I have my vehicle set up to make infection control and biosecurity at the forefront of
I have my vehicle set up to make infection control and biosecurity at the forefront of

my mind, and simple to achieve.
my mind, and simple to achieve.

So I have gloves in my eye line, to remind me to put them on straight away.
So I have gloves in my eye line, to remind me to put them on straight away.

Alcohol hand rub is easily accessible, so I use it before leaving every property.
Alcohol hand rub is easily accessible, so I use it before leaving every property.

Sharps disposal and clinical waste are secure and accessible.
Sharps disposal and clinical waste are secure and accessible.

There is a complete set of PPE made up in a separate tub.
There is a complete set of PPE made up in a separate tub.

I also have disinfectant within reach, so I can disinfect my gear before I leave the
I also have disinfectant within reach, so I can disinfect my gear before I leave the

property.
property.

So let me take you through my approach when I first arrive at a property.
So let me take you through my approach when I first arrive at a property.

At the time the client calls to book an appointment, the team member who takes the call asks if
At the time the client calls to book an appointment, the team member who takes the call asks if

the horse has been well, what its current vaccination status in, and any relevant history,
the horse has been well, what its current vaccination status in, and any relevant history,

so I know this before I arrive.
so I know this before I arrive.

When I'm dealing with an apparently healthy horse, I automatically run through a mental
When I'm dealing with an apparently healthy horse, I automatically run through a mental

checklist in my head.
checklist in my head.

What's the horse's history?
What's the horse's history?

What am I seeing and detecting right now?
What am I seeing and detecting right now?

What does the horse look like on distant exam?
What does the horse look like on distant exam?

The horse's demeanour, signs of clinical disease, whether it has a fever, and what my level
The horse's demeanour, signs of clinical disease, whether it has a fever, and what my level

of contact will be with blood and body fluids.
of contact will be with blood and body fluids.

I then ask the owner for a detailed recent history on the horse.
I then ask the owner for a detailed recent history on the horse.

And some of this includes whether the horse has recently displayed any changes to eating,
And some of this includes whether the horse has recently displayed any changes to eating,

drinking, or behaviour.
drinking, or behaviour.

Or, has displayed any signs of illness, such as a fever, respiratory signs, or neurological
Or, has displayed any signs of illness, such as a fever, respiratory signs, or neurological

symptoms.
symptoms.

What's its current vaccination status?
What's its current vaccination status?

Specifically around Hendra virus, and is it up to date?
Specifically around Hendra virus, and is it up to date?

If the horse has traveled from an area known to have had cases of Hendra virus infection,
If the horse has traveled from an area known to have had cases of Hendra virus infection,

and are any other horses on the property sick?
and are any other horses on the property sick?

Then I take a tiered approach to selecting my PPE.
Then I take a tiered approach to selecting my PPE.

Healthy horse, with a non-invasive procedure, I need tier 1 PPE.
Healthy horse, with a non-invasive procedure, I need tier 1 PPE.

A healthy horse, undergoing invasive procedures where I may have contact with blood or bodily
A healthy horse, undergoing invasive procedures where I may have contact with blood or bodily

fluids, I need tier 2.
fluids, I need tier 2.

And a sick horse, I need tier 3 PPE.
And a sick horse, I need tier 3 PPE.

I choose tier 1 PPE for examining a healthy horse.
I choose tier 1 PPE for examining a healthy horse.

I wear disposable gloves to examine every horse because often I have no or limited water
I wear disposable gloves to examine every horse because often I have no or limited water

to wash.
to wash.

And wearing my gloves makes me think about not contaminating my face or phone.
And wearing my gloves makes me think about not contaminating my face or phone.

I'm almost always coming into contact with blood or body fluids, even if it's just saliva
I'm almost always coming into contact with blood or body fluids, even if it's just saliva

when I check the mucus membranes.
when I check the mucus membranes.

I'm always careful to cover any cuts or abrasions, and I always wash my hands or use alcohol
I'm always careful to cover any cuts or abrasions, and I always wash my hands or use alcohol

hand rub after removing my PPE.
hand rub after removing my PPE.

