With an active pandemic, everyone needs PPE based on local mandates and when physical distancing with non-household members is not possible. Those with a confirmed or possible case of COVID-19 should wear a face mask when being evaluated medically or in the presence of others. PPE is used by healthcare providers, first responders, essential workers, office workers, shoppers, teachers and students, exercisers, public transportation passengers, and virtually anyone else who comes in contact with others.

There are many acceptable ways to put on PPE gear. Follow your facility’s procedures when available. Below is one example from the CDC of how to put on PPE gear:

Identify and gather the proper PPE, making sure the gown size is correct.Use hand sanitizer or wash your hands.Put on the isolation gown, tying of its ties.Put on a NIOSH-approved N95 or higher filtering face piece respirator or a face mask if a respirator is not available. Fit the nose piece to the nose using both hands. Extend the face covering under your chin, making sure that your mouth and nose are protected. Never wear the face covering under your chin or store it in your pocket between uses.For respirators and face masks with straps, place the top strap on the crown of the head and the bottom strap at the base of the neck. Check the respirator’s seal and fit each time you put it on.For face masks with loops, loop them around your ears.Put on goggles or a clear face shield, making sure it doesn’t interfere with the fit or seal of the respirator.Put on disposable gloves, making sure the gloves cover the gown’s cuff.

There are many acceptable ways to remove PPE gear. Below is another CDC example:

Remove and dispose of gloves, taking care not to contaminate the hands.Remove gown by untying (or gently breaking) all ties. Reach up to the shoulders and carefully pull the gown down and away from the body. You may also roll the gown down.Dispose of gloves and the gown in the trash receptacle.Perform hand hygiene.Remove the face shield or goggles by grabbing the strap and pulling upwards and away from head without touching the front surface.Remove and dispose of the N95 respirator or face mask without touching the front surface.For respirators, start by grasping the bottom strap and bringing it carefully over the head followed by the top strap then pull the respirator away from the face without touching its front.For face masks, carefully unhook or untie the straps and pull the face masks away from your face without touching its front.Perform hand hygiene.

Unintentional loss includes theft, damage, or accidental loss. Use inventory systems to track daily usage and identify areas of higher-than-expected use. It may become necessary to keep supplies in a locked cabinet. Many healthcare providers have switched from using small bottles of hand sanitizer to wall-mounted and freestanding hand sanitizer stations to both encourage frequent hand hygiene and discourage accidental loss.

There are various standards and guidelines covering PPE by standards organizations like American National Standards Institute (ANSI) and the Association of the Advancement of Medical Instrumentation (AAMI). It’s important to understand the hazards and exposure risks including source, transmission modes, pressures and types of contact, and duration and type of tasks to be completed by the PPE wearer. It’s important that gowns have sufficient fabric overlap so the gown covers the back and provides protection even if the user sits or squats.

They should wear non-sterile, disposable patient isolation gowns.

Again, it comes down to the contamination risk level. For critical zones where it’s likely to directly encounter blood, bodily fluids, and other potentially infectious materials, the highest level of protection is recommended. For medium to high-risk zones, level 3 or 4 isolation gowns are commonly used. For low-, medium- and high-risk zones, levels 1-4 surgical gowns can be used. Level 1 or 2 gowns are generally used when the risk of contact with bodily fluids is low or minimal.

Gowns are familiar and much easier to put on and take off than coveralls. Coveralls provide greater protection as they cover the entire body. Coveralls tend to be hotter due to the design and extended coverage.

Yes. Both PPE gowns and coveralls are appropriate for EMS personnel to wear. Coveralls provide greater coverage but may be hotter to wear while gowns are cooler and easier to take off. Follow all training procedures on how to wear and remove PPE.

Non-sterile, disposable patient examination gloves.

Standard for gloves are by the American Society for Testing and Materials (ASTM). Minimum length ranges from 220 to 230mm depending on glove type and size. The specifications for nitrile gloves, natural rubber gloves, and polychloroprene gloves have higher minimum tensile strength and elongation requirements compared to vinyl gloves.

No, the CDC does not recommend this practice.

They can be used but it is not specifically recommended by the CDC.

Check with your facility for specific guidance. If none is available, use the CDC’s sequence as described below.

Again, it comes down to knowing the hazards and exposure risks to select the appropriate type of glove. It is crucial to wash your hands with soap and water for 20 seconds or longer or use an alcohol-based hand sanitizer with 60 to 95 percent alcohol to perform hand hygiene after removing PPE.

N95 respirators, which were initially in short supply, were recommended to be reserved for use in healthcare settings. In public, surgical masks, reusable cloth face masks, and other face coverings may be used along with other measures such as physical distancing, hand hygiene, avoiding touching your face, and covering your sneeze or cough with a tissue.

Respirators, which are often used in healthcare settings, are certified by the CDC/NIOSH. A respirator is a form of PPE worn on the face or head covering the nose and mouth at a minimum. Respirators are designed to reduce the risk of inhaling infectious agents, smoke, gases, vapor, and other hazardous airborne particles.

An N95 filtering face-piece respirator filters out at least 95 percent of 0.3 micron particles including bacteria and viruses.

N95 respirators are tight-fitting face masks that filter out at least 95 percent of tiny airborne particles including bacteria and viruses. They are fit-tested to the individual to ensure a tight seal against the face. This keeps all air moving through the filter rather than around it. Not everyone can wear an N95 face mask safely.

Surgical face masks are loose-fitting and designed to protect against large respiratory particles and droplets. They provide barrier protection rather than filtering. Face masks are used for source control, which helps to prevent contamination when someone sneezes or coughs.

Surgical or medical N95 respirators are used by healthcare providers at risk of airborne and fluid hazards. They are only used in operative or procedural healthcare settings when high velocity splashes, sprays, or splatters of blood or body fluids are likely. Healthcare providers should wear these respirators when in operative or procedural settings likely to produce these hazards.

The characteristics that make medical N95 respirators so effective can also make them hot and uncomfortable. Those who are not likely to be exposed to high velocity bodily fluid streams and splashes and not in surgical environments may consider wearing a standard N95 with an exhalation valve.

Some N95 respirators have an exhalation valve to help make it easier to breathe and exhale. The N95 respirator with exhalation valve provides the same filtration as the N95 but it should not be used in sterile environments or in settings where containment of the wearer’s respiratory droplets is desired. A surgical mask may be worn over the N95 with exhalation valve.

No. This type of respirator protects the wear but may not prevent the virus spreading from the wearer to others. If both source control and respiratory protection are desired, use an N95 respirator without an exhalation valve or wear a secondary facial covering such as a surgical mask on top of it.

The NIOSH approval label (with NIOSH name, approval number, lot number, model number, and filter designations) is usually located on the packaging or on the respirator. You can also crosscheck your N95 respirator’s approvals on the NIOSH Certified Equipment List.

NIOSH maintains a webpage listing counterfeit N95 respirators on its Counterfeit Respirators / Misrepresentation of NIOSH-Approval webpage.

Yes, N95 respirators have a limited shelf life as various parts may degrade over time and lose effectiveness. Before using any N95 respirators, expired or not, the user should inspect it and perform a seal check. The CDC offers additional guidance on using N95 respirators beyond their expiration dates.

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