Personal Protective Equipment (PPE) is specialized clothing or equipment worn by an individual to create a physical barrier against environmental hazards, such as infectious agents or chemicals. The purpose of this gear is to prevent contact with and transmission of contaminants, thereby safeguarding the wearer’s skin, clothing, and respiratory system. The process of putting on, or “donning,” this equipment must follow a precise, sequential order. Following a strict sequence is paramount because it ensures that the cleanest item is placed over a potentially less clean one, building a continuous barrier from the inside out.
Essential Pre-Donning Preparation
Before touching any protective gear, the wearer must perform meticulous hand hygiene to prevent self-contamination. This involves washing hands thoroughly with soap and water or using an alcohol-based hand sanitizer. Hands must be completely dry before proceeding, as they will handle the interior, clean surfaces of the equipment.
Next, inspect all components of the personal protective equipment to be used. Check each item for visible defects, such as tears in the gown or mask, and confirm that all pieces are available and correctly sized. This preparatory check also includes verifying the expiration dates on sterile or chemical-resistant items to ensure their barrier integrity has not been compromised.
Step-by-Step Application Sequence
The application sequence begins with the gown, which serves as the primary barrier for the body. The gown must cover the torso from the neck down to the knees, with sleeves extending to the end of the wrists. The wearer secures the neck ties and then brings the gown around the back to fasten the waist ties, ensuring the garment covers any exposed clothing in the back.
Next, a mask or respirator is applied over the mouth and nose to protect the respiratory system from inhalation hazards. A surgical mask is secured using ear loops or ties, and the flexible metal nose piece is pinched to conform snugly to the bridge of the nose. When donning an N95 respirator, the top strap is placed high on the crown of the head while the bottom strap is positioned around the neck, below the ears.
Eye protection, either goggles or a face shield, is donned immediately after the respiratory protection. This item should be positioned over the mask or respirator without disturbing the seal of the facepiece beneath it. The eye protection must cover the eyes and surrounding facial areas to shield against splashes and droplets.
The final item applied is the gloves, which are considered the most contaminated piece during use and are therefore put on last. The gloves must be pulled up so that the cuff extends completely over the cuff of the gown sleeve. Creating this overlap ensures a continuous, unbroken physical barrier, eliminating any exposed skin at the wrist area.
Verifying Proper Seal and Fit
A final verification of the fit and seal must be performed before entering any hazardous environment. The most rigorous check involves the respiratory device, where a user seal check is performed for N95 respirators.
Positive Pressure Check
Place both hands over the respirator and exhale sharply. The facepiece should bulge slightly, and the wearer should feel no air leaking around the edges of the mask.
Negative Pressure Check
Inhale sharply, which should cause the respirator to collapse slightly on the face without any air leaking in around the seal.
If air leakage is detected during either test, adjust the straps or nosepiece and repeat the seal check until a satisfactory fit is achieved. For the entire ensemble, visually check for overall coverage, ensuring no skin is exposed, particularly at the neck and wrists.