1. Donning and Doffing of PPE BIOS 1471- INTRODUCTION TO LABORATORY SAFETY March 1 st, 2012 BIOS 1471- INTRODUCTION TO LABORATORY SAFETY March 1 st, 2012

2. Donning and Doffing The terms donning and doffing are often used with PPE. Donning is the procedure of assembling PPE on the user and doffing is the procedure for removal of PPE. Responders should only don PPE for which they have been thoroughly trained, medically cleared to use, and fit tested to wear.

3. Level A Protective Equipment Wear this level of protection when… — Measured (or potential for) high concentration of atmospheric vapors, gases, or particulates; or the site operations and work functions involve a high potential for splash, immersion, or exposure to unexpected vapors, gases, or particulates of materials that are harmful to skin or capable of being absorbed through the skin. —Substances with a high degree of hazard to the skin are known or suspected to be present, and skin contact is possible; or —Operations must be conducted in confined, poorly ventilated areas, and the absence of conditions requiring Level A have not yet been determined. —When an event is uncontrolled or information is unknown about: the type of airborne agent, the dissemination method, if dissemination is still occurring or it has stopped

4. Level B Protective Equipment Wear this level of protection when…. —The type and atmospheric concentration of substances have been identified and require a high level of respiratory protection, but less skin protection. —IDLH conditions but not skin hazard —The atmosphere contains less than 19.5 percent oxygen; or —The presence of unknown or incompletely identified vapors or gases is indicated by a direct-reading organic vapor detection instrument, but vapors and gases are not suspected of containing high levels of chemicals harmful to skin or capable of being absorbed through the skin. —A liquid-splash-resistant ensemble used with the highest level of reparatory protection.

5. Level C Protective Equipment Wear this level of protection when…. –The atmospheric contaminants, liquid splashes or other direct contact will not adversely affect any exposed skin. –The types of air contaminants have been identified, concentrations measure and –A canister or cartridge is available that can remove the contaminant. –All criteria, including fitness testing, for the use of air-purifying respirators are met. –The atmosphere contains at least 19.5 percent oxygen.

6. Level D Protective Equipment No respiratory protection necessary and minimal skin protection. A uniform affording minimal protection for minor contamination, closed toe shoes Optional – N-95, surgical mask, gloves, safety glasses, face shield, chemical resistant boots, particulate boot covers Atmosphere contains no known hazards Atmosphere contains sufficient oxygen

7. Establishing Work Zones Purpose: To minimize the transfer of hazardous substances from the site. Security & physical barriers to exclude unnecessary personnel Optimizing # of personnel for effective operations Control points to regulate access Operate with intent to reduce exposures and eliminate airborne dispersion Perform decontamination

8. Establishing Work Zones Hot Zone - Contaminated area Warm Zone - Contamination reduction zone or decon area Cold Zone - Clean area for support equipment, traffic limited, normal work PPE, no contaminated PPE worn or stored in this area. Safe Zone - to facilitate nuisance free area

10. Factors Influencing PPE Selection Type of exposure anticipated Splash/spray versus touch Category of isolation precautions Durability and appropriateness for the task Fit

11. Gloves Purpose – patient care, environmental services, other Glove material – vinyl, latex, nitrile, other Sterile or nonsterile One or two pair Single use or reusable

12. Do’s and Don’ts of Glove Use Work from “clean to dirty” Limit opportunities for “touch contamination” - protect yourself, others, and the environment –Don’t touch your face or adjust PPE with contaminated gloves –Don’t touch environmental surfaces except as necessary during patient care

13. Do’s and Don’ts of Glove Use (cont’d) Change gloves –During use if torn and when heavily soiled (even during use on the same patient) –After use on each patient Discard in appropriate receptacle –Never wash or reuse disposable gloves

14. Gowns or Aprons Purpose of use Material – –Natural or man-made –Reusable or disposable –Resistance to fluid penetration Clean or sterile

15. Face Protection Masks – protect nose and mouth –Should fully cover nose and mouth and prevent fluid penetration Goggles – protect eyes –Should fit snuggly over and around eyes –Personal glasses not a substitute for goggles –Antifog feature improves clarity

16. Face Protection Face shields – protect face, nose, mouth, and eyes –Should cover forehead, extend below chin and wrap around side of face

17. Sequence* for Donning PPE Gown first Mask or respirator Goggles or face shield Gloves

18. How to Don a Gown Select appropriate type and size Opening is in the back Secure at neck and waist If gown is too small, use two gowns –Gown #1 ties in front –Gown #2 ties in back

19. How to Don a Mask Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with ties or elastic Adjust to fit

20. How to Don a Particulate Respirator Select a fit tested respirator Place over nose, mouth and chin Fit flexible nose piece over nose bridge Secure on head with elastic Adjust to fit Perform a fit check – –Inhale – respirator should collapse –Exhale – check for leakage around face

21. How to Don Eye and Face Protection Position goggles over eyes and secure to the head using the ear pieces or headband Position face shield over face and secure on brow with headband Adjust to fit comfortably

22. How to Don Gloves Don gloves last Select correct type and size Insert hands into gloves Extend gloves over isolation gown cuffs

23. How to Safely Use PPE Keep gloved hands away from face Avoid touching or adjusting other PPE Remove gloves if they become torn; perform hand hygiene before donning new gloves Limit surfaces and items touched

24. Sequence for Removing PPE Gloves Face shield or goggles Gown Mask or respirator

25. Where to Remove PPE At doorway, before leaving patient room or in anteroom* Remove respirator outside room, after door has been closed* *Ensure that hand hygiene facilities are available at the point needed, e.g., sink or alcohol-based hand rub

26. How to Remove Gloves (1) Grasp outside edge near wrist Peel away from hand, turning glove inside-out Hold in opposite gloved hand

27. How to Remove Gloves (2) Slide ungloved finger under the wrist of the remaining glove Peel off from inside, creating a bag for both gloves Discard

28. Remove Goggles or Face Shield Grasp ear or head pieces with ungloved hands Lift away from face Place in designated receptacle for reprocessing or disposal

29. Removing Isolation Gown Unfasten ties Peel gown away from neck and shoulder Turn contaminated outside toward the inside Fold or roll into a bundle Discard

30. Removing a Mask Untie the bottom, then top, tie Remove from face Discard

31. Removing a Particulate Respirator Lift the bottom elastic over your head first Then lift off the top elastic Discard

32. Donning & Doffing of PPE Vedios Personal Protective Equipment (PPE) –http://www.youtube.com/watch?v=iHBbWLYpCuUhttp://www.youtube.com/watch?v=iHBbWLYpCuU PPE: Chemical Level C –Donning –http://www.youtube.com/watch?v=L6fsYcTgeB0http://www.youtube.com/watch?v=L6fsYcTgeB0 PPE: Chemical Level C - Doffing –http://www.youtube.com/watch?v=2Oi5_NKObZchttp://www.youtube.com/watch?v=2Oi5_NKObZc

33. Scenario A student called and reported a chemical spill in room R118. The student had planned on resuming his experiment from the day before. When the student opened the lab door, he smelled an unusual pleasant sweet odor. In the lab the student found a 500-mL bottle labeled “Benzene” that had tipped over the bench and made a puddle on the floor underneath. If you need to clean up the spill what kind of PPE should you choose? *The concentration was determined to be 2ppm.