Donning and Doffing of PPE

1. Donning and Doffing of PPE BIOS 1471-INTRODUCTION TO LABORATORY SAFETY March 1st, 2012

2. Donning and Doffing • The terms donning and doffing are often used with PPE. Donning is the procedure of assembling PPE on the user and doffing is the procedure for removal of PPE. Responders should only don PPE for which they have been thoroughly trained, medically cleared to use, and fit tested to wear.

3. Level D Protective Equipment • No respiratory protection necessary and minimal skin protection. • A uniform affording minimal protection for minor contamination, closed toe shoes • Optional – N-95, surgical mask, gloves, safety glasses, face shield, chemical resistant boots, particulate boot covers • Atmosphere contains no known hazards • Atmosphere contains sufficient oxygen

4. Establishing Work Zones • Purpose: To minimize the transfer of hazardous substances from the site. • Security & physical barriers to exclude unnecessary personnel • Optimizing # of personnel for effective operations • Control points to regulate access • Operate with intent to reduce exposures and eliminate airborne dispersion • Perform decontamination

5. Establishing Work Zones • Hot Zone - Contaminated area • Warm Zone - Contamination reduction zone or decon area • Cold Zone - Clean area for support equipment, traffic limited, normal work PPE, no contaminated PPE worn or stored in this area. • Safe Zone - to facilitate nuisance free area

7. Factors Influencing PPE Selection • Type of exposure anticipated • Splash/spray versus touch • Category of isolation precautions • Durability and appropriateness for the task • Fit

8. Gloves • Purpose – patient care, environmental services, other • Glove material – vinyl, latex, nitrile, other • Sterile or nonsterile • One or two pair • Single use or reusable

9. Do’s and Don’ts of Glove Use • Work from “clean to dirty” • Limit opportunities for “touch contamination” - protect yourself, others, and the environment • Don’t touch your face or adjust PPE with contaminated gloves • Don’t touch environmental surfaces except as necessary during patient care

10. Do’s and Don’ts of Glove Use (cont’d) • Change gloves • During use if torn and when heavily soiled (even during use on the same patient) • After use on each patient • Discard in appropriate receptacle • Never wash or reuse disposable gloves

11. Gowns or Aprons • Purpose of use • Material – • Natural or man-made • Reusable or disposable • Resistance to fluid penetration • Clean or sterile

12. Face Protection • Masks – protect nose and mouth • Should fully cover nose and mouth and prevent fluid penetration • Goggles – protect eyes • Should fit snuggly over and around eyes • Personal glasses not a substitute for goggles • Antifog feature improves clarity

13. Face Protection • Face shields – protect face, nose, mouth, and eyes • Should cover forehead, extend below chin and wrap around side of face

14. Sequence* for Donning PPE • Gown first • Mask or respirator • Goggles or face shield • Gloves

15. How to Don a Gown • Select appropriate type and size • Opening is in the back • Secure at neck and waist • If gown is too small, use two gowns • Gown #1 ties in front • Gown #2 ties in back

16. How to Don a Mask • Place over nose, mouth and chin • Fit flexible nose piece over nose bridge • Secure on head with ties or elastic • Adjust to fit

17. How to Don a Particulate Respirator • Select a fit tested respirator • Place over nose, mouth and chin • Fit flexible nose piece over nose bridge • Secure on head with elastic • Adjust to fit • Perform a fit check – • Inhale – respirator should collapse • Exhale – check for leakage around face

18. How to Don Eye and Face Protection • Position goggles over eyes and secure to the head using the ear pieces or headband • Position face shield over face and secure on brow with headband • Adjust to fit comfortably

19. How to Don Gloves • Don gloves last • Select correct type and size • Insert hands into gloves • Extend gloves over isolation gown cuffs

20. How to Safely Use PPE • Keep gloved hands away from face • Avoid touching or adjusting other PPE • Remove gloves if they become torn; perform hand hygiene before donning new gloves • Limit surfaces and items touched

21. Sequence for Removing PPE • Gloves • Face shield or goggles • Gown • Mask or respirator

22. Where to Remove PPE • At doorway, before leaving patient room or in anteroom* • Remove respirator outside room, after door has been closed* * Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub

23. How to Remove Gloves (1) • Grasp outside edge near wrist • Peel away from hand, turning glove inside-out • Hold in opposite gloved hand

24. How to Remove Gloves (2) • Slide ungloved finger under the wrist of the remaining glove • Peel off from inside, creating a bag for both gloves • Discard

25. Remove Goggles or Face Shield • Grasp ear or head pieces with ungloved hands • Lift away from face • Place in designated receptacle for reprocessing or disposal

26. Removing Isolation Gown • Unfasten ties • Peel gown away from neck and shoulder • Turn contaminated outside toward the inside • Fold or roll into a bundle • Discard

27. Removing a Mask • Untie the bottom, then top, tie • Remove from face • Discard

28. Removing a Particulate Respirator • Lift the bottom elastic over your head first • Then lift off the top elastic • Discard

29. Donning & Doffing of PPE Vedios • Personal Protective Equipment (PPE) • http://www.youtube.com/watch?v=iHBbWLYpCuU • PPE: Chemical Level C –Donning • http://www.youtube.com/watch?v=L6fsYcTgeB0 • PPE: Chemical Level C - Doffing • http://www.youtube.com/watch?v=2Oi5_NKObZc

30. Scenario A student called and reported a chemical spill in room R118. The student had planned on resuming his experiment from the day before. When the student opened the lab door, he smelled an unusual pleasant sweet odor. In the lab the student found a 500-mL bottle labeled “Benzene” that had tipped over the bench and made a puddle on the floor underneath. If you need to clean up the spill what kind of PPE should you choose? *The concentration was determined to be 2ppm.