Welcome to using method
of Personal Protective Equipment Based on the current available evidence, the
COVID-19 virus is transmitted between people through droplet transmission when
susceptible individuals come into contact with the respiratory secretions from
a symptomatic person’s cough or sneeze. It could also be transmitted through
direct and indirect contact with contaminated surfaces and then touching your
face.
The
people most at risk of infection are those who are in close contact with a
COVID-19 patient or who care for COVID-19 patients.
Therefore,
we made this video to demonstrate how you can best protect yourself as a
healthcare worker when coming into contact with a suspected or confirmed
COVID-19 patient.
Introduction
This
is a guide for healthcare workers involved in patient care activities in a
health care setting.
It
aims to show the type of personal protective equipment (PPE) needed to
correctly protect oneself according to risk assessment, and the procedure to be
carefully followed to put them on and to remove them.
It will cover:
•
How to put on PPE correctly
•
How to remove PPE correctly and safely to avoid cross contamination to the
healthcare worker and the environment.
PPE is part of a larger
infection prevention and control approach and should be accompanied by
educational posters and training.
Only
clinical staff who are trained and competent in the use of PPE should be
allowed to enter the patient’s care area.
Safe
putting on and removal of PPE should be done outside of the patients room,
ideally in a dedicated area and either using a mirror or under the supervision
of a trained observer (colleague).
The recommended PPE set
includes:
•
A long-sleeve, fluid resistant surgical gown
•
Disposable medical gloves
•
A medical mask, also known as a surgical mask, or respirator mask for aerosol
generating procedures
•
Eye protection such as a face shield or goggles.
Ensure you have all the
necessary PPE and are able to put on the protective equipment outside of the
patient’s room.
USING OF PPE
To begin ensures you remove
all jewelry and personal items and that your hair is tied back, if applicable.
Make sure you
consider the risk involved in the care you are going to provide to the patient
to ensure you are using appropriate PPE for the precautions needed.
A. Step
1 is to perform hand hygiene: Either with
•
The preferred method of alcohol hand rub for 20-30 seconds
•
OR if not available or hands are visibly soiled, with water and soap for 40-60
seconds Clean your hands by rubbing them with an alcohol-based solution. It is
the fastest and most effective method and better tolerated by your skin. Follow
the WHO technique that ensures all the surfaces of hands are carefully covered
by the product and will eliminate the microorganisms on your hands.
Follow
these steps: STEPS: for 20 – 30 seconds
1) Apply
the product into a cupped hand.
2) Rub hands together, rubbing palm to palm.
3) Rub
the back of each hand with interlaced fingers.
4) Palm
to palm with interlaced fingers.
5) Rotate
the hands in a cupped shape.
6) Rub
thumbs rotationally.
7) Rub
tips of fingers and nail beds in each palm, continue rubbing until hands are
completely dry.
8) And
now your hands are clean and safe to proceed with the PPE.
B.
Now that you are ready to put on the
PPE, check the integrity of the equipment; and do not use any damaged equipment.
C.
Now you are
ready to put on the gown;
Tie
back long hair if applicable. Inspect equipment for damage prior to donning
each piece Put on your gown, tie around the neck and around the waist, and
secure it around the back Ensure all clothing is covered by the gown.
D.
Now, place
the medical or surgical mask on;
Ensure it is over your
nose and mouth. Pinch the metal piece to ensure a tight fit. Try not to touch
the mask once it is secured on your face. If you must do so, perform hand
hygiene before and after touching the mask.
OPTION
FOR RESPIRATOR:
OR
if you are performing an aerosol generating procedure or you need to follow
airborne precautions, put on a N95 /FFP2 / FFP3 respirator instead of medical
mask and perform a seal check.
· Lift
your chin and pull the bottom strap over your head and position it around the
back of your neck below the ears. Ensure strap is on bare skin only. Pull the
top strap over your head resting it high at the back of your head. Ensure the
straps are not overlapping or crossed.
· Place
fingertips of both hands at the top of the metal nosepiece. Mould the nosepiece
(using two fingers on each hand) to the shape of your nose applying pressure on
sides of nose to ensure seal.
· Perform
a seal check by placing your hands at the top and side of your face – without
touching the mask. Now exhale sharply. There should be no air escaping from the
sides of the mask, this would indicate a positive pressure inside the
respirator.
· If
there is leakage of air, adjust position and/or tension of the straps. Retest
the seal. Repeat the steps until respirator is sealed properly.
· Perform
a negative seal check: Inhale deeply. If no leakage, negative pressure will
make respirator cling to your face. Leakage will result in loss of negative pressure
in the respirator due to air entering through gaps in the seal.
E. Next,
put on the eye protection:
Goggles (OPTION face
shield – which can be placed over the mask with the top resting in the middle
of your forehead.)
F. Finally,
put on a pair of gloves;
Ensure they are
placed over the cuff of the gown and that no skin is exposed you must check
each piece of equipment at the end thoroughly and ensure that the equipment is
placed on correctly. It might be helpful to have a buddy, a colleague who is
competent in this procedure and could perform visual inspection.
Now you are ready to enter the patient’s room.
REMOVING PPE
The
removal of PPE poses the highest risk of transmission to health care workers.
Make sure to avoid any contact between potentially contaminated PPE and the
clothes, skin, or your face. Respect the order indicated in front of a
colleague or mirror, if possible.
STEPS;
A.
The first step
is to remove gloves:
Using
the glove to glove and skin to skin technique. This is the most soiled item
which needs to be removed first and discarded safely.
B.
Next, remove the gown:
By undoing the ties and ensure the gown is
pulled away from the body ensuring there is no contamination of your clothes or
the environment. Turn the gown inside out and dispose of safely in the garbage
or laundry hamper.
C.
Next, perform
hand hygiene with alcohol based handrub
(for 20 to 30 seconds before touching your
face to …)
D.
Remove
the eye protection:
By leaning forward and pulling them away from
your face; whether that is the face shield or goggles.)
ü Ensure
you clean the goggles or the face shield if they are reusable and place them in
a clean container.
E.
Next, remove
the mask or N95/FFP2 / FFP3:
By pulling it from the rear and dispose of it
in the disposal container or garbage.
ü Ensure
you are taking the mask off with the straps, avoid touching the mask.
F.Now as a final
step perform hand hygiene:
with alcohol based handrub or with soap and
water if they are visibly soiled.
_______________________
Prabin Dahal
______________________________
Temp= Chabahil-7, Kathmandu, Nepal
Perm= Sirthouli-5, Sindhuli, Nepal (Dudhouli-4, Sindhuli, Nepal)
CELL: 977-9860491769 / 977-
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