11/13/24, 7\:26 PM Guide | PPE

PPE

Table of contents

Introduction

This guide covers the donning (putting on) and do
patients who are suspected or conlatest guidance from the UK
Government.
1,2,3
The article provides PPE guidance for both aerosol-generating procedures (AGPs) 1
and non-aerosol generating procedures
(non-AGPs).
2
The highest risk of transmission of respiratory viruses is during AGPs of the respiratory tract, and use of enhanced respiratory
protective equipment is indicated for health and social care workers performing or assisting in such procedures.
3
The UK Government has de
3
intubation, extubation and related procedures, for example, manual ventilation and open suctioning of the respiratory tract
(including the upper respiratory tract)
tracheotomy or tracheostomy procedures (insertion or open suctioning or removal)
bronchoscopy and upper ENT airway procedures that involve suctioning
upper gastrointestinal endoscopy where there is open suctioning of the upper respiratory tract
surgery and post mortem procedures involving high-speed devices
some dental procedures (for example, high-speed drilling)
non-invasive ventilation (NIV); bi-level positive airway pressure ventilation (BiPAP) and continuous positive airway pressure
ventilation (CPAP)
induction of sputum
high
high-frequency oscillatory ventilation (HFOV)

PPE for AGPs [1]

General points

Keep your hands away from your face and the PPE you are wearing.
Change your gloves when torn or heavily contaminated.
Minimise the surfaces you touch within the patient environment.
Regularly perform hand hygiene.
Always clean your hands after removing gloves.

Equipment

PPE required for AGPs includes the following\:
Surgical gown (long, rear-fastening,
Coverall (an alternative to a surgical gown)
Alcohol hand rub
Gloves
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Disposable full-face visor or goggles
Respirator (a

Before putting on PPE

Ensure you are hydrated to minimise the risk of fainting.
Tie your hair back and remove any jewellery.
Ensure the PPE you have chosen is the correct size for you.
Wash your hands with alcohol hand rub (see our video guide here).

Putting on PPE (donning)

All PPE should be put on OUTSIDE of the patient's room and where possible should be supervised by a buddy at a distance of
2 metres.
A buddy is a member of sta
Don a surgical gown or coveralls
You should have access to either a surgical gown or a coverall.
Gown\:
1. Put on the disposable gown
2. Do not use the inside tie
3. Fasten the necktie/velcro and waist ties securely
Coveralls\:
1. Step into the coveralls
2. Pull the coveralls up to your waist
3. Insert your arms into the sleeves\:
If thumb hoops are available then hoop these over your thumbs
Ensure the sleeves are long enough to reach the glove cu
4. Pull the coveralls up over your shoulders
5. Fasten the zip all the way to the top
Don a respirator
The respirator you use MUST be one you have already been
1. Position the upper straps of the respirator on your head, above your ears.
2. Position the lower strap at the nape of your neck.
3. Ensure the respirator is positioned
4. Mould the nose piece, using both hands, pressing down both sides of your nose with your

5. Perform a
For an unvalved product, exhale sharply to test
For a valved product, inhale sharply to test
If air
If air
If an adequate
If wearing glasses\:
Remove glasses before donning the respirator
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Clean them with an alcohol lens wipe
Replace them before donning the visor
Don eye protection
1. Place the eye protection over your face and eyes\:
a disposable full-face visor is preferred
goggles may be used if a visor is not available
if using a visor, ensure it covers all of your face including your chin
2. Adjust the headband to achieve a secure
3. If a buddy is not available, you will need visible con
Don gloves
1. Put on a pair of non-sterile, nitrile gloves
2. Choose gloves that are the appropriate size to ensure they
3. Pull each glove cu
Final check
Before entering the patient room, you need to perform a
the gown ties at the neck and waist are secure
the respirator is correctly
the visor is in the correct position
the gloves are covering the cu
Once you are con
remain vigilant of both your own and your colleague's PPE integrity.
In the event of a high exposure episode (e.g. projectile vomiting) or if there are concerns about PPE integrity, LEAVE THE
ROOM at the earliest opportunity and inform your buddy prior to removing any PPE.
Putting on PPE for AGPs video demonstration
See the video demonstration here.

