PPE Use in Healthcare Settings

Adopted by the Orlando Fire Department using guidance from:

Centers for Disease Control&

OCEMS - Office of the Medical Director

• Provide information on the selection and use of PPE in healthcare settings

• Practice how to safely don and doff PPE To be performed during Safety Stand-downand formal training at EMS.

Objectives

Donning of PPE

Includes:• Impermeable Full Body Suit• Inner Gloves• Sleeve Covers• Outer Gloves• SCBA Mask w/ Adapter• P100 Canister/Cartridge

Donning Procedure

1. Perform hand hygiene 2. Step into suit (leave shoes on)3. Zip up suit to neckline4. Put on inner gloves, pull suit sleeves over gloves, and tape5. Put on sleeve covers6. Put on outer gloves (overlapping covers)7. Put on SCBA mask w/ adapter and canister/cartridge8. Pull suit hood over head9. Pull zipper all the way up 10.Place tape across top of the SCBA mask sealing mask to

suit and then down both sides and across the bottom making sure no skin is exposure

Image courtesy of CDC

Step 1 – Perform Hand Hygiene

Step 2 – Step Into Suit (leave shoes on)

Take care to avoid tearing suit.

Step 3 – Zip Up Suit To Neckline

Step 4 – Inner Gloves & Sleeve Covers

• Don inner glove• Suit sleeve should go over the glove

• Apply tape around wrist• Create a tab to enable easy removal

Step 5 – Sleeve Covers

• Don sleeve covers• Covers overlap inner gloves at the wrist

Step 6 – Outer Gloves

• Put on outer gloves

• Gloves should go over sleeve covers

Step 7 – SCBA Mask w/ Canister

• Attach adapter to SCBA mask• Screw canister into adapter• Don SCBA mask assembly

Perform a fit check:Inhale – respirator should collapseExhale – check for leakage around face

Step 8 – Pull Suit Hood Over Head

Step 9 – Pull Zipper All The Way Up

Step 10 – Pull Suit Hood Over Head

Safe PPE Use Considerations

• Keep gloved hands away from face

• Avoid touching or adjusting other PPE

• Remove gloves if they become torn; perform hand hygiene before donning new gloves

• Limit surfaces and items touched

Doffing of PPE

•PPE must be removed in the proper sequence and with extreme care, to prevent inadvertent exposure.

•A basic principle is to touch ONLY “clean to clean” and “dirty to dirty.”

•When possible, utilize a “Buddy” to observe the process and prevent compromises or other procedural breaches.

Removal Procedure1. Remove sleeve covers2. Remove outer gloves (taking care not to contaminate inner gloves)3. Don new, clean, outer gloves4. Decon back of BTU and stretcher5. Remove tape from around partners SCBA mask from the top

pulling down using tabs6. Remove outer gloves (taking care not to contaminate inner gloves)7. Unzip suit8. Remove tape, roll down, and peel away suit including inner gloves9. Step out of suit 10.Perform hand hygiene and don a fresh pair of gloves11.Remove SCBA mask, grasping as far to the rear as possible12.Disconnect canister and discard13.Disconnect adapter, place mask and adapter into 5 gallon bucket

of 10% bleach solution.14.Remove gloves and perform hand hygiene

Step 1 - Remove Sleeve Covers

• Remove sleeve cover (if used)• Grasp outside edge of glove near wrist• Peel away from hand, turning glove inside-out• Hold in opposite gloved hand

Step 2 - Outer Gloves• Grasp outside edge near wrist, peel away from hand, turning glove inside-out

• Hold removed glove in opposite gloved hand• Slide finger under the wrist of the remaining outer glove

• Peel off from inside, creating a bag for both gloves and discard

Steps 3 & 4 – BTU and Stretcher Decon

The following steps address cleaning of the BTU and stretcher:•Don clean outer gloves (staged)•Remove and discard BTU isolation system•Decon BTU patient compartment•Decon stretcher•Return stretcher to BTU

Step 5 – Remove tape from SCBA mask

• Partner will grasp tabs on top piece of tape• Peel tape down to remove

Step 6 - Outer Gloves• Grasp outside edge near wrist, peel away from hand, turning glove inside-out

• Hold removed glove in opposite gloved hand• Slide finger under the wrist of the remaining outer glove

• Peel off from inside, creating a bag for both gloves and discard

Step 7 – Unzip Suit

• Use care to avoid touching clean areas inside of suit

• Peel suit back while opening

Step 8 – Roll Down Suit & Inner Gloves• Remove tape from inner glove.• Tuck, roll down, and peel away suit including inner gloves

Step 9 – Step Out Of Suit

Remove inner glove

Step 10 – Perform Hand Hygiene& Don Fresh Gloves

Image courtesy of CDC

Step 11 – Remove SCBA Mask

•Remove goggles, grasping as far to the rear as possible

Step 12 – Disconnect canister, discard

Step 13 – Disconnect adapter• place SCBA mask and adapter into bleach bucket

Step 14 – Remove Gloves &Perform Hand Hygiene

Image courtesy of CDC

Final Thoughts

•PPE is available to protect you from exposure to infectious agents in the healthcare workplace

•Know what type of PPE is necessary for the duties you perform and use it correctly