Ebola-specific guidance on properly donning and removing personal protective equipment

Haymarket Media

October 6, 2014

4. Slip on gloves
Extend to cover wrist of isolation gown

1. Put on gown

Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back

Fasten in back of neck and waist

5. Remove contaminated gloves using this sequence

Grasp outside of glove with opposite gloved hand; peel off

Hold removed glove in gloved hand

Slide fingers of ungloved hand under remaining glove at wrist

Peel glove off over first glove

Discard gloves in waste container

3. Wear goggles or face shields

Place over face and eyes and adjust to fit

7. Safely remove contaminated personal protective gowns

Unfasten ties

Pull away from neck and shoulders, touching inside of gown only

Turn gown inside out

Fold or roll into a bundle and discard

2. Protective masks or respirators

Secure ties or elastic bands at middle of head and neck

Fit flexible band to nose bridge

Fit snug to face and below chin

Fit-check respirator

6. Properly take off goggles and face shields

To remove, handle by head band or ear pieces

Place in designated receptacle for reprocessing or in waste container

8. Take off protective masks or respirators

Do not touch

Grasp bottom, then top ties or elastics and remove

Discard in waste container

Perform hand hygiene immediately after removing all PPE

New guidelines for clinicians treating patients suspected of Ebola

The enhanced guidance is centered on three principles: 1) all healthcare workers undergo rigorous training and are practiced and competent with PPE, including putting it on and taking it off in a systemic manner; 2) no skin exposure when PPE is worn; 3) all workers are supervised by a trained monitor who watches each worker putting PPE on and taking it off.

New PPE suggested for handling Ebola

Double gloves

Boot covers that are waterproof and go to at least mid-calf or leg covers

Single-use fluid resistant or impermeable gown that extends to at least mid-calf or coverall without integrated hood

Respirators, including either N95 respirators or powered air purifying respirator (PAPR)

Single-use, full-face shield that is disposable

Surgical hoods to ensure complete coverage of the head and neck

Apron that is waterproof and covers the torso to the level of the mid-calf (and that covers the top of the boots or boot covers) should be used if Ebola patients have vomiting or diarrhea

Goggles no longer recommended

Goggles are no longer recommended as they may not provide complete skin coverage in comparison to a single-use, disposable full-face shield. Additionally, goggles are not disposable, may fog after extended use, and healthcare workers may be tempted to manipulate them with contaminated gloved hands.

The Centers for Disease Control and Prevention (CDC) is tightening previous infection control guidance for healthcare workers caring for patients with Ebola, to ensure there is no ambiguity.

The guidance focuses on specific personal protective equipment (PPE) health care workers should use and offers detailed step by step instructions for how to put the equipment on and take it off safely.

The type of personal protection equipment (PPE) used will vary based on the level of precautions required, such as standard and contact, droplet or airborne infection isolation precautions.

These tips from the CDC demonstrate how to safely put on and remove protective equipment used in treating patients suspected of infectious diseases such as Ebola.

Updated 10/22/14. Information courtesy of the U.S. Centers for Disease Control and Prevention. Compiled by Brianne Aiken, Hannah Dellabella, and Nicole Blazek.

Slideshow

4. Slip on gloves