NETEC: Personal Protective Equipment for COVID-19

[Music] personal protective equipment for healthcare workers caring for patients with coronavirus disease kovat 19 the following guidance is based on CDC interim infection prevention and control recommendations for patients confirmed with or under investigation for coronavirus disease kovat 19 CDC guidelines call for strict adherence to standard contact and airborne precautions including the use of eye protection the information provided in this video is current as of February 15th 2020 when preparing to care for patients with an infectious disease it is helpful to understand the series of events that occur to cause infection this series of events is known as the chain of infection and each link in the chain of infection presents us with an opportunity to break the chain to prevent the spread of the disease the chain of infection begins with the presence of an infectious agent or pathogenic organism for our purposes we will describe the chain of infection for Co vid 19 the novel coronavirus formerly known as 2019 and Co V to break the chain of infection and prevent the spread of a pathogen like Ovid 19 the pathogen must be removed or destroyed a healthcare worker performing hand hygiene with alcohol-based hand rub to disinfect their hands is an example of breaking the chain of infection by destroying pathogens to continue to survive an infectious pathogen requires a reservoir or host in which it can live reproduce and multiply in the case of kovat 19 there is much to learn as the virus is new to infecting humans humans infected with kovat 19 are a new host for this virus the portal of exit in the chain of infection is the path by which a pathogen leaves its host to infect others for covet 19 the portal of exit includes the respiratory tract via respiratory secretions when a patient coughs sneezes or talks there may be other portals of exit such as the gastrointestinal tract via stool but for now we will focus on the respiratory system having a patient wear a mask to block respiratory secretions is one way to break the chain of infection at the portal of exit the mode of transmission is the means in which the pathogen travels to a new host the mode of transmission is the contact droplet and airborne for kovat 19 the CDC recommends standard contact and airborne precautions with eye protection the portal of entry is the path in which a pathogen enters a new host this can be through inhalation when a person inhales the pathogen into their body or through mucous membranes by way of hand to face contact health care workers wearing personal protective equipment that offer respiratory protection preventing the inhalation of an infectious pathogen is one way the chain of infection can be broken at the portal of entry a susceptible host refers to a person who does not have the ability to fight off the invading pathogen to break the chain of infection at this point would require the potential host to have immunity to the pathogen in question in certain situations immunity to a pathogen can be acquired naturally as a response to past infections or it can be artificially acquired by vaccination the chain of infection is a useful tool and consideration should be given to methods for breaking links in the chain early in the process for example health care worker is caring for patients with kovat 19 can break the chain of infection at the mode of transmission and portal of entry by wearing the appropriate personal protective equipment the CDC recommends standard contact and airborne precautions with eye protection when caring for patients or persons under investigation for Co vid 19 this includes a disposable isolation gown and n95 respirator a face shield or goggles and gloves each facility will have variations in the types and styles of personal protective equipment or PPE that is available to staff what is important is that the PPE chosen must provide protection for the anticipated task and the level of isolation PPE should be durable non restrictive and fit well training on the correct use of PPE should be provided to staff additional items that will be required include alcohol-based hand rub EPA approved disinfectant wipes and a waste container lined with a red biohazard bag donning personal protective equipment should occur in a space where it is safe for personnel to be without PPE gather the PPE items that will be required from the supply area to have in one location at the start of the donning process all PPE must be donned prior to entering the patient care area check each item of PPE to ensure there are no defects such as rips in the gown seams or creases on the face shield staff with long hair should tie it up in preparation to Don PPE staff with facial hair should shave in order to wear an n95 respirator wearing jewelry is discouraged as it can lead to breaches in infection control and PPE the CDC and World Health Organization both provide excellent instructions on how to perform quality hand hygiene the links to these resources can be found in the information below always begin the PPE donning procedure by performing hand hygiene apply the manufacturer recommended amount to the palm of one hand and rub hands palm to palm rub the right palm over the back of the left hand with interlaced fingers and vice versa now rub both palms together with fingers interlaced with the left thumb clasped in the right palm rub rotationally and switch next cup your hands and place the backs of fingers to opposing palms and rub side to side with fingers interlocked rub the clasped fingers of the right hand forward and backwards in a circular pattern on the palm of the left hand and vice-versa finally rub both hands together with fingers closed until the sanitizer is dry this process should take no less than 20 seconds to complete you now that the appropriate PPE has been gathered checked for defects and hand hygiene performed the first item to be donned is the disposable isolation gown ensure the disposable gown meets the Association for the Advancement of medical instrumentations standard for the anticipated task and level of isolation and dawn the gown following the manufacturer's recommendations you after donning the isolation gown put on the n95 respirator because n95 respirators come in various sizes and styles it is important that staff use the same size and style of n95 respirator that they did during annual fit testing for proper placement and 95 respirators must fit close to the face this fit can be affected by facial hair or jewellery there are two straps on the n95 respirator the proper placement of the top strap is on the crown of the head while the bottom strap sits at the nape of the neck below the ears do not crisscross the straps once the n95 respirator is in place the nose piece should be gently molded to the bridge of the nose and a seal check performed by inhaling and exhaling quickly while using fingers to feel for air leaks around the edges of the mask if air is escaping around the nose remould the nose piece and repeat the seal check if air escapes from the sides or bottom of the respirator readjust