A barrier device is a specialized piece of equipment designed to create a physical separation between two entities, most commonly used in health and emergency settings to prevent the exchange of infectious agents. This separation is fundamental to infection control, safeguarding both the person using the device and the person receiving care. They function by establishing an impenetrable wall against potentially infectious bodily fluids, minimizing the risk of disease transmission during close contact.
Preventing Pathogen Transmission
The fundamental purpose of a barrier device is to interrupt the chain of infection, which requires a susceptible host, a pathogen, and a route of transmission. These devices create a non-permeable physical shield that specifically blocks the contact and droplet routes of infection. Pathogens like bacteria and viruses are often suspended in liquid particles from respiratory droplets or body fluid splashes, which the barrier material is designed to stop. The material must be intact and non-porous to prevent fluid penetration.
The most sophisticated barrier devices, especially those used in resuscitation, include a one-way valve or filter mechanism to allow air to pass in only one direction. This feature permits the rescuer to deliver ventilations, but it immediately blocks the backflow of the patient’s exhaled air, saliva, or vomit, which may contain pathogens. By halting the transfer of contaminated fluids, the device eliminates the direct contact necessary for transmission. This interruption is the core rationale for using a barrier to reduce the spread of bloodborne and airborne pathogens.
Categories for Protection and Resuscitation
Barrier devices are broadly categorized based on their primary function in either general protection or specific emergency procedures.
Personal Protective Equipment (PPE)
The most common types are classified as Personal Protective Equipment (PPE), intended to protect the user from exposure to a patient’s bodily fluids. Examples of PPE include non-latex medical gloves, and face shields or goggles, which protect the vulnerable mucous membranes of the eyes, nose, and mouth from droplet splash. These items are designed for single-use and form a defense against surface and fluid contamination.
Resuscitation Barriers
A distinct category is Resuscitation Barriers, specifically engineered for use during cardiopulmonary resuscitation (CPR) to facilitate rescue breaths. The pocket mask is a molded plastic device that fits over the patient’s nose and mouth, creating a tight seal for effective ventilation. Simpler versions, like the CPR face shield, are flat plastic barriers with a filter or one-way mouthpiece that can be carried on a keychain for rapid deployment in an emergency.
Safe Application and Disposal
The effectiveness of a barrier device relies heavily on the proper sequence of both application, known as “donning,” and removal, or “doffing.”
Donning
Before donning any device, the user should perform thorough hand hygiene to ensure a clean starting surface. The device must then be applied to ensure a complete seal against potential contaminants. For example, a resuscitation mask must be positioned correctly over the face to prevent air leakage, while gloves must be pulled over the cuff of a long-sleeved garment, if worn, to eliminate exposed skin.
Doffing
The removal process, or doffing, is often the riskiest step because the outer surface of the device is now considered contaminated. The general rule is to remove the most contaminated items first, handling them by the clean inner surfaces only, and avoiding contact between the soiled outside and the skin or clothing. Gloves, for instance, are removed by pulling them off inside-out to contain the contaminants and should be discarded immediately.
Disposal
Following use, barrier devices must be disposed of promptly and safely to prevent secondary contamination of the environment or other people. For the public or first responders, any device contaminated with bodily fluids should be sealed in a secure plastic bag, preferably double-bagged, before being placed in the regular waste bin. In professional settings, this material is designated as biohazardous waste and must be placed in a specialized, leak-proof container for disposal via incineration or other regulated methods.