CBRNE Training Academy Advanced Personal Protective Equipment (PPE) and Standard Precautions CBRNE Training - Personal Protective Equipment

Objectives Establish the buddy system Show standard precautions Illustrate preparation Illustrate proper donning of PPE Illustrate proper doffing of PPE Describe post operation activities Define safety and health issues CBRNE Training - Personal Protective Equipment

Find a buddy Like any activity, it is always important to have a buddy. Your buddy may be anyone who can assist you in putting on your gear. CBRNE Training - Personal Protective Equipment

Tie back all hair Always remember to secure long hair prior to putting on gear. CBRNE Training - Personal Protective Equipment

Remove watches, jewelry, etc. Remember to remove all valuables, watches and jewelry prior to putting on the protective equipment. This will prevent their loss, as well as prevent them from getting contaminated in case of suit failure. CBRNE Training - Personal Protective Equipment

Before anything else. . . Water . . . Check. CBRNE Training - Personal Protective Equipment

Drink water Prior to donning the gear, make sure that you hydrate yourself with at least 8 to 16 ounces of water. The suits can become very hot, and depending on the ambient temperature, you can sweat profusely. CBRNE Training - Personal Protective Equipment

Go to the bathroom Always remember to go to the bathroom before putting on the gear. CBRNE Training - Personal Protective Equipment

Brief exam and vital signs It is important to have a baseline prior to putting on all the equipment. Check heart rate, blood pressure, and generally assess how a person is feeling. This is a stressful time. If someone doesn’t feel well enough to put on and use the equipment, they should stop here. CBRNE Training - Personal Protective Equipment

What equipment do we use? My buddy with my gear bag . . . Check. CBRNE Training - Personal Protective Equipment

Duct tape . . . Check. Duct tape . . . Check. CBRNE Training - Personal Protective Equipment

Inner gloves . . . Check. Inner gloves, nitrile. . . Check. CBRNE Training - Personal Protective Equipment

Outer gloves . . . Check. Outer gloves, neoprene or butyl rubber (dishwashing gloves) . . . Check. CBRNE Training - Personal Protective Equipment

Footies (clear) . . . Check. Inner footwear, in this case clear plastic booties . . . Check. CBRNE Training - Personal Protective Equipment

Standard footies . . . Check. Inner footwear, in this case cloth footies . . . Check. CBRNE Training - Personal Protective Equipment

Outer rubber boots . . . Check. Outer footwear, butyl rubber boots . . . Check. CBRNE Training - Personal Protective Equipment

Tyvek suit . . . Check. Protective suit . . . Check. CBRNE Training - Personal Protective Equipment

No rips, intact seams . . . Check. Layout the suit, check seams and look for holes . . . Check. Make sure that the suit is of a larger size than you think you need, so that it doesn’t rip when you are bending or exerting yourself. CBRNE Training - Personal Protective Equipment

Everything together Gear laid out and assembled CBRNE Training - Personal Protective Equipment

Air filters for PAPR . . . Check. Filters for the PAPR . . . Check. CBRNE Training - Personal Protective Equipment

Battery pack . . . Check. FULLY charged battery . . . Check. CBRNE Training - Personal Protective Equipment

PAPR hood and hose . . . Check. PAPR hood, hose and unit, along with filters . . . Check. CBRNE Training - Personal Protective Equipment

Everything together All gear laid out CBRNE Training - Personal Protective Equipment

Donning

Sit and take off your shoes First thing is to sit and to remove your shoes CBRNE Training - Personal Protective Equipment

Put on foot covers Then apply the inner footwear of your choice, in this case, footies, over your socks CBRNE Training - Personal Protective Equipment

Suit on to waist Pull on the suit, halfway to your waist CBRNE Training - Personal Protective Equipment

Heavy outer boots Pull on the heavy outer boots CBRNE Training - Personal Protective Equipment

Pull them all the way on CBRNE Training - Personal Protective Equipment

Your buddy can help you Your partner can assist you in getting the boots on your feet CBRNE Training - Personal Protective Equipment

Tape the boot to the suit Start to tape the cuff of the boot to the suit CBRNE Training - Personal Protective Equipment

Seal it tightly Make sure to seal the boot tightly CBRNE Training - Personal Protective Equipment

Leave a flap for later When finishing taping, make a flap of tape so that removal later is easier with gloves. CBRNE Training - Personal Protective Equipment

Put on inner gloves Put on your inner gloves. You may elect to put on your outer gloves at this time as well. CBRNE Training - Personal Protective Equipment

Outer gloves on (or not) CBRNE Training - Personal Protective Equipment

Suit on, outer gloves over Pull up the suit, and place your hands through. Layer the gloves so that it is skin – inner glove – suit cuff – outer glove CBRNE Training - Personal Protective Equipment

