FEDERAL RESOURCES - Cleveland Clinic · FEDERAL RESOURCES 235-G Log Canoe Circle Stevensville, MD...
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FEDERAL RESOURCES 235-G Log Canoe Circle Stevensville, MD 21666 800.892.1099 federalresources.com
Transcript of FEDERAL RESOURCES - Cleveland Clinic · FEDERAL RESOURCES 235-G Log Canoe Circle Stevensville, MD...
FEDERAL RESOURCES 235-G Log Canoe Circle Stevensville, MD 21666 800.892.1099 federalresources.com
PPE is Mission Critical
When providing care to highly infectious patients, PPE is the last line of defense between you and the disease Maintain Situational Awareness:
When others around are wearing PPE, you probably should be too.
U S D e p a r t m e n t o f S t a t e - M E D
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
Course Objective
This course is intended to prepare you to select, don, use and doff personal protective equipment (PPE) for liquid pathogen hazards, such as Ebola Virus Disease (EVD).
While this course will describe protective measures from pathogens, it is not intended to provide pathogen specific information such as symptoms, diagnosis, or treatment.
U S D e p a r t m e n t o f S t a t e - M E D
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
Agenda
45 min lecture
PPE Ensemble Level of Protection Role of the Trained Observer Donning PPE – (CDC Video) Wearing PPE Doffing PPE – (CDC Video) PPE Breach
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Personal Protective Measures
Quarantine Avoidance Engineering Controls Work Practices Administrative Controls Proper PPE Use Proper PPE Donning and Doffing
PPE is one Piece of the Puzzle
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Engineering Controls
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A portable Isolation POD is an example of an Engineering Control.
Staff should still use PPE in conjunction with the ISO POD
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Avoidance U S D e p a r t m e n t o f S t a t e - M E D
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PPE Ensemble
N95 Respirator
Goggles or faceshield
Tyvek Suit Hood or booties may be integrated or separate piece Inner Gloves
Outer Gloves
Boot Covers
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Level of Protection
PPE ensemble provides full body isolation from bodily fluids in the liquid state, including:
Blood Semen Mucus Feces Urine Vaginal secretions Breast milk
Amniotic fluid Cerebrospinal fluid Synovial fluid Sweat Vomit Pericardial fluid
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Level of Protection
Your PPE ensemble is the appropriate level of protection from pathogens spread by contact (direct and indirect) and droplet transmission. EVD is an example of a pathogen spread by contact and droplet transmission. It is not intended to provide protection against airborne pathogens. Measles is an example of disease spread by airborne transmission.
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
U S D e p a r t m e n t o f S t a t e - M E D
Level of Protection
If the PPE Ensemble is intended to provide protection from contact and droplet hazards, but is not intended for airborne hazards… Why do I need a respirator?
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
U S D e p a r t m e n t o f S t a t e - M E D
Droplet Transmission
Droplet Transmission Shown in Red
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Vomit may Spray up to 10 feet
UK Health and Safety Laboratory used ultra violet light to track how far 1 liter of simulated stomach contents can travel.
“Vomiting Larry” test unit
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Surgical PPE is not Sufficient
Gowns are Not Recommended Gowns alone leave skin exposed
Surgical Masks are Not Recommended They do not provide sufficient inward filter. If tested to NIOSH standards, some surgical
masks would rate as an N10
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PPE for CBRN
Your PPE Ensemble, as configured, is not intended for protection against other Hazardous Materials such as Industrial Chemicals, Smoke, Radiological, or Chemical Warfare Agents. Your Tyvek suit will provide resistance to some chemicals and radiological material, but additional respiratory protection is required. Inhalation is this most common form of chemical exposure.
U S D e p a r t m e n t o f S t a t e - M E D
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Role of the Trained Observer
• Observe and assist with donning PPE
• Observe PPE use and patient care
• Observe and direct doffing PPE
Photo Credit: Robert Gay, Associated Press
Dedicated individual to ensure adherence to safe work practices
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Video: PPE Donning Steps
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PPE Stress
• PPE may be cumbersome, making movement more difficult.
• Multiple gloves will compromise manual dexterity.
• Limited vision • Reduced voice
communications
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Physical Stress
PPE Stress
• Personnel may feel claustrophobic
• Concern over potential exposure to a hazard may cause can cause anxiety or emotional stress.
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Psychological Stress
Training is Important
Training and experience in donning, doffing, and operating in PPE are key factors in reducing and adapting to physical and psychological stress.
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Public Perception
Responders wearing PPE need to be cognizant of how their appearance can affect the general public. Use of a protective ensemble may create fear and uncertainty in patients, especially children.
Responders board a crowded aircraft in Level A PPE. Photo Credit Patrick Narvaez/YouTube
U S D e p a r t m e n t o f S t a t e - M E D
Full Body Decontamination
Current CDC guidelines do not recommend decontamination for US health care workers upon exiting the patient treatment area. Doffing of PPE will include hand decontamination between doffing steps
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Decon Considerations
Consider implementing Decon procedures prior to doffing PPE when: • Working in field or uncontrolled environments • Conditions or resources do not allow for patient treatment
area to be cleaned and disinfected • Providing care to patients with “wet” symptoms Implementing and staffing a decon area requires additional training.
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“Wet” Symptoms
DRY Symptoms
WET Symptoms
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Video: PPE Doffing Steps
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U S D e p a r t m e n t o f S t a t e - M E D
PPE Breach
• Self Contact (Adjusting your face piece) • Minor tear (Common in gloves) • Needle puncture • Glove/Boot falls off • Degradation • Loss of Suit Integrity “Blow Out”
• Blow out often happens on rear suit seam • Wearer will likely not see suit damage
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Types of PPE Breaches
PPE Breach U S D e p a r t m e n t o f S t a t e - M E D
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
Example of a PPE Breach, A Glove Tear
Avoiding PPE Breaches
Safe Work Practices
• Wear the correct size suit, or larger • Avoid squatting or stretching • Do not kneel or sit on the ground or other
contaminated surfaces • Avoid or use caution on steps • Use safe work practices when handling
needles and other sharps
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U S D e p a r t m e n t o f S t a t e - M E D
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
PPE Breach
If a PPE Breach is Discovered: • Don’t touch the torn area of PPE • Don’t touch the torn area of PPE
• Often your first instinct • Touching it will likely contaminate the damaged area
• Exit the hot zone • Proceed to Decon (if established) • Doff gear according to protocol • Wash affected area with soap and water or decon solution • If exposed area is a mucous membrane, or eye, flush the area with
generous amounts of water. (Do not use decon solutions) • Take a shower • Report exposure to chain of command
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Groups of 8 Participants Led by Facilitator / Instructor Each participant will practice donning and doffing PPE
PPE Practical Exercises U S D e p a r t m e n t o f S t a t e - M E D
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“Under Pressure you don’t rise to the occasion, you sink to the level of your training”
Enjoy the Conference U S D e p a r t m e n t o f S t a t e - M E D
U N C L A S S I F I E D / F O R O F F I C I A L U S E O N LY
