COVID-19 / Coronavirus Outbreak: Donning and Doffing Personal Protective Equipment (PPE) for Healthcare Providers

Appropriate personal protective equipment (PPE) should be worn when screening patients for COVID19. The PPE package must include:

Gown,
Gloves,
Respirator or medical mask
Eye protection

The following protocol describes the proper procedures for donning and doffing PPE.

1. Follow these steps when donning, or putting on, the PPE:

NOTE: Open shoes are prohibited. Use boot covers if they are available. If available, please use a disposable cap to cover long hair.

Visually inspect the PPE ensemble for any damage.
Slide your arms inside the sleeves of the fluid-resistant, non-sterile disposable isolation gown. You may use a gown with a thumb hole located at the wrist area. Put your thumb through this hole to make sure that there is no visible skin between the sleeves and gloves. Then, tie the gown at the back to secure it around your body.
Hold the N95 respirator mask in the palm of your hands facing down, letting the straps dangle to the floor. Place the respirator mask around your nose and mouth, secure the top strap at the crown of your head and bring the bottom strap below the ears to the base of your neck. Mold the nose piece around the bridge of your nose until it is secure.
Place goggles or a face shield around your eyes and secure them. Make sure the eye protection covers the front and sides of your face. Alternatively, select a surgical mask with a face shield and apply it over your nose and mouth. Cuff the elastic bands around your ears and spread the mask to cover your face from the bridge of your nose to your chin.
Slide latex or nitrile gloves onto your hands, pulling them over the sleeves of your gown. Make sure that your wrists are covered and that no skin is visible.

2. After patient care, you are contaminated and should take the following steps to take off the PPE:

While still in the isolation room, remove your gloves using the glove-to-glove/skin-to-skin technique.
1. Grasp the outside of one glove at the wrist, making sure to not touch your bare skin.
2. Peel the glove away from your body, pulling it inside out.
3. Peel off the second glove by putting your fingers inside the glove at the top of your wrist.
4. Turn the second glove inside out while pulling it away from your body, leaving the first glove inside the second.
5. Dispose of the gloves safely.
Untie your gown strap and pull the gown off carefully, away from your body. Roll off the sleeves, taking care to avoid contaminating yourself. Then, roll the gown up into a ball before disposing of it.
Prior to removing your eye protection, clean your hands by rubbing all hand surfaces with a 70% alcohol hand sanitizer.
Lean forward and gently remove the googles or face shield, avoiding contact with your body.
After leaving the isolation area, take off your mask by grabbing it from behind. Pull the bottom strap off first and then the top strap.
Clean your hands once again with a 70% alcohol hand sanitizer or with a proper handwashing method.

No conflicts of interest declared.

Transcript

Your personal protective equipment or PPE must include a gown, gloves, respirator or medical mask, and eye protection. Keep in mind that open shoes are prohibited, and boot covers should be used if available. Before donning the PPE, visually inspect the ensemble.

Slide your arms inside the sleeves of the fluid-resistant, non-sterile, disposable isolation gown. If using a gown with a thumb hole located at the wrist area, put your thumb through this hole to make sure that there is no visible skin between your sleeves and gloves. Then tie the gown from the back to secure it around your body.

Hold an N95 respirator mask in the palm of your hand facing down, letting the straps dangle to the floor. Place the mask around your nose and mouth. Then secure the top strap at the crown of your head.

Bring the bottom strap below your ears to the base of your neck, and mold the nose piece around the bridge of your nose until it is secure. Place goggles or a face shield around your eyes and secure them, making sure that your eye protection covers the front and sides of your face.

Alternatively, select a surgical mask with a face shield and apply it to your nose and mouth. Cuff the elastic bands around your ears, and spread the mask to cover your face from the bridge of your nose to your chin.

Slide two latex or nitrile gloves on your hands, pulling them over the sleeves of your gown. Make sure that your wrists are covered and there is no visible skin.

After patient care, you are contaminated and should take the following steps to take off the PPE while still in the isolation room. Begin by removing your gloves using the glove-to-glove or skin-to-skin technique. Grasp the outside of one glove at the wrist, making sure not to touch your bare skin. Peel the glove away from your body and pull it inside out.

Peel off the second glove by putting your fingers inside the glove at the top of your wrist. Turn the second glove inside out while pulling it away from your body, leaving the first glove inside the second. Then safely dispose of the gloves.

Next, untie your gown strap and pull the gown off carefully away from your body. Roll off the sleeves, taking care to avoid contaminating yourself. Roll the gown up into a ball before disposing of it.

Before removing your eye protection, clean your hands by rubbing all hand surfaces with a 70% alcohol hand sanitizer. Then lean forward and gently remove your goggles or face shield, avoiding contact with your body.

After leaving the isolation room, take off your mask. Grab it from behind. Pull the bottom strap off first. And then pull off the top strap. Finally, clean your hands once again with a 70% alcohol hand sanitizer or with a proper hand-washing method.

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