the respirator and repeat the seal check until no air leaks are found staff must resist the temptation to adjust the n95 respirator while wearing it in the patient care area if the PPE ensemble includes a face shield for eye protection put it on so that the foam head beast's rests on the forehead if goggles are worn ensure they sit comfortably and securely over the eyes and do not interfere with the fit of the n95 respirator a face shield or goggles will need to fit over eyeglasses if the face shield or goggles fog up due to breathing it is likely the n95 respirator does not have a proper seal at no time should I protection or the n95 respirator be readjusted while the healthcare worker is in the patient care area Don gloves in a size that is comfortable and conducive to providing patient care ensure no skin is exposed between the glove and gown cuffs by pulling the sleeve down towards the knuckles and holding on to the sleeve while pulling the glove on some disposable gowns may have thumb holes that help keep sleeves from migrating upward while gloves are donned workers caring for patients with kovat 19 must take precautions to keep from contaminating PPE do not readjust PPE while in the patient care area if gloves become contaminated wipe them clean with an epa-approved disinfectant wipe and perform hand hygiene on the gloves hand hygiene should be performed as usual when caring for patients including hand hygiene before touching a patient before clean or aseptic procedures after body fluid exposure after touching a patient or after touching the patient surroundings limit touching surfaces in the patient care area as this may lead to glove contamination and the spreading of contamination to other areas be mindful that the parts of the PPE most likely to become contaminated are the hands arms and torso PBE doffing must be performed in a location where too safe to do so and in a manner that reduces the potential for self contamination from contaminated PPE all PPE with the exception of the n95 respirator is to be doffed by the door inside the patient care area check for signs of gross contamination and remove if possible perform hand hygiene prior to doffing PPE there are several methods for the healthcare worker to remove their gowns safely one is to remove the gown and the gloves in the same process begin first by pulling at the gowns midsection to break the waist ties cross the arms to grasp for the front of the gown below the shoulders and pull the gown firmly away from the body to break the neck ties if the gown does not tear away or the ties do not break the healthcare worker will need to safely untie the neck and back ties ensuring they do not touch their clothing skin or hair with the gown sleeves this can be achieved by reaching behind the head to undo the tie or by pulling the gown forward and to the side away from the face to bring the tie into reach next keeping the hands in the sleeves roll the gown inside-out and away from the body bending slightly forward will help keep the gown at a distance once the gown is rolled up pull the hands out while removing the gloves with the sleeves one arm at a time you dispose of the gown and gloves into the trash do not compress waste in the trash container to make more room as this can lead to aerosolization of contaminants and if a sharp object was inadvertently placed in the trash it could lead to injury do not allow trash containers to become more than three quarters full as this may lead to loads that are heavy and difficult to manage this may also lead to difficulty in tying the bag closed another method for gown and glove removal is to remove them separately first the gown and then the gloves this method might be preferable if a gown without thumb holes is being used this method will prevent contamination from gown sleeves to the health care workers unprotected hands if the gloves were to be removed first prior to removing gloves the healthcare worker should perform hand hygiene on the gloves and remove them safely there are several methods for glove removal that can be utilized such as the glove and glove technique the glove and glove technique is performed by pinching the glove of one hand at the wrist with the forefinger and thumb of the other hand and pulling the glove off while turning it inside out hold the removed glove in the gloved hand slide the forefinger of the non gloved hand into the wrist of the other glove and pull it off make sure to only touch the inside of the glove and that the glove turns inside out and envelops the other glove another method of glove removal is the beak method begin by pinching and pulling the wrist of one glove with a gloved hand then using a middle finger scoop the cuff to pull the glove inside out and over the fingers and thumb to create a beak use the beaked hand to pinch the wrist of the other glove pull it down and off slide the index finger of the unloved hand into the inside of the glove and slide it off after the gloves are removed dispose of them safely do not throw or sling gloves into the trash you perform hand hygiene to remove the faith shield bend slightly forward and grasp the headband from the sides or back of the head pull the band forward over and away from the face alternatively pinched the front of the visor and pull it off from the front to avoid placing hands behind the head where they cannot be seen once removed placed the face shield gently into the trash face down and perform hand hygiene the only item of personal protective equipment remaining at this time should be the n95 respirator exit the patient care room by opening the door and step out ensure the door closes immediately and completely perform hand hygiene to remove the n95 respirator pull one strap at a time over the head beginning with the bottom strap as the top strap is removed keep hold of the strap and use it to guide the n95 respirator into the trash perform hand hygiene if a healthcare worker feels they may have become contaminated at any point in the doffing process they should notify their supervisor and follow facility protocols contamination could occur if the health care workers respiratory protection was compromised or if they inadvertently touched their face or eyes with contaminated hands at this time there is still much to learn about Co vid 19 despite this health care workers that don appropriate PPE and utilized the hand hygiene and donning and doffing techniques discussed in this video can be confident in their ability to safely care for a patient confirmed with or under investigation for Co vid 19 please continue to follow the CDC for news and updates as events unfold if you have any questions please contact nee tech at info at nee tech org any tech subject-matter experts are standing by to answer your questions thank you you

Channel: The NETEC

Views: 758,097

Keywords: NETEC, National Ebola Training and Education Center, PPE, Personal Protective Equipment, Novel Coronavirus, COVID-19, 2019-nCoV, Special Pathogens of Concern, Biocontainment, Special Pathogen Isolation Area

Id: bG6zISnenPg

Length: 17min 59sec (1079 seconds)

Published: Tue Feb 18 2020