Lift the bottom Lift the bottom elastic over your elastic over your head firsthead first

Then lift off the top Then lift off the top elasticelastic

DiscardDiscard

AcknowledgementsAcknowledgements

Centre for Disease Control and Centre for Disease Control and PreventionPrevention

Guidance for the Selection and Use of Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Personal Protective Equipment (PPE) in

Healthcare SettingsHealthcare Settings