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Personal Protective Equipment: Protecting Yourself and the Community from Infectious Disease Presented by: The Massachusetts Department of Public Health The Local Public Health Institute of Massachusetts Fall 2005 Next HOME The purpose of this training is… To promote a common-sense approach to infection control in a community setting To present basic, introductory information about the use of personal protective equipment for protection against and control of infectious diseases NOT to create new policy or regulations concerning the proper use of personal protective equipment Back Next HOME Defining PPE PPE Basics Personal Protective Equipment (PPE) is specialized clothing or equipment worn for protection against dangerous or infectious materials PPE prevents contact with an infectious agent, or body fluid that may contain an infectious agent, by creating a barrier between the potentially infectious material and the public health responder Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Defining Additional Terms PPE Basics Using PPE “Community setting” is any setting outside a hospital or established health care clinic in which a public health responder carries out medical interventions A “public health responder” is a public health professional (either medical or non-medical) serving in a public health capacity Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Defining Disease Transmission PPE Basics The spread of infectious disease requires a: Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Source of infection Route of transmission Host susceptible to the infection Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Defining Disease Transmission PPE Basics Using PPE Infectious diseases are spread through one or more of the following routes of transmission: Contact (skin, fecal-oral, blood) Hand Hygiene Respiratory Hygiene Standard Precautions Droplet (coughing, sneezing, talking: droplets are large and only travel within 3 feet) Final Quiz Measles Common vehicle (food, water, objects) Other Uses of PPE Comprehensive Scenario Meningoccocal Meningitis Airborne (coughing, sneezing: particles are small and travel more than 3 feet) Expanded Precautions Hepatitis B Salmonella Vector-borne (mosquitoes, ticks) Back Lyme Disease Next HOME Controlling Disease Transmission PPE Basics Using PPE The spread of infectious disease can be controlled by: Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Wearing PPE Practicing Hand Hygiene Promoting Respiratory Hygiene Following Standard Precautions Following Expanded Precautions, as necessary Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Wearing PPE PPE Basics PPE acts as a barrier between you and: Your client Objects in your client’s environment Infectious agents, substances, or materials Wear PPE to: Stop the spread of illness/infection Protect your health Protect your client’s health Protect your family’s health Protect the community’s health Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Available PPE PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE A variety of PPE is available for your protection, including: Gowns, Aprons, Cover-All Suits Masks Respirators Goggles Face shields Gloves Shoe covers (booties) Hair covers Comprehensive Scenario Final Quiz Back Next HOME Donning PPE PPE Basics Using PPE Don PPE in the following order: Hand Hygiene 1. Respiratory Hygiene 2. Standard Precautions 3. 4. Expanded Precautions Other Uses of PPE 5. Gown (or apron/cover-all suit) Shoe and/or hair covers (when worn) Mask/Respirator Goggles (or face shield in lieu of mask and goggles) Gloves Comprehensive Scenario Final Quiz Back Next HOME Donning Gowns PPE Basics The first piece of PPE you should put on is the gown. Using PPE Hand Hygiene 1. Respiratory Hygiene 2. Standard Precautions 3. Expanded Precautions Other Uses of PPE Click on Movie to Play Make sure the opening is in the back Secure at the neck and waist If the gown is too small, use two gowns: Gown #1 ties in front Gown #2 ties in back Comprehensive Scenario Final Quiz Back Next HOME About Masks PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz There are several types of masks that can be worn to prevent the spread of infectious disease Masks are not respirators Masks vary by: Shape (rectangular, round) Method of securing (elastic, ties) Select a mask you are comfortable wearing and one that provides an adequate amount of protection Use common sense when donning and removing masks, as the procedure may vary based on the method of securing the mask to your face Back Next HOME About Masks, Continued PPE Basics This training demonstrates the use of one type of mask Other common types of masks include: Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Elastic tie Back Cloth ties Next HOME Donning Masks PPE Basics Using PPE 1. Hand Hygiene 2. Respiratory Hygiene Standard Precautions 3. Expanded Precautions 4. Place mask over your mouth, nose and chin Fit the flexible nose piece over nose bridge Secure with ties or elastic Adjust to fit Other Uses of PPE Click on Movie to Play Comprehensive Scenario Final Quiz Back Next HOME About Respirators PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE There are several types of respirators that can be worn to control the spread of infectious disease Respirators vary by: Size (small, medium, large) Shape (oval, round) Level of respiratory protection offered (N95 versus N100) Unlike masks, respirators must be fit-tested before use to ensure they fit your face properly Comprehensive Scenario Final Quiz Back Next HOME Fit-Testing Respirators PPE Basics Respirators must have a mask-to-face seal and must be checked annually to ensure adequate protection Fit-testing is the procedure used to ensure a maskto-face seal and involves tests to make sure there is no air leakage between the mask and the face Contact your regional Health Educator for additional information about respirator fit-testing Remember: NEVER use a respirator that has not been fit-tested for your face Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME About Respirators, Continued PPE Basics This training demonstrates the use of one type of N95 respirator Other common types or variations of the N95 respirator include: Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz N95 Back N100 N95 Next HOME Donning Respirators PPE Basics Select a fit-tested respirator, such as an N95 respirator mask Place the respirator over your nose, mouth and chin Fit the flexible nose piece over your nose bridge Secure on your head with elastic Adjust to fit Perform a fit check: 1. Using PPE 2. Hand Hygiene 3. Respiratory Hygiene 4. Standard Precautions 5. Expanded Precautions 6. Other Uses of PPE Click on Movie to Play Inhale: Respirator should collapse Exhale: Check for leakage around face Comprehensive Scenario Final Quiz Back Next HOME Donning Goggles PPE Basics 1. Using PPE Hand Hygiene 2. Respiratory Hygiene Position goggles over eyes and secure to the head using the ear pieces or headband Adjust to fit comfortably *If wearing a face shield instead of a mask and goggles, position the face shield over face and secure on brow with headband Standard Precautions Expanded Precautions Other Uses of PPE Click on Movie to Play Comprehensive Scenario Final Quiz Back Remember: Eyeglasses alone do NOT provide adequate protection Next HOME Donning Gloves PPE Basics 1. Using PPE 2. Hand Hygiene Respiratory Hygiene 3. Standard Precautions 4. Expanded Precautions Put gloves on last Select the correct type and size Insert hands into gloves If you are wearing a gown, tuck the gown cuffs securely under each glove Other Uses of PPE Comprehensive Scenario Final Quiz Click on Movie to Play Back Next HOME Removing PPE PPE Basics 1. Remove PPE in an area where you are not in danger of exposure to the infectious agent Separate room Porch or garage Breezeway or other entryway 2. Identify “clean” and “contaminated” areas of PPE Clean areas: Have NOT been in contact with infectious agent Contaminated areas: HAVE been in contact with infectious agent Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Removing PPE 3. PPE Basics To limit self-contamination, remove PPE in the following order: 1. Using PPE 2. Hand Hygiene 3. 4. Respiratory Hygiene Standard Precautions 5. 4. Discard PPE immediately and properly so as not to contaminate the “clean” area 5. Perform hand hygiene immediately after removing PPE Expanded Precautions Other Uses of PPE Gloves Goggles (or face shield in lieu of mask and goggles) Gown (or apron/cover-all suit) Shoe and/or hair covers (when worn) Mask/respirator Comprehensive Scenario Final Quiz Back Next HOME Removing Gloves 1. PPE Basics 2. Using PPE 3. Hand Hygiene Respiratory Hygiene 4. Standard Precautions 5. Expanded Precautions 6. Other Uses of PPE Comprehensive Scenario Final Quiz Click on Movie to Play 7. Back Remove your gloves first Hold the outside edge near your wrist Peel the glove away from your hand, turning the glove inside-out Hold the glove in the opposite gloved hand Slide your ungloved finger under the wrist of the remaining glove Peel off from the inside, creating a bag for both gloves Discard in a plastic bag Next HOME Removing Gowns PPE Basics 1. Using PPE 2. Hand Hygiene Respiratory Hygiene 3. Standard Precautions 4. Expanded Precautions 5. Other Uses of PPE Unfasten the ties Peel the gown away from your neck and shoulder Turn the contaminated outside toward the inside Fold or roll into a bundle Discard in a plastic bag Click on Movie to Play Comprehensive Scenario Final Quiz Back Next HOME Welcome to STANDARD PRECAUTIONS PPE Basics Using PPE This section includes: Hand Hygiene Respiratory Hygiene Standard Precautions An overview of Standard Precautions PPE for Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Overview PPE Basics Using PPE Most of the time you respond in a public health role, you will not have a confirmed diagnosis for the person you might be dealing with Use Standard Precautions regardless of diagnosis Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME PPE for Standard Precautions: Determining What to Wear PPE Basics Decisions about PPE use are determined by the type/level of contact you will have with the client To determine what PPE to wear, ask yourself: Will I be touching the client or potentially contaminated objects in their environment? Is there a likelihood of blood or body fluids spraying or splashing? Is the client coughing, sneezing, or vomiting? Do they have diarrhea? When in doubt, applying the most conservative level of PPE is the best protection Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME PPE for Standard Precautions PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Use: Gloves: When you may touch a client in a way that might lead to exposure to blood or body fluids or touch objects in their environment that may be contaminated, and/or Gowns: When there is a risk of your clothing or exposed skin coming in contact with anything wet or weeping, and/or Mask and goggles or a face shield: When there is a risk of being splashed or sprayed with blood or body fluids Practice: Hand hygiene and promote respiratory hygiene (if working with clients who have respiratory symptoms) as a regular part of Standard Precautions Back Next HOME What PPE Would You Wear… PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions When working with a client: With a skin infection, or an open wound? Who has incontinent diarrhea? For whom you deliver food and mail without interaction? Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Welcome to EXPANDED PRECAUTIONS PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions This section includes: An overview of Expanded Precautions A description of Contact and Droplet Precautions, and Airborne Infection Isolation PPE for Expanded Precautions Scenario demonstrating use of Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Overview PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Expanded Precautions are used in addition to Standard Precautions to prevent the spread of infection when you know or suspect: A client’s diagnosis What illness or infectious agent you may be exposed to The client’s symptoms lead to a risk of contact with blood or body fluids Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Overview PPE Basics Expanded Precautions is the use of PPE in addition to Standard Precautions Expanded Precautions include: Contact Precautions Droplet Precautions Airborne Infection Isolation Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME PPE for Expanded Precautions: Determining What to Wear PPE Basics Decisions about PPE use are determined by the diagnosis or suspected diagnosis of the client, the client’s symptoms, or type of infectious agent or illness you will encounter To determine what PPE to wear, ask yourself: What is the client’s diagnosis or suspected diagnosis? Is the client infectious? What is the infectious agent or illness I may encounter? What is the mode of transmission of this agent or illness? Does the client have symptoms which lead to increased likelihood of transmission? Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME PPE For Expanded Precautions PPE Basics Using PPE Hand Hygiene Respiratory Hygiene In addition to Standard Precautions, and based on your assessment of the mode of transmission of the agent or illness you may encounter, it may be necessary to follow: Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Contact Precautions Wear gown and gloves for all contact with client and/or objects in the client’s environment Droplet Precautions Wear appropriate respiratory protection within 3 feet of client Airborne Infection Isolation Wear appropriate respiratory protection (e.g., N-95 respirator) when entering client’s environment Back Next HOME What Type of Expanded Precautions Would You Follow When… PPE Basics Using PPE Visiting with a client who has been diagnosed with: Hepatitis A and is incontinent/diapered? Influenza? Pulmonary tuberculosis? SARS? What PPE would you wear? Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME What Type of Expanded Precautions Would You Follow When… PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Visiting with a client who has been diagnosed with: Hepatitis A and is incontinent/diapered Answer: Contact Precautions - Gown, gloves Influenza Answer: Droplet Precautions - Appropriate respiratory protection (e.g., mask) Pulmonary tuberculosis Answer: Airborne Infection Isolation - Appropriate respiratory protection (e.g., N-95 respirator) SARS Answer: Contact Precautions, Droplet Precautions, Airborne Infection Isolation - Gown, gloves, goggles, appropriate respiratory protection (e.g., N-95 respirator) Back Next HOME Other Uses of PPE PPE Basics Using PPE Sometimes, PPE may be used to protect public health responders from contact with a bioterrorism (BT) agent or hazardous material, such as one encountered during a bioterrorist event or other public health emergency PPE used for protection from exposure to biological agents may not protect against exposure to chemical agents Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Other Uses of PPE PPE Basics Using PPE In these situations, you may hear terms such as: Level A, B, C and D PPE Types of PPE used to protect against exposure to hazardous materials and bioterrorism (BT) agents Special training needed to use levels A, B, and C Hot, Warm and Cold Zones Terms to identify level of danger of a particular site for control purposes during a chemical, biological, or radiological event Hazmat Teams Teams that are highly trained and fully equipped to respond to a situation involving a hazardous material Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Other Uses of PPE PPE Basics Using PPE Hand Hygiene http://www.cdc.gov/niosh/topics/emres/ppe.html Respiratory Hygiene Standard Precautions For more information about the PPE required for protection against hazardous materials and infectious agents, please visit: Future training opportunities may be available on this topic Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz Back Next HOME Thank You PPE Basics Using PPE Hand Hygiene Respiratory Hygiene Standard Precautions Expanded Precautions Other Uses of PPE Comprehensive Scenario Final Quiz
