5 Personal Protective Equipment

Choose PPE for the task and exposure

Personal protective equipment (PPE) includes gloves, gowns, masks, eye protection, and respirators. Choose equipment according to the task, expected exposure, and any indicated precautions rather than wearing the same items for every interaction.

Standard Precautions apply to every patient. Assess the anticipated exposure even when no Transmission-Based Precautions are indicated and there is no known infection. For example, wear gloves when a task could expose hands to body fluids, and add other PPE when the task or exposure risk calls for it.

Follow the indicated precautions

Use the posted isolation instructions along with facility PPE procedures. Precautions determine what is generally required on entry, while the task and anticipated exposure may call for additional protection.

• Contact Precautions: Generally put on a gown and gloves when entering for care that may involve contact with the patient or nearby surfaces. Discard them before leaving, according to posted instructions and facility procedure.

• Droplet Precautions: Generally put on a mask upon entry to the patient’s room or care space. Additional PPE may be needed based on the task and expected exposure.

• Airborne Precautions: Put on the required fit-tested respirator before entry and check its fit. Follow the facility’s respiratory-protection procedures and posted precautions.

Match protective equipment to the exposure

Select PPE for the specific exposure expected. If a procedure is likely to splash blood toward the face and contaminate clothing, gloves and a gown protect the hands and clothing, while a mask with eye protection or a face shield helps protect the face from splashes. PPE choices should match the exposure rather than rely on a single item, such as gloves alone or a mask alone.

Put on PPE in sequence

Perform hand hygiene before donning PPE. A usual example sequence for putting on a gown, mask or respirator, eye protection, and gloves is:

1. Gown.

2. Mask or respirator.

3. Goggles or face shield.

4. Gloves.

Make sure the gown covers the torso and arms, and extend the gloves over the gown cuffs. Follow the procedure for the specific PPE being used.

Remove contaminated PPE carefully

Remove PPE carefully because its outer surfaces may be contaminated. Avoid touching contaminated surfaces with bare hands, and follow the procedure for the specific equipment.

• Gloves: Grasp the outside of one glove with the other gloved hand and peel it off. Slide fingers under the cuff of the remaining glove and peel it off without touching its outside. Discard single-use gloves.

• Eye protection: Handle a face shield by its strap or arms, not its front. Handle reusable eye protection by its designated clean areas for reprocessing.

• Gown: Peel it away and turn it inside out so the contaminated surface is turned inward. The front and sleeves may be contaminated.

Dispose of PPE and perform hand hygiene

For the CDC example sequence when leaving a room under Airborne Precautions, remove other PPE before leaving the room, then remove the respirator after exiting and closing the door. Posted instructions or facility procedures may specify a different procedure, so follow the applicable directions.

Dispose of single-use PPE in the appropriate waste container. Put reusable equipment in its designated receptacle or reprocessing area for cleaning and disinfection. Do not leave PPE for the next staff member, keep it in a pocket for later disposal, or reuse single-use items for another patient because they look clean. Perform hand hygiene after removing PPE and whenever hands become contaminated during removal.