MODERATOR: Hello. We are going to demonstrate how to don and doff PPE when dealing with patients with COVID 19. Dr. Howard is going to demonstrate first how to don the personal protective equipment when you are concerned with droplet precautions, which will be in the majority of cases.
First, she has collected her hair. That follows by hand hygiene. It's important that you rub your hands until they are dry. That usually takes about 15 seconds.
After that, you will wear the gown. The gown has to fully cover the torso from the neck to the knees and the arms to the end of the wrists. You have to wrap around and fasten in the back. They are two fasteners, one on top and one mid torso.
After donning the gown, you can always do more hand hygiene. And then you're going to proceed with the mask, which for droplet precautions is going to be a surgical mask. If that is the kind of mask you are using, you need to add eye protection. Alternatively you can use a mask with a face shield. Finally, you wear your gloves.
Again, it's a good routine to perform hand hygiene between each of the steps. Although that will delay you a little bit, because of the fact that you need to rub your hands for 15 seconds so they are dry. And finally, you wear your gloves. And this is the standard routine droplet precaution donning of the PPE.
At the doffing, you will do this inside the patient's room. You are expected to be close to the door. And you should make sure that you have handed the waste container, the hand sanitizer, and the bag where you are going to save the equipment that can be sterilized later.
As you saw, the first thing is that she took off her gloves. Because that is the most highly contaminated part of the PPE. And that is followed by the face mask, and finally the gown.
She is being careful, because the outside of the gown is the part that is more likely to be contaminated. Then hand hygiene, and then you leave the room, and you close the door behind you.
Now we're going to make note of the modifications when you have to don PPE and there's going to be an aerosol generating procedure. As before, you will be outside the room, and you will perform hands hygiene first. And that will be followed by wearing the gown.
And in this case, an N95 mask. Remember N95 respirators are used not routinely, but only for aerosol generating procedures. Depending on the situation, you may want to cover the N95 with a surgical mask that has eye protection like that one. It's very important that there is eye protection. And again, gloves are the last item of the equipment.
Now there is an important difference when doffing the equipment in a patient's room after an aerosol generating procedure. It begins the same way, taking off the gloves first. And then you can take off the surgical mask and the eye shield if you want, but you need to leave the NP95 in place until you leave the room.
You take off the gown inside the room. You discard it. But then while still wearing the N95, you leave the room. You close the door, and then you take off your N95 mask. And that's how to doff the PPE after an aerosol generating procedure.