When I'm examining an apparently healthy horse, I'm mitigating against zoonotic diseases,
When I'm examining an apparently healthy horse, I'm mitigating against zoonotic diseases,

both known and emerging, that pose a risk to human health.
both known and emerging, that pose a risk to human health.

Some of these include emerging zoonoses like psittacosis of equine origin, multi-resistant
Some of these include emerging zoonoses like psittacosis of equine origin, multi-resistant

organisms, Salmonella infection, Hendra virus infection, Australian bat lyssavirus, which
organisms, Salmonella infection, Hendra virus infection, Australian bat lyssavirus, which

has caused disease in horses, and also more common diseases, such as ringworm.
has caused disease in horses, and also more common diseases, such as ringworm.

I choose tier 2 PPE for contact with an apparently healthy horse on which I'm performing an invasive
I choose tier 2 PPE for contact with an apparently healthy horse on which I'm performing an invasive

procedure.
procedure.

If I'm going to have contact with non- intact skin, mucus membranes, or blood and body fluids,
If I'm going to have contact with non- intact skin, mucus membranes, or blood and body fluids,

then I wear gloves.
then I wear gloves.

I always wear gloves.
I always wear gloves.

Eye or face protection, such as safety glasses or goggles, or a face shield if I think I
Eye or face protection, such as safety glasses or goggles, or a face shield if I think I

could be splashed in the face.
could be splashed in the face.

And a gown or coveralls to cover my clothing.
And a gown or coveralls to cover my clothing.

If I'm going to do a procedure that may generate infectious aerosols, especially from the respiratory
If I'm going to do a procedure that may generate infectious aerosols, especially from the respiratory

tract, then I wear gloves, a disposable P2 respirator, eye or face protection, and a
tract, then I wear gloves, a disposable P2 respirator, eye or face protection, and a

gown or overalls to cover my clothing.
gown or overalls to cover my clothing.

I choose tier 2 PPE for invasive procedures on a healthy horse to mitigate zoonoses such
I choose tier 2 PPE for invasive procedures on a healthy horse to mitigate zoonoses such

as Hendra virus, multi-drug resistant organisms, psittacosis of equine origin, especially with
as Hendra virus, multi-drug resistant organisms, psittacosis of equine origin, especially with

exposure to placentas and foetal fluids, or any other emerging zoonoses that we don't
exposure to placentas and foetal fluids, or any other emerging zoonoses that we don't

know about.
know about.

I choose tier 3 PPE if I'm dealing with a sick horse.
I choose tier 3 PPE if I'm dealing with a sick horse.

However, then I break this down into two categories in my head.
However, then I break this down into two categories in my head.

So if Hendra is part of the differential diagnoses, I don a complete set of PPE.
So if Hendra is part of the differential diagnoses, I don a complete set of PPE.

The AVA EVA 2011 video Suit Up takes you through PPE for Hendra virus.
The AVA EVA 2011 video Suit Up takes you through PPE for Hendra virus.

If Hendra virus is not part of the differential diagnoses, but I could be exposed to other
If Hendra virus is not part of the differential diagnoses, but I could be exposed to other

zoonoses or there are biosecurity risks, then PPE will depend on my level of contact with
zoonoses or there are biosecurity risks, then PPE will depend on my level of contact with

blood and body fluids and what infections diseases I'm considering and how these spread.
blood and body fluids and what infections diseases I'm considering and how these spread.

So this might include things like gloves, eye or face protection - that is safety glasses
So this might include things like gloves, eye or face protection - that is safety glasses

or goggles or a face shield if blood and body fluids can splash on my face - a disposable
or goggles or a face shield if blood and body fluids can splash on my face - a disposable

P2 respirator if I could inhale infections aerosols, shoe covers or rubber boots, and
P2 respirator if I could inhale infections aerosols, shoe covers or rubber boots, and

overalls.
overalls.

If I'm treating a horse with diarrhea or known Salmonella infection, I will also wear disposable
If I'm treating a horse with diarrhea or known Salmonella infection, I will also wear disposable

overalls and rubber boots.
overalls and rubber boots.

By learning and following these steps in the use of PPE, you're protecting yourself and
By learning and following these steps in the use of PPE, you're protecting yourself and

others from the spread of disease.
others from the spread of disease.