Buddy tape on outer gloves Have your partner assist you in taping the outer glove to the suit CBRNE Training - Personal Protective Equipment

Make a tight seal CBRNE Training - Personal Protective Equipment

Secure this well Make sure that the tape/suit seam is tightly taped CBRNE Training - Personal Protective Equipment

Don’t forget the flap Remember the flap CBRNE Training - Personal Protective Equipment

Sealed outer glove (with flap) Remember the flap CBRNE Training - Personal Protective Equipment

Zip the suit (almost all the way) Zip up the front of the suit, almost to the top CBRNE Training - Personal Protective Equipment

Tuck in the suit hood Roll the hood up, and tuck it into the back of the suit. It tends to get in the way, and fall in your face when you are wearing the PAPR hood. CBRNE Training - Personal Protective Equipment

Prepare filters Prepare your filters, first by removing the cap that covers the attachment to the PAPR unit CBRNE Training - Personal Protective Equipment

Remove screw cap CBRNE Training - Personal Protective Equipment

***Remove pull tab*** *** IMPORTANT *** If you do not remove the cap on the atmospheric side of the filter, you will NOT BE ABLE TO BREATHE CBRNE Training - Personal Protective Equipment

*** Remove pull tab *** *** IMPORTANT *** Do NOT FORGET to pull the cap off the filter CBRNE Training - Personal Protective Equipment

Screw filter to PAPR Attach the filter units to the PAPR unit CBRNE Training - Personal Protective Equipment

Screw filter to PAPR CBRNE Training - Personal Protective Equipment

Screw filter to PAPR CBRNE Training - Personal Protective Equipment

Plug in the battery, test flow Plug in the battery to test the unit, and the airflow CBRNE Training - Personal Protective Equipment

Check air flow meter Test the airflow of the unit using the supplied meter CBRNE Training - Personal Protective Equipment

Put the hood on Pull the hood over your head CBRNE Training - Personal Protective Equipment

Adjust so you can see Comfortable, isn’t it? CBRNE Training - Personal Protective Equipment

Buddy help put on belt Have your partner assist you in applying the PAPR belt CBRNE Training - Personal Protective Equipment

PAPR belt CBRNE Training - Personal Protective Equipment

Cinch the belt tightly Secure the belt tightly to your waist, comfortably position the unit in the back. CBRNE Training - Personal Protective Equipment

Tuck in the PAPR inner flap With your partners assistance, tuck the inner flap of the PAPR hood into the suit. This is why we didn’t seal up the suit all the way. CBRNE Training - Personal Protective Equipment

Tuck the inner flap Tuck the inner flap into the suit CBRNE Training - Personal Protective Equipment

Tuck all around Hold up the outer flap CBRNE Training - Personal Protective Equipment

Now seal the front of the suit Have your partner assist you in sealing up your suit. If your suit does not come with an adhesive strip like the one pictured, tightly tape the front seam of the suit with duct tape, making sure to seal all the way up to the neck. Make a tape flap at the end to facilitate removal. CBRNE Training - Personal Protective Equipment

Take the air hose and . . . Take the airhose and position it OVER your shoulder CBRNE Training - Personal Protective Equipment

Put it OVER your shoulder Correct orientation and placement of the airhose CBRNE Training - Personal Protective Equipment

Fully CHARGED battery Connect the FULLY CHARGED battery CBRNE Training - Personal Protective Equipment

Hook battery to belt Attach the battery to the belt CBRNE Training - Personal Protective Equipment

Battery out of the way Make sure that the battery is fully seated on the belt, and not in the way of hands or the PAPR CBRNE Training - Personal Protective Equipment

Secure the connection Secure the battery to the belt with a piece of duct tape CBRNE Training - Personal Protective Equipment

Fully suited . . . Now you are fully suited CBRNE Training - Personal Protective Equipment

Label everyone clearly Have your partner place a large piece of tape on your back with your name and role. Alternatively, you can wear a posey or other vest that indicates the same thing. CBRNE Training - Personal Protective Equipment

Record the “time on air” Make sure that your partner, or the safety officer or other official, marks down the time that the battery was connected to the PAPR, so that someone can keep track of how long you are on “artificial air.” CBRNE Training - Personal Protective Equipment

Ready to go! Practice your hand signals. CBRNE Training - Personal Protective Equipment

Doffing

Last one through . . . You have successfully completed the mission. The last person through the decontamination shower should be you. That is snow, not fallout. CBRNE Training - Personal Protective Equipment

Nothing like a shower This should remove the majority of the gross decontamination left on the suit, and should make doffing a safer process. CBRNE Training - Personal Protective Equipment

Border of warm and cold zones Mission accomplished. You are now in the warm zone, ready to get out of this gear. CBRNE Training - Personal Protective Equipment

