Information Sheet 3.

1-1
Personal Protective Equipment (PPE)

Learning Objective:

After reading this INFORMATION SHEET, YOU MUST be able to:

1. Understand the importance of using Personal Protective Equipment (PPE)
2. Identify the type of PPE to use in specific health care situations
2. Describe the proper use of PPE

Personal protective equipment is equipment of clothing used or worn by

workers, students or visitors to shield or protect them from workplace hazards.
The proper use of PPE will significantly lessen if not eliminate hazards. The use
and disposal PPE is essential for reducing exposure.

Selecting PPE

The use of PPE requires selection factors that include supply, size, fit,
protection level, comfort, design and experience in use. For example, glove
selection is based on the type of exposure. Non-latex gloves are used for
protection from infectious diseases, while chemical-resistant gloves are used
for protection from chemicals. Other considerations include providing PPE

Types of PPE

Gloves
Gloves must be worn according to Standard and Contact Precautions:
 Hand hygiene should be performed when appropriate, regardless of
indications for glove use.
 Use of sterile gloves is indicated when an invasive procedure involving
mucus membranes or blood is involved (e.g. surgical operations, vaginal
delivery, invasive radiological procedures, invasive cardiovascular
procedures, total parenteral nutrition and chemotherapeutic agent).
 The use of examination gloves is indicated when there is potential for
touching blood, body fluids, secretions, excretions and items visibly soiled
by body fluids.
 Situations with risk of direct human exposure include: contact with blood,
contact with mucous membrane and with non-intact skin, and the potential
presence of highly infectious and dangerous organisms; epidemic or
emergency situations; IV insertion and removal; drawing blood;
discontinuation of venous line; pelvic and vaginal examination; and
suctioning non-closed systems of endotracheal tubes.
 Situations with risk of indirect patient exposure include: emptying emesis
basins,
 Handling cleaning instruments, handling wastes, and cleaning spills of
body fluids.
 Situations with risk of direct human exposure include: taking blood
pressure, temperature and pulse; performing subcutaneous and
intramuscular injections; bathing and dressing the patient; transporting
patients; caring for eyes and ears (without secretions); and any vascular line
manipulation in the absence of blood leakage.
 Situations with risk of indirect patient exposure include using the
telephone; writing in the patient chart; giving oral medications; distributing
or collecting patient dietary trays; removing and replacing linen for the
patient’s bed; placing non-invasive ventilation equipment and oxygen
cannula; and moving patient’s furniture.

Facial protection (eyes, nose, and mouth)

A surgical or procedure mask and eye protection (eye visor, goggles) or a face-
shield should be worn to protect mucous membranes of the eyes, nose and
mouth during activities that are likely to generate splashes or sprays of blood,
body fluids, secretions and excretions. Shoe/boot covers, hoods and aprons
should also be worn.

Gowns and coveralls

Gowns and coveralls should be worn to protect skin and to prevent soiling of
clothing during activities that are likely to generate splashes or sprays of blood,
body fluids, secretions, or excretions. The soiled gown or coverall should be
removed as soon as possible, and hand hygiene should be performed.

Respirators
Respirators protect workers from airborne hazards. There are two types of
respirator: air-purifying and atmosphere-supplying. Respirators can also be
classified As tight-fitting or loose-fitting. N95 respirators or respirators with a
higher protection factor should be used when inhalation hazards are present.
Tight-fitting respirators include a tight seal between the respirator and the face
and/or neck of the user.

If the respirator’s seal leaks, contaminated air will be pulled into the face-piece
and can be breathed in. Therefore, anything that interferes with the respirator
seal (such as facial hair, earrings, headscarves, wigs and facial piercings) is not
permitted.

Loose-fitting respirators do not depend on a tight seal with the face to provide
protection and therefore they do not need to be fit-tested.

The employee must be medically cleared and fit-tested with the same make,
model, style and size of respirator that will be used. Fit-testing is done to be
sure that the respirator’s face-piece fits the face. Respirators must be fit-tested
before being used for the first time. Retesting should be conducted at least
every 12 months to be sure that the respirator continues to fit. Additionally, fit-
testing needs to be repeated if there are changes in facial features from surgery
or weight gain.

A user seal check is performed by the wearer each time the respirator is put
on. The check determines if the respirator is properly seated to the face or
needs to be readjusted.

Masks or surgical masks are NOT respirators and do not protect the user from
exposure to airborne hazards.

Donning and doffing of personal protective equipment

For effective use of PPE to protect health workers, it is essential to follow
standard procedures for putting on and take off the equipment.

Donning PPE
Gown:
● Fully cover torso from neck to knees, arms to end of wrists, and wrap
around the back.
● Fasten at back of neck and waist. Use duct tape to secure.

Mask or respirator:
● 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.

Goggles or face-shield:
● Place over face and eyes and adjust to fit.
● Extend to cover wrist of isolation gown.

Gloves:
 Choose the proper glove size for you
 Remove jewelry
 Wash hands thoroughly
 Keep hands above the waist
 Open the sterile glove package
 Remove the inner warp
 Pick up your dominant hand glove
 Place the glove into your dominant hand
 Slip on the second glove
 Adjust your gloves
 Check the glove for rips
Doffing PPE
Gloves:
● Outside of gloves is contaminated!
● 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 off the second glove.
● Discard gloves in waste container.

Goggles or face-shield:
● Outside of goggles or face-shield is contaminated!
● To remove, handle by head band or ear pieces.
● Place in designated receptacle for reprocessing or discard in waste container.
Gown:
● Gown front and sleeves are contaminated!
● 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.
Mask or respirator:
● Front of mask/respirator is contaminated — DO NOT TOUCH!
● Grasp bottom, then top ties or elastics and remove.
● Discard in waste container.
Source:
World Health Organization, Occupational safety and health in public health
emergencies: A manual for protecting health workers and responders GENEVA,
2018