Personal Protective Equipment

1
Personal Protective Equipment
May, 2007
2
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

3
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

4
Types of PPE

• Gloves
• Gowns
• Masks (surgical and particulate respirator)
• Eye protection (goggles and face shields)

5
Precaution Levels

• All levels require hand hygiene
• Standard
• Transmission based precautions
• Contact
• Droplet
• Airborne

6
Standard Precautions

• Prevent the transmission of common infectious
  agents
• Hand washing key
• Assume infectious agent could be present in the
  patients
• Blood
• Body fluids, secretions, excretions
• Non-intact skin
• Mucous membranes

7
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

8
Droplet Precautions

• Prevent infection by large droplets from
• Sneezing
• Coughing
• Talking
• Examples
• Neisseria meningitidis
• Pertussis
• Influenza

9
Transmission of Influenza Viruses
10
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

11
Airborne Precautions

• Taken in addition to Standard Precautions
• Prevent spread of infection through inhalable
  particles
• Examples
• Tuberculosis
• Measles
• Varicella
• Variola

12
Airborne Precautions

• Use for confirmed or suspected avian influenza
  cases

13
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

14
Sequence for Donning PPE

• Wash hands
• Gown
• N95 Particulate respirator
• Perform seal check
• Hair cover
• Goggles or face shield
• Gloves

15
Sequence for Removing PPE

• Remove in anteroom when possible
• Gloves
• Hand hygiene
• Gown (and apron, if worn)
• Goggles
• Mask
• Hand hygiene

16
Choosing the Appropriate PPE
17
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

18
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

19
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

20
Specimen Collection Exposed Persons and Birds

• High-risk aerosol-generating procedure
• PPE recommended
• Gloves
• Gown
• Goggles or face-shield
• N95 or better respirator

21
Activities

• Participate in group discussions using the
  Trainee Guide