Training structure EFFO Ebola Safety and good quality work Module 1: Knowledge about Ebola Virus Disease Module 2: Community response Module 3: Standard pre-cautions Module 4: Triage & isolation Module 5: Personal protective equipment Module 6: Water, disinfection and cleaning Support from the community Support from the hospital administration Support from the population 20.05.2015

Personal Protective Equipment (PPE) Module 5 20.05.2015

Learning objectives module 5 General objective To know how to put on and take off PPE, and being prepared to work in PPE Specific objectives To know the principles of PPE To know the conditions for working in PPE Know how to use every element of PPE To be able to put on PPE  To be able to take off PPE   20.05.2015

Principle of PPE Completely cover skin and mucosa→ protection against contact with infectious agent Thereby Protecting yourself Protecting hospital staff Protecting other patients Protecting the community 20.05.2015

Which PPE is the most suitable? Examples: These are examples, and the skin is not protected. PPE may need to be adapted depending on the situation and the equipment available. Any PPE is better than nothing! However, even if you have the perfect PPE but do not know how to use it, the PPE will not protect you. RKI 20.05.2015

Always work in twos (pairs)! Demonstration N.B.: There are different types of each component of PPE, and several methods for dressing and undressing. HERE: MSF method! Repeated practice in using PPE is essential, because in critical scenarios, there is a zero tolerance for errors. Always work in twos (pairs)! Here: MSF standard!!! 20.05.2015

Elements of PPE Explanation/demonstration of PPE and exercise with gloves, goggles and hats RKI 20.05.2015

How to don personal protective equipment 20.05.2015

Before getting dressed Before getting dressed, check the following: Have you taken the time to drink sufficient fluids and go to the toilet? Have you made sure you have removed all jewellery? Long hair should be securely tied back. Is all the equipment available? Is the decontamination area prepared (-> mirror, poster, doffing instructor etc.)? Is your buddy ready and did you assign your roles (clean/ dirty person) in the red zone? Enter your name on the list when entering isolation 20.05.2015

Checklist I 1 liquid-proof suit (type 3) 2 pairs of gloves adapted for long sleeves 1 mask (FFP3, without valve) 1 pair of goggles 1 liquid-proof apron 1 hood (MSF) 1 pair of boots surgical cap (for persons with long hair) PPE FOR ONE PERSON adhesive tape 1 pen 1 binbag 1 pair of scissors 1 large poster: How to don PPE 1 mirror List of persons in PPE, attendance sheet, time of entry and exit 20.05.2015

First, put on the suit and then the boots. Step 1 Cut the legs of the suit. First, put on the suit and then the boots. Be familiar with all the component parts of your PPE, especially the suit (where the fastenings are, etc.). Cut the legs to a sufficient length. 1. Put on the legs of the outfit; 2. Put on the boots. Sit down on a chair for this step. MSF 20.05.2015

Finish putting on the suit. Put on the inner pair of gloves. Step 2 Finish putting on the suit. Put on the inner pair of gloves. MSF 20.05.2015

Put on an FFP3 mask. Step 3 MSF For person with long hair: wear a surgical cap. Always perform a seal check! MSF 20.05.2015

Step 4 Put on the hood. Make an opening in the hat mask only if necessary. MSF 20.05.2015

Put on the liquid-proof apron. Step 5 Put on the liquid-proof apron. The apron must be as high as possible. Tie the knot on a specific side. MSF 20.05.2015

Step 6 Put on goggles. Use an anti-fog spray for the goggle lenses. MSF 20.05.2015

Step 7 Put on the second pair of gloves. MSF 20.05.2015

Self-inspection Mutual inspection Before beginning work RKI RKI 20.05.2015

MSF 20.05.2015

How to doff personal protective equipment 20.05.2015

Checklist II Basin with 0.5% bleach for foot bath Sprayer with 0.5%bleach 0.5% bleach for glove-disinfection in yellow zone 0.05% bleach for hand-disinfection in green zone 1 large dustbin Basin with 0.05% bleach for reusable equipment Bin bags 1 pair of gloves large poster: How to doff PPE 1 large mirror List of persons in PPE, attendance chart Cellulose or paper towels Mop Is there sufficient bleach available? 20.05.2015

Spray the back with bleach. Spray the front of the PPE with bleach. Step 1 Bleach: 0.5 % Take off the apron. Spray the back with bleach. Spray the front of the PPE with bleach. MSF 20.05.2015

Spray the back of the PPE with bleach. Step 2 Spray the back of the PPE with bleach. MSF MSF 20.05.2015

Take off the first pair of gloves. Step 3 Bleach: 0.5 % Take off the first pair of gloves. OR Correct procedure for removing gloves! MSF 20.05.2015

Step 4 Take off the apron. Bleach: 0.5 % MSF Do not touch the front of the apron! Hold the apron by the string at the back of your neck and take it off without it touching your head. Always bend over! MSF 20.05.2015

Step 5 Take off the mask. Take off the outfit. Take off the goggles. Bleach: 0.5 % Take off the mask. Take off the outfit. Take off the goggles. Always bend over! Hold the front of the goggles and pull them off and down without touching your head. MSF 20.05.2015

Step 6 Take off the mask. Take off the hood. Take off the outfit. Bleach: 0.5 % Take off the mask. Take off the outfit. Take off the hood. Always bend over. Ensure that the strings are hanging laterally when they are torn/open. MSF 20.05.2015

Step 7 Open the fastening. Bleach: 0.5 % MSF Use the mirror and follow the instructions of the doffing instructor; work slowly and carefully! MSF 20.05.2015

Step 8 Take off the mask. Take off the suit. Bleach: 0.5 % MSF Use the mirror and follow the instructions for the decontaminator; work slowly and carefully! Touch only the inside of the outfit! If you touch the outside, wash your hands! Do not touch your clothing! MSF 20.05.2015

Use your feet to finish removing the PPE. Step 9 Use your feet to finish removing the PPE. Pull down the suit without touching your boots or your clothing. Touch only the inside of the suit! MSF 20.05.2015

Step 10 Spray the suit. MSF 20.05.2015

Step 11 Take off the mask. Bleach: 0.5 % MSF Hold the mask from the front and pull it down and off without touching your head. MSF 20.05.2015

Step 12 Take off the gloves. Bleach: 0.5 % MSF Correct procedure for gloves! MSF 20.05.2015

Spray the boots all over. Step 13 Spray the boots all over. MSF 20.05.2015

Spray the soles of the boots. Leave the high-risk area. Step 14 Spray the soles of the boots. Leave the high-risk area. MSF 20.05.2015

Step 15 Wash your hands with a 0.05% bleach solution as soon as you leave the high-risk area MSF 20.05.2015

20.05.2015

Store PPE in its original packaging Store it above ground Storing PPE Store PPE in its original packaging Store it above ground Store it in a dry place The recommended temperature range is theoretically -10 °C to + 40°C Follow instructions on package The recommended temperature range depends on the manufacturer's recommendations. 20.05.2015

Maximum working time in PPE 45-60 minutes, because: The breathing mask leads to exhaustion from the resistance it causes during breathing. Dehydration from perspiration. 20.05.2015

Thank you for your attention! 20.05.2015