# PPE & Transmission-Based Precautions

## Overview

Infection Prevention and Control (IPC) during procedures includes the safe management of ‘sharps’, encompasses high-level measures such as health facility design and management, protocol-based measures such as adherence to national and facility level guidelines, and individual actions by each health care provider and ancillary staff member. The health care provider is encouraged to familiarise themselves with their facility’s specific IPC protocols and reporting systems, which is outside the scope of this module.

All clinical procedures pursue the IPC goal of asepsis. The traditional hierarchy of sterile, aseptic, and clean is outdated, poorly-defined and misleading, and is no longer recommended. This module describes how to use Personal Protective Equipment (PPE) and other measures to protect yourself and patients against the transmission of diseases by contact, droplets, and the airborne route.

## Indications

## Preparation & Choice of PPE

### Standard precautions

### Contact precautions

### Droplet precautions

### Airborne precautions

## Procedure

## Donning

After performing hand hygiene, don PPE in the correct

order:

order:

This order changes when scrubbing and gowning for theatre.

## Doffing

Remove PPE in the following order:

## Troubleshooting

I am unsure of precautions needed for COVID-19 patients.

COVID-19 spreads by contact, droplets and the airborne route. Follow the protocol at your facility, which may differ for suspected and confirmed cases, and for routine and aerosolising procedures.

Due to shortages, I have to reuse my PPE.

- Gloves:

Gloves may only be worn for one patient. In a crisis, gloves may be sanitised or washed and used for multiple patients, but only when necessary. Gloves should not be taken off and re-used, as this increases the risk of tearing.

- Medical masks:

Medical masks should ideally only be worn for one patient encounter. In emergencies, a medical mask may be worn for 6-8 hours as long as it remains clean, dry, and untouched. Fabric masks should not be used to replace medical masks.

- Respirators:

Respirators should ideally only be worn for one day. They may be worn for up to a week, as long as they remain clean and dry.

- Gowns/aprons:

Gowns and aprons should ideally only be worn for one patient encounter. In a crisis, they may be worn for a cohort of patients such as a COVID-19 ward, as long as one remains in the ward.

- Face shields/goggles:

These may be worn until damaged or no longer wearable. They should be sanitised between each use.

## References