This video shows how to don and doff personal protective equipment or PPE, used for High
Consequence Infectious Disease Level One Full Barrier Isolation.
These guidelines are adapted from CDC guidance.
Please refer to the written step-by-step instructions for donning and doffing PPE in the HCID Readiness
Binder for situations where level one PPE is used and also for more detailed information.
Angie is a trained observer and she will read the steps out loud while Heather dons the
PPE.
Heather starts by removing personal items like watches, cell phones, and pagers.
Long hair and eye glasses should be secured with a tie.
Heather visually inspects all PPE prior to donning to assure that it is not torn or ripped.
This demonstration uses a gown ensemble.
She selects the correct size PPE, ensuring that the gloves fit properly and her gown
falls to mid-calf.
Next, Heather puts on protective booties.
This step is optional.
She then performs hand hygiene with alcohol-based hand rub.
Please note that the hand hygiene steps recorded throughout this demonstration are abbreviated
for sake of time.
Since Heather suspects a viral hemorrhagic fever or VHF, she dons inner gloves with extended
cuffs.
If a respiratory HCID is suspected, she would put on a single pair of gloves later in the
donning process.
After her inner gloves are in place, Heather puts on her gown, making sure all ties and
fasteners are secured.
The gown should fall to mid-calf, and Heather should be able to move unrestricted.
The inner glove cuffs should be tucked under gown sleeves.
Next, Heather chooses the appropriate facial protection.
Heather puts on a surgical face mask since it can be used in place of a respirator for
clinically stable persons under investigation for VHF.
If her patient has a respiratory HCID, Heather would don an N95 respirator or a powered air-purifying
respirator also known as a PAPR.
Next, Heather puts on a hair cover.
It should cover all hair and the ears.
This step is optional and should be skipped if using a PAPR.
She then dons the outer gloves and ensures the extended cuffs are pulled over the gown
sleeves.
This is where you would put on a single pair of extended cuff gloves for a respiratory
HCID.
Next, Heather puts on a full face shield over the hair cover and surgical mask or N95 respirator.
This is where a PAPR with an integrated face shield would be donned.
Heather asks Angie to help verify the integrity of the PPE ensemble.
Heather makes sure she is comfortable and able to go through a range of motion while
remaining correctly covered.
Heather is ready to enter the level 1 full barrier isolation room.
As Heather exits the room, she knows her PPE is contaminated.
Angie, the trained observer, helps her visually inspect the PPE to assess for visible contamination,
cuts, or tears before starting to remove it.
If PPE is visibly contaminated, Heather would clean and disinfect it using an EPA-registered
disinfectant wipe.
Since Heather donned two pairs of extended cuff gloves, she first disinfects the outer
gloves with an alcohol-based hand rub and then removes the outer gloves.
Because her patient has a suspected viral hemorrhagic fever, the discarded PPE is placed
into a red bag inside a leak-proof infectious waste container.
If the patient has a suspected respiratory HCID like MERS, SARS, or pandemic influenza,
the PPE can be placed into the regular waste stream.
Next, Heather inspects and disinfects her inner gloves.
If a single pair of gloves was worn for a patient suspected of having a respiratory
illness, inspect and disinfect.
Heather removes the full face shield, leaving the surgical face mask or N95 respirator on.
She tilts her head slightly forward, grasps the rear strap, and pulls it gently over her
head, allowing it to fall forward.
If Heather was wearing a PAPR with an external belt-mounted blower instead of a respirator
and face shield, she would remove it at this time by first removing the PAPR tubing from
the hood.
Next, Heather would remove the hood by tilting the head slightly forward and allowing the
hood to fall forward.
Then, she would unfasten the PAPR belt and place the reusable components into a container
for cleaning.
If she was wearing a PAPR with a self-contained blower in the helmet, Heather would wait until
the end of doffing to remove it.
After removing the face shield and disinfecting the inner gloves, Heather removes and discards
the hair cover if worn.
To do this, she tilts her head slightly forward and pulls it off.
Next, she disinfects the inner gloves again.
Heather removes the gown by untying or gently breaking the fasteners.
She carefully pulls the gown away from her body, folds inside out, and places it in the
waste receptacle.
Heather disinfects the inner gloves, and removes booties if worn.
She sits on a clean surface to avoid contaminating her pant legs.
Next, Heather disinfects and removes her inner gloves, taking care not to contaminate her
bare hands during the removal process.
Heather needs to perform hand hygiene on her bare hands before donning a new pair of gloves.
Now, she removes the face mask, taking care to not touch the front of the mask or respirator.
If Heather used an N95 respirator, she would remove it now by tilting the head forward,
grasping the bottom elastic strap first, then the top elastic strap, and pulling them over
her head.
If she used a PAPR with a self-contained blower in the helmet, she would remove it now.
Once the facial protection is removed, Heather disinfects and removes her gloves and performs
hand hygiene one final time.
Once all the level one PPE is removed, Angie helps Heather inspect her clothing for contamination.
If contamination is identified, Heather would need to shower immediately and inform the
occupational health coordinator about the potential exposure.