An isolation gown is a form of personal protective equipment (PPE) that acts as a physical barrier in healthcare settings. It is a long-sleeved garment designed to cover the wearer’s clothing and exposed body areas, typically from the neck to the mid-thigh or knees. The primary objective is to prevent the transfer of microorganisms, particulates, and body fluids between the healthcare worker and the patient or environment. These gowns are used when contact with potentially infectious materials is anticipated, helping to manage infection risk.
Fundamental Purpose and Function
The core function of an isolation gown is to interrupt the chain of infection through barrier protection. This barrier prevents the wearer’s uniform or skin from becoming contaminated with infectious agents found in blood, body fluids, secretions, or excretions. The gown creates a defense line, significantly reducing the chances of germs being carried on clothing from one patient area to another, a process known as cross-contamination.
The design typically ensures that the torso and arms, the areas most likely to encounter splashes or direct contact, are fully covered. By covering these surfaces, the gown serves a dual purpose: protecting the wearer from exposure and protecting vulnerable patients from microorganisms carried by the healthcare worker. This makes the isolation gown an important part of standard precautions and contact isolation protocols used across various medical environments.
Classification of Protection Levels
Not all isolation gowns offer the same level of fluid resistance; their protection capabilities are standardized by the ANSI/AAMI PB70 standard in the United States. This system classifies gowns into four distinct levels based on their barrier performance against liquid penetration. Test methods evaluate the gown’s ability to resist fluid impact and hydrostatic pressure, which determines the appropriate clinical use for each level.
Protection Levels
The four levels of protection are:
- Level 1 gowns provide the lowest protection, characterized by minimal risk and light fluid resistance, suitable for basic care or visitor use.
- Level 2 gowns are rated for low risk and are used during procedures with a slight risk of fluid exposure, such as blood draws or suturing.
- Level 3 gowns offer moderate protection against fluids and are used where the risk of splash or spray is higher, such as in the emergency room or during arterial blood draws.
- Level 4 designates the highest rating for high-risk situations, providing a robust barrier against fluid and viral penetration, reserved for long, fluid-intensive procedures or highly infectious diseases.
The entire gown, excluding cuffs, hems, and bindings, is considered a “critical zone” of protection and must meet the