CC BY-NC-ND 4.0 · Journal of Cardiac Critical Care TSS
DOI: 10.1055/s-0040-1712804
Point of Technique

A Practical Guide to a Safe Sequence of Donning and Doffing of Personal Protective Equipment in Relation to COVID-19

Vijay Samuel Richard
1  Consultant, Hospital Infection Control
,
Muralidhar Kanchi
2  Department of Cardiac Anaesthesia and Critical Care, Narayana Institute of Cardiac Sciences, Bangalore, Karnataka, India
› Author Affiliations
 

Abstract

When caring for patients with suspected or confirmed COVID-19 (coronavirus disease 2019), especially when involved in procedures that generate aerosol, personal protective equipment (PPE) with full-body coverage is recommended. The Centers for Disease Control and Prevention emphasizes and recommends the following principles with regard to donning and doffing of PPE: (1) training and education (rigorous and repeated training of the health care workers [HCWs]), (2) all HCWs must exhibit competency in the PPE donning and doffing, and (3) PPE doffing should be done in a manner that prevents self-contamination or self-inoculation with contaminated PPE or hands (remove the most contaminated PPE items first, perform hand hygiene at each stage of doffing, and discard disposable items in containers for biomedical waste).


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General Principles

When caring for patients with suspected or confirmed COVID-19 (coronavirus disease 2019), especially when involved in procedures that generate aerosol, personal protective equipment (PPE) with full-body coverage is recommended. The Centers for Disease Control and Prevention emphasizes and recommends the following principles with regard to donning and doffing of PPE: (1) training and education (rigorous and repeated training of the health care workers [HCWs]), (2) all HCWs must exhibit competency in the PPE donning and doffing, and (3) PPE doffing should be done in a manner that prevents self-contamination or self-inoculation with contaminated PPE or hands (remove the most contaminated PPE items first, perform hand hygiene at each stage of doffing, and discard disposable items in containers for biomedical waste).


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Procedure for Donning the PPE

The procedure for donning the PPE is as follows: (1) wear the PPE in a designated area before entering the patient care area, (2) undertake the procedure of putting on PPE under the guidance and supervision of a trained observer (colleague), (3) remove all personal items such as watch, jewelry, pen, cell phone, and so on, (4) use the restroom and drink sufficient water before starting to wear the PPE, (5) before donning, ensure that all required PPE are available, and (6) follow the steps as shown in [Fig. 1].

Zoom Image
Fig. 1 Donning of personal protective equipment (PPE).

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Procedure for Doffing of PPE

The procedure for doffing of PPE is as follows: (1) doffing is done in a designated area, (2) always perform doffing under the guidance and supervision of a trained observer or colleague, and (3) ensure that PPE is discarded immediately into the appropriate bin, and (4) follow the steps shown in [Fig. 2].

Zoom Image
Fig. 2 Doffing of personal protective equipment (PPE).

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Conflict of Interest

None.


Address for correspondence

Muralidhar Kanchi, MD, FIACTA, FICA, MBA, FASE
Department of Anaesthesia and Critical Care, Narayana Institute of Cardiac Sciences, Narayana Health City
#258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore 560 099, Karnataka
India   

Publication History

Publication Date:
21 May 2020 (online)

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Thieme Medical and Scientific Publishers Private Ltd.
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Zoom Image
Fig. 1 Donning of personal protective equipment (PPE).
Zoom Image
Fig. 2 Doffing of personal protective equipment (PPE).