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: If:
• Gloves • Touching
– Respiratory secretions
– Contaminated items or surfaces
– Blood & body fluids
• Gowns
• Soiling clothes with patient body
fluids, secretions, or excretions

• Eye • Procedures are likely to generate

Protection splashes / sprays of blood, body
fluids, secretions, excretions
and / or Mask
 Droplet Precautions
• Prevent infection by
large droplets from
– Sneezing
– Coughing
– Talking

• Examples
– Neisseria meningitidis
– Pertussis
– Influenza
Transmission of Influenza Viruses
Seasonal Current Avian
Influenza in Influenza in Humans
Humans
Droplet most likely possible
route

Airborne possible at possible at close

close distances distances

Contact possible Most likely

(bird to human), and
possible (human to
human)
 Droplet Precautions
Taken 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