Personal Protective Equipment and Covid-19 | NEJM – nejm.org

Because you may be wearing PPE for an extended period of time, make sure that you are well hydrated and use the restroom before putting on PPE. If you wear prescription eyeglasses, make sure that they are positioned securely on your face. Prescription eyeglasses alone do not suffice as eye protection.

Put on the PPE when you are near the patient’s room. Before donning PPE, it is advisable to change into scrubs, secure long hair, and remove personal items such as jewelry.

Before handling any PPE, wash your hands with soap and water or clean your hands with an alcohol-based hand sanitizer. Visually check the integrity of the equipment. If possible, have an observer watch you as you put on the PPE to make sure there are no breaches in technique.

If the gown has an opening for your head, pull the gown over your head through the opening. If the gown does not have such an opening, fasten it behind your neck. When using a respirator, cup the outside of the respirator in your dominant hand, holding the pliable nasal strip with your fingertips and letting the two straps hang freely around your hand. Bring the respirator to your face. Secure the lower strap around the back of your neck, and then secure the upper strap behind your head. Mold the pliable nasal strip around the bridge of your nose with both hands, without tenting it. Do not pinch the nosepiece with one hand.

Figure 1. Figure 1. Testing for Air Leaks.

Check the seal of the respirator. Begin by covering the respirator with your hands and inhaling deeply and quickly several times. The respirator should collapse slightly against your face when you inhale. Next, place your hands around the edges of the respirator and exhale to determine whether there are any air leaks (Figure 1). If the respirator fails to collapse or if air leaks from the sides, remold the nasal strip and adjust the positioning of the respirator on your face. If you are still unable to obtain a complete seal, consider using a PAPR.

Put on the face shield, letting it rest on your forehead and securing the strap on the back of your head. If your hair is tied in a bun, make sure the strap is positioned in a manner that ensures that the strap will not slide up or down. Adjust the elastic strap if necessary, to ensure a snug fit. If you are wearing eyeglasses, make sure they are secure to minimize the need to readjust them during patient care.

Disinfect your hands with an alcohol-based hand sanitizer. Put on the gloves and extend the cuffs over the sleeves of the gown. You are now ready to enter the patient’s room.