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 patient’s • 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