Operating in Personal Protective Equipment #Ebola #globalhealth

From Chapter 9: Operating in Personal Protective Equipment in Operation Ebola: Surgical care during the West African Outbreak

Table 9.1. Lessons learned on staying safe while wearing personal protective equipment (PPE)

1. Don with a thought to how you will doff.
2. Don and doff the same way every time.
3. Don and doff correctly—have a safety person check your equipment and performance.
4. Loosen the ties on your facemask and adjust them carefully, because you cannot readjust them once you are in a hot zone.
5. Choose a suit that is snug enough to work in safely and loose enough to doff easily and safely.
6. Use the packaging bag to cover your boots when you don so they slide into the legs of your PPE more easily and do not make small tears.
7. Stretch the ankle elastic bands on the PPE so it comes off the boots more easily during doffing.
8. Some PPE suits have finger loops—do not use them. Poke a small hole in the sleeve for your thumb to prevent a gap at the cuff.
9. Wear long inner gloves so rundown doesn’t get inside your suit if your sleeves ride up.
10. Try to use colored inner gloves so you can spot a tear more easily.
11. Tie your apron’s neck up behind you so it covers up to your chin.
12. Goggles are more secure but fog more quickly than a face shield.
13. When sweat starts to pool in the sleeves of your PPE, periodically raise your arms so it runs down into your boots instead of into your gloves.
14. If your mask becomes so filled with sweat that you begin to suffocate, tip your head back to let it flow out—drink it if you need to. Tongue the mask off your nose and break scrub.
15. When you get sweat in your eyes, stay calm but step back from the table and shake it off.
16. Do not operate if you cannot see. You must be able to see and avoid sharps.
17. Do not adjust your PPE once you are in a high-risk area and NEVER allow someone else to adjust or reach inside of your PPE (to wipe sweat, for example).
18. Do not allow yourself to become so exhausted, dehydrated, or hot that you are at risk of fainting—doffing an unconscious colleague puts everyone at risk and is preventable.
19. Drink before you are thirsty and more than you can imagine. Start before you sweat and continue until your urine is clear. Do not make the ORS stronger than recommended, it will function as a bowel prep if you do and you’ll lose even more fluid.
20. Keep a situational awareness at all times, especially for sharps and splash hazards.
21. Rest before you become impaired and always remember—your safety depends on your actions.
22. Do not hesitate to break scrub if the situation feels dangerous or you are compromised.
23. Finally, there are no real emergencies in a hot zone—stay safe is the only absolute rule.