Sit down Sit down. You deserve it. CBRNE Training - Personal Protective Equipment

Your buddy is watching From a safe position in the cold zone, your buddy should be monitoring your progress CBRNE Training - Personal Protective Equipment

Undo the tape flap Grasp the conveniently placed tape flap on your boots. CBRNE Training - Personal Protective Equipment

Un-tape the outer boots Unwrap the tape CBRNE Training - Personal Protective Equipment

Un-tape boots CBRNE Training - Personal Protective Equipment

What is wrong with this? Toss the tape in a receptacle. Technically, this should be a clear plastic bag, and should not be a red biohazard bag. CBRNE Training - Personal Protective Equipment

Dispose in CLEAR bags Bio-hazard waste is expensive to eliminate. Most of the time, you don’t know what you are dealing with in a decontamination event. A clear bag offers the same convenience, is disposable, and allows you to see what you have in there without having to open it later. CBRNE Training - Personal Protective Equipment

Remove the outer boot Remove your outer boots CBRNE Training - Personal Protective Equipment

Collect (or dispose) outer boot Place the boots in the same receptacle if not recyclable, or a separate container if they are to be re-used CBRNE Training - Personal Protective Equipment

Grasp outer glove tape flap Grasp the conveniently placed tape flap on your gloves CBRNE Training - Personal Protective Equipment

Remove tape Unwrap the tape CBRNE Training - Personal Protective Equipment

Remove tape CBRNE Training - Personal Protective Equipment

Remove outer gloves Remove the outer gloves. Same note applies as to the boots and the bag CBRNE Training - Personal Protective Equipment

Unhook the PAPR belt Unhook your PAPR belt CBRNE Training - Personal Protective Equipment

Pull the outer flap OVER head Pull from the back of the outer hood, forward, leaning forward CBRNE Training - Personal Protective Equipment

Pull PAPR hood forward Pull the hood off your head forward CBRNE Training - Personal Protective Equipment

Place hood on ground Place the hood, and PAPR unit on the ground CBRNE Training - Personal Protective Equipment

Unseal and unzip suit Unseal the front of your suit, and begin to unzip CBRNE Training - Personal Protective Equipment

Unzip suit Carefully unzip the suit, always pulling away from yourself CBRNE Training - Personal Protective Equipment

Peel front to back Roll the suit backwards off of your body CBRNE Training - Personal Protective Equipment

Unroll like a banana CBRNE Training - Personal Protective Equipment

Keep peeling Continue to roll the suit down, like you are peeling a banana CBRNE Training - Personal Protective Equipment

Unpeel into receptacle The suit goes into the same receptacle as the boots and gloves, based on the recycle or reuse policy at your institution CBRNE Training - Personal Protective Equipment

Remove shoe covers Warm Zone Cold Zone Clean chair in the cold zone. Fresh bag for your shoe covers. Notice that the outer lip of the cover is grasped, and the shoe cover is rolled from out to off. Feet technically should then reside in the cold zone once the cover is off (since your shoes or socks should be clean.) CBRNE Training - Personal Protective Equipment

Removing the inner glove Warm Zone Cold Zone Sitting in the cold zone. Grab the outer lip of the inner glove. Start to roll the glove off of your hand. CBRNE Training - Personal Protective Equipment

Removing the inner glove Warm Zone Cold Zone Pull off the glove. Keeping your clean hand free. CBRNE Training - Personal Protective Equipment

Remove the other glove Warm Zone Cold Zone Slide your clean fingers under the cuff of the other glove. CBRNE Training - Personal Protective Equipment

Remove the other glove Warm Zone Cold Zone Roll the glove off your hand CBRNE Training - Personal Protective Equipment

Remove the other glove Warm Zone Warm Zone Cold Zone Finally, dispose of both the gloves in the clear bag. The bag should be in the warm zone. CBRNE Training - Personal Protective Equipment

Post operation check Check in with your buddy or the safety officer. CBRNE Training - Personal Protective Equipment

Did we forget anything?

Recheck vitals It is important to be evaluated after being outside working in the suits. Pulse, blood pressure and general examination should be performed CBRNE Training - Personal Protective Equipment

Drink MORE water Don’t forget to drink another 8 to 12 ounces of water after being outside. CBRNE Training - Personal Protective Equipment

A job well done! A job well done! CBRNE Training - Personal Protective Equipment

Standard precautions doff Follows same principles as PPE See handout in appendix

Fully protected, now done

First, the gloves

Grasp outer, peel off

Peel off, like a banana

Now the other glove

Slide under cuff, peel out

Peel away from skin

Throw into receptacle

Now the gown . . .

Just like a banana

Always in front of you

Into the trash

Now the mask . . .

Fini!

Questions ?