Personal Protective Equipment

May, 2007

Learning Objectives

• Demonstrate knowledge of the principles of infection control

• Recognize gaps in infection control infrastructure

• Demonstrate proper selection and use of personal protective equipment

Personal Protective Equipment (PPE)

• When used properly can protect you from exposure to infectious agents

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

Types of PPE

• Gloves

• Gowns

• Masks (surgical and particulate respirator)

• Eye protection (goggles and face shields)

Precaution Levels

**All levels require hand hygiene**

• Standard

Transmission based precautions:• Contact • Droplet • Airborne

Standard Precautions

• Prevent the transmission of common infectious agents

• Hand washing key

• Assume infectious agent could be present in the patient’s – Blood – Body fluids, secretions, excretions– Non-intact skin– Mucous membranes

PPE for Standard Precautions

Wear:• Gloves

• Gowns

• Eye Protection and / or Mask

If:• Touching

– Respiratory secretions– Contaminated items or surfaces– Blood & body fluids

• Soiling clothes with patient body fluids, secretions, or excretions

• Procedures are likely to generate splashes / sprays of blood, body fluids, secretions, excretions

Droplet Precautions

• Prevent infection by large droplets from– Sneezing– Coughing– Talking

• Examples– Neisseria meningitidis– Pertussis– Influenza

Transmission of Influenza VirusesSeasonal

Influenza in Humans

Current Avian Influenza in Humans

Droplet most likely route

possible

Airborne possible at close distances

possible at close distances

Contact possible Most likely

(bird to human), and possible (human to

human)

Droplet PrecautionsTaken in addition to Standard Precautions

• Place patients in single rooms or cohort 3 feet apart

• Wear surgical mask within 3 feet or 1 meter of patient

• Wear face shield or goggles within 3 feet or 1 meter of patient

• Limit patient movement within facility– Patient wears mask when outside of room

Airborne Precautions

Taken in addition to Standard Precautions

• Prevent spread of infection through inhalable particles

• Examples– Tuberculosis– Measles– Varicella– Variola

Airborne Precautions

• Use for confirmed or suspected avian influenza cases

Airborne Precautions for Avian Influenza

• N95 respirator (or equivalent) for personnel– Check seal with each use

• Patient in isolation

• Airborne isolation room, if available– Air exhaust to outside or re-circulated with HEPA

filtration

• Patient to wear a surgical mask if outside of the isolation room

Sequence for Donning PPE

1. Wash hands

2. Gown

3. N95 Particulate respirator

– Perform seal check

4. Hair cover

5. Goggles or face shield

6. Gloves

Sequence for Removing PPE

Remove in anteroom when possible

1. Gloves

2. Hand hygiene

3. Gown (and apron, if worn)

4. Goggles

5. Mask

6. Hand hygiene

Choosing the Appropriate PPE

Avian Influenza

• Currently not easily transmitted human to human

• Routes of transmission to humans not known, cannot rule-out any routes

• Current transmission from poultry to human or human to human for H5N1 requires very close contact

Interviewing - Asymptomatic Exposed Persons and Contacts

• Low-risk activity

• Routine use of PPE not recommended

• Maintain >3 feet distance between interviewer and interviewee

• Use proper hand hygiene– May use hand sanitizer (at least 60% alcohol) if

hands not visibly soiled

Interviewing - Symptomatic Exposed Persons

• Higher risk activity

• PPE recommended in community and healthcare facility– Contact precautions– Droplet precautions– N95 respirator

• In healthcare facility, person should be placed in airborne isolation room

• Maintain a distance > 3 feet if possible

Specimen Collection – Exposed Persons and Birds

• High-risk aerosol-generating procedure

• PPE recommended– Gloves– Gown– Goggles or face-shield– N95 or better respirator

Activities

• Participate in group discussions using the Trainee Guide