The Role of Personal Protective Equipment
Critically important tools in helping prevent the spread of infection during a pandemic
In the event of a pandemic, the availability and appropriate use of PPE is critical in protecting hospital staff, other patients, and visitors. Even with the use of antiviral medications, N95 respirators, gowns and gloves are the last line of defense against the spread of a virus. Disposable PPE should be used whenever possible, because the virus can remain infectious on garments for long periods of time.
Who Should Use PPE During a Pandemic?
- All healthcare workers who provide direct patient care (e.g. doctors, nurses, radiographers, physiotherapists)
- All support staff, including medical aides and cleaning staff
- All laboratory workers handling specimens from a patient being investigated for the infectious disease
- All Central Service Professionals handling equipment that requires decontamination and has come from a patient with the infectious disease
- Family members or visitors
Prioritizing the Use of PPE
Prioritizing the Use of PPE When Supplies Are Limited
According to WHO Guidelines, "Provision of necessary PPE supplies should be an institutional priority.7 Reuse of disposable PPE should be avoided because it may increase the potential for contamination. However, if a sufficient supply of PPE is not available, your facility "may consider reuse of some disposable items only as an urgent, temporary solution and only if the item has not been obviously soiled or damaged (e.g. creased or torn).8
- Aerosol-generating procedures create aerosols of different sizes (large and small-article aerosols) (Annex 4). Examples of aerosol-generating procedures include: endotracheal intubation; aerosolized or nebulized medication administration; diagnostic sputum induction; bronchoscopy; airway suctioning; tracheostomy care; chest physiotherapy; nasopharyngeal aspiration; positive pressure ventilation via face mask (e.g. BiPAP, CPAP); high frequency oscillatory ventilation; postmortem excision of lung tissue.
- Wherever possible, aerosol-generating procedures should be performed in negative pressure rooms, side rooms or other single-patient areas with minimal staff present (Annex 4). PPE should cover the torso, arms, and hands as well as the eyes, nose and mouth.
- Standard precautions are the minimum level of precautions indicated for all patients at all times.
- Gloves should be worn in accordance with standard precautions. If glove demand is lightly to exceed supply, gloves use should always be prioritized for contact with blood and body fluids (ambidextrous nonsterile gloves), and contact with sterile sites (sterile gloves).
- Gloves and gown or apron should be worn during cleaning procedures.
- If splashing with blood or other body fluids is anticipated, and gowns that are not fluid-resistant are used, waterproof apron should be worn over the gown.
- If particulate respirator is not available, use tight fitting surgical mask.
- If particulate respirator is not available, use tight fitting surgical mask and face shield.
- Use eye protection if close contact (< 1 meter) with patient if possible.
- Provides surgical mask for patient (if tolerated), when patient is outside the isolation room-area.
Click here for a guide on the proper removal of PPE.
Click here to view the complete WHO Interim Infection Control Guidelines.
┼ Bird exposure in regions with AI infections in animals or exposure to AI-infected patient.
7 Avian Influenza, Including Influenza A (H5N1), in Humans: WHO Interim Infection Control Guideline for Health Care Facilities, p.14, World Health Organization, Amended April 24, 2006
8 Avian Influenza, Including Influenza A (H5N1), in Humans: WHO Interim Infection Control Guideline for Health Care Facilities, p.22, World Health Organization, Amended April 24, 2006