The fitting and use of personal protective equipment is so important to limit infection spread. We aren’t always the best at it. Sometimes we are too embarrassed to ask how to do it properly and we certainly can’t practice with every team member in the hospital, especially at times of greatest need, such as pandemics, as supplies of gowns and masks are short.
Here are the approaches:
Remember this: The gloves are the DIRTIEST thing you will remove. Don’t contaminate other things with them.
Recommendation from the Department of Health.
There are 2 techniques that can be used:
TECHNIQUE 1
- Take the gloves off first, without touching the skin of your hands, then wash hands or use alcohol-based hand wash, before doing anything else.
In some centres they advocate putting on another set of gloves, although this is not always necessary.
- Then take the goggles off by pulling them off from the back, not front.
- Then take off the gown, by remove it from behind as the front is more likely to be contaminated.
- Remove the respirator by pulling off from the back not front, but only do this when out of the room.
- Then wash hands.
TECHNIQUE 2 ( my preferred technique)
- Pull the front of the gown forward and pull into itself, folding it, so that the contaminated sections are folded inward on themselves.
Peel the gloves off at the same time, only touching the inside of the gloves.
Fold and throw away.
- Remove the goggles from behind
- Remove the respirator when you leave the room, by pulling it forward from behind.
- Wash hands immediately
Think about how you would do it.
COVID-19 Specific
- Limit the number of people in the room
- Beware as high-flow nasal oxygenation, Non-Invasive Ventilation and nebulisers may increase viral spread.
- If the patient is very unwell and needs intubation do the following:
- The most experienced person should be intubating
- Rapid Sequence Intubation should be used
- Video laryngoscopy, if it shortens the time to intubation should be used
- The person intubating should wear sealed goggles, so as not to have droplets depositing into the eyes.
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