PPE & Source Control

Training your staff

This is going to take time. Create a plan and start early. Emergency worker (nursing, Xray, MD etc), cleaning staff. You will likely be recruiting much of your outpatient staff as well so plan to train them. Make a schedule and do short, frequent practices.

Cart for Personal Protective Equipment (PPE)

A PPE cart will need to be set up near COVID rooms.

• Use appropriate PPE for doing tests.

• This information is constantly being updated.

• Please check for latest recommendations.

1. Source Control

• Ensure all patients have Mask of Filter on. In the case of Bagging or Intubation - a Viral Filter must be part of the circuit directly at the patient.

• Ensure all Staff have a Mask on - because we can be the source.

• At the very least cloth masks on asymptomatic patients and providers for Source Control

2. Personal Protective Equipment (PPE)

For protection when health care worker is at increased risk due to proximity or type of procedure.

• PPE don/doff MUST be practiced by staff before it is needed. Improper doffing is a high risk activity for infection.

• Don/Doff should be observed by another healthcare provider.

• Video link:

  • https://www.youtube.com/watch?v=bG6zISnenPg

• Printouts should be put up on doors.

• A copy of WHO PPE Don/Doff is attached in the WHO Don & Doff Guidance section.

• There are some variations in technique, e.g., CDC vs WHO. Pick one and use one that fits your reality.

General Approach to Doffing PPE - Tear-Away-Gown

Before Donning - Setup Containers for Garbage and Recuperating Reusable Material for your Doff

Inside the patient room (or in an ante-room)

1. Clean gloves with ethanol hand sanitizer

2. Remove gown and gloves

   • • Pull the gown forwards to tear the gown away from body.

     • Roll gown inside out and away from body, bending forwards.

     • This creates a "glove / gown ball".

3. Clean Hands with alcohol-based hand sanitizer.

4. Remove face shield

   • • Don't touch the front of the shield (which may be dirty).

     • Remove by touching the band of the face shield.

5. Clean hands with alcohol-based hand sanitizer.

Outside the patient room

1. If inside door handle was touched: Clean hands with alcohol-based hand sanitizer

2. Remove N95 / surgical mask using the straps to pull the mask away from your face.

1. 1. • Front of the mask be be contaminated - don't touch this.

      • Avoid touching your face with hands or straps of the mask.

3. Clean hands with alcohol-based hand sanitizer.

• Modified from The Internet Book of Critical Care, by @PulmCrit

WHO Publications

The links below will direct you to WHO publication infographic procedures for PPE Don and Doff instructions with a Coverall.

• • Steps to put ON personal protective equipment (‎PPE)‎ including coverall

  • Steps to take OFF personal protective equipment (‎PPE)‎ including coverall

The WHO infographics are reproduced below for your convenience (always refer to the WHO site for the latest publication versions).

You may want to print these and post in key locations across your facilities.