Personal Protective Equipment (PPE) functions as a physical barrier between the wearer and potentially infectious materials. This equipment is designed to minimize exposure to hazards by blocking contaminants from reaching the skin, respiratory system, or mucous membranes. Proper application (donning) and safe removal (doffing) are essential to ensure the equipment provides its intended protection and prevents the spread of pathogens. Following established protocols maintains safety for both the individual and others.
Components of Standard PPE
Standard protection involves four primary components, each serving a distinct protective function. The isolation gown covers the torso and clothing, preventing contamination from splashes or sprays of bodily fluids. A mask or specialized respirator protects the nose and mouth, filtering particles from the air or blocking droplets from entering the respiratory tract. Eye protection, such as goggles or a face shield, safeguards the eyes, which are a direct entry point for infectious agents. Gloves protect the hands, which are the most frequent point of contact with contaminated surfaces and materials.
Step-by-Step Donning Sequence
The process of putting on PPE is carefully sequenced to ensure that one item is not contaminated by the application of the next, establishing a complete barrier. This sequence begins with performing hand hygiene, either by washing hands thoroughly or using an alcohol-based hand sanitizer. The isolation gown is put on next, covering the body from the neck down to the knees and secured at the neck and waist.
Following the gown, the mask or respirator is applied, making sure the top edge is securely molded over the bridge of the nose. If a respirator is used, a user seal check must be performed to confirm no air leaks occur. Eye protection is applied next, positioning the goggles or face shield for a comfortable but secure fit.
The final item is the gloves, which must be pulled over the gown’s wrist cuff. This ensures there is no exposed skin at the wrist, completing the barrier. Once all pieces are in place, the wearer should avoid touching the outside of the items, as this surface collects contaminants.
The Critical Process of Safe Doffing
Removing contaminated PPE (doffing) is the highest-risk step for accidental self-contamination and must be performed with slow, deliberate movements. The procedure starts with the removal of the gloves, which are removed using an ‘inside-out’ technique. The wearer grasps the outside of one glove near the cuff, peeling it off and holding it in the gloved hand. The ungloved hand then slides two fingers underneath the cuff of the remaining glove, peeling it off so the first glove is contained inside the second. This bundled waste is discarded.
The wearer then proceeds to remove the gown. The gown is untied or unfastened and pulled away from the neck and shoulders, touching only the inside surfaces. The gown is rolled downward into a compact bundle, turning the contaminated outer surface inward to prevent contact with the body or clothing. Once the gown is discarded, hand hygiene is performed immediately.
Eye protection is removed next by handling only the earpieces or headband, avoiding the contaminated front shield. The last item removed is the mask or respirator. It is removed by grasping the bottom strap, then the top strap, and lifting it away from the face without touching the front. Following the removal and disposal of the mask, a final, thorough hand hygiene procedure must be performed.