Taking o

Where possible, the process of removing PPE should be supervised by a buddy at a distance of two metres.
The buddy can assist you when removing your PPE to reduce the risk of you contaminating yourself.
DO NOT step into the clean area whilst wearing contaminated PPE.
If you become aware of a potential PPE breach or high-exposure contamination (e.g. projectile vomiting), inform your buddy
before removing your PPE.
Remove your gloves
1. Grasp the outside of your glove with your opposite gloved hand and peel o
2. Hold the removed glove in your gloved hand
3. Slide the
glove
4. Dispose of both gloves into the clinical waste bin
5. Clean your hands with alcohol hand gel or rub (if not available, use soap and water)
Remove your surgical gown
The surgical gown should be removed slowly and carefully\:
1. Undo the necktie
2. Undo the waist tie
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3. Pull the surgical gown away from your neck and shoulders (touching the inside of the gown only) using a peeling motion, as
the outside of the gown will be contaminated
4. Turn the gown inside out, fold into a bundle and discard immediately into a clinical waste bin
Remove your visor
1. To remove the visor, ensure you are standing straight and not bending forward (as this brings the bottom of the visor in
contact with the clean upper body)
2. Reach for the elastic strap at the back of your head, close your eyes and lift the strap upwards and then over your head using
both hands
3. Place the visor into the clinical waste bin immediately
4. Leave the patient's room whilst still wearing your respirator
5. Clean your hands with alcohol gel or rub
Remove your respirator
1. Carefully remove the FFP3 respirator without touching the front of the device which is contaminated
2. Reach to the back of your head with both hands to
3. Lift both straps over the top of your head
4. Let the respirator fall away from your face and drop it into the clinical waste bin
5. You can now leave the designated do
If wearing glasses\:
Remove them before removing the respirator
Clean your glasses with an alcohol lens wipe
Do not put your glasses back on until you have completed the removal of the respirator and have washed your hands
once more
Taking o
See the video demonstration here.

PPE for Non-AGPs [2]

Equipment

PPE required for NAGPs includes the following\:
Alcohol hand rub
Gloves
Eye protection (if a risk assessment indicates that these are required to prevent eye splashes)
Fluid resistant surgical face mask

Before putting on PPE

Ensure you are hydrated to minimise the risk of fainting.
Tie your hair back and remove any jewellery.
Ensure the PPE you have chosen is the correct size for you.
Wash your hands with alcohol hand gel or rub (see our video guide here).

Putting on PPE (donning)

Don an apron
Put on the disposable apron and ensure the ties are securely tied at the back of the apron.
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Don a surgical face mask
Putting on a surgical face mask (elastic type)\:
1. Secure the mask around your ears with the pieces of elastic
2. Mould the mask around each side of the nose, ensuring it is
3. Extend the mask down to fully cover your chin
Putting on a surgical face mask (with ties)\:
1. Position the straps of the mask on the crown of your head and tie the bow above your ears
2. Tie the lower straps at the nape of your neck
3. Mould the mask around each side of your nose, ensuring it is
4. Extend the mask down to fully cover your chin
Don eye protection
Eye protection must be worn if a risk assessment indicates the need for it.
Regular spectacles are NOT considered adequate eye protection.
Don some gloves
Put on disposable non-sterile gloves (there is no requirement for double gloving).
Final check
Before entering the patient room, you need to perform a
the apron ties at the neck and waist are secure
the surgical mask is correctly
eye protection is being worn if appropriate
gloves are worn
Once you are con
remain vigilant of both your own and your colleague's PPE integrity.

Taking o

PPE should be removed in an order that minimises the potential for self-contamination.
Remove your gloves
1. Grasp the outside of your glove with your opposite gloved hand and peel o
2. Hold the removed glove in your gloved hand
3. Slide the
glove
4. Dispose of both gloves into the clinical waste bin
5. Clean your hands with alcohol hand gel or rub (if not available, use soap and water)
Remove your disposable apron
1. Unfasten or break the apron ties at the neck and let the apron fold down on itself
2. Unfasten or break the ties at the waist and fold the apron in on itself (DO NOT touch the outside, as this will be contaminated)
3. Discard into a clinical waste bin
Remove your eye protection
1. Hold onto both arms of the eye protection, then lift and then pull away from your face
2. Discard after use into a clinical waste bin
3. Clean your hands with alcohol hand gel or rub (if not available, use soap and water)
Remove your surgical face mask
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This should be performed OUTSIDE of the patient area.
Removing a surgical face mask (elastic type)\:
1. Using both hands, grasp the elastic ties around your ears, stretch them and carefully pull away from your face
2. Dispose of the mask into a clinical waste bin immediately
3. Wash your hands with soap and water
Removing a surgical face mask (ties)\:
1. Using both hands unfasten the lower neck strap
2. Then unfasten the strap above your ears and lift the mask forwards (do not touch the front of the mask, as this is
contaminated)
3. Dispose of the mask into a clinical waste bin immediately
4. Wash your hands with soap and water
If glasses are worn\:
Carefully remove them and clean them with an alcohol lens wipe before washing your hands
Do not replace them until you have completed hand hygiene
Taking o
See the video demonstration here.

References

1. UK Government. Guidance\: COVID-19\: personal protective equipment use for aerosol-generating procedures. Published 10th
January 2020. Last updated 10th April 2020. Accessed 15th April 2020. Available from\: [LINK]
2. UK Government. Guidance\: COVID-19\: personal protective equipment use for non-aerosol generating procedures. Published
10th January 2020. Last updated 8th April 2020. Accessed 15th April 2020. Available from\: [LINK]
3. UK Government. Guidance\: Personal Protective Equipment (PPE). Last updated 12th April 2020. Accessed 15th April 2020.
Available from\: [LINK]
Source\: geekymedics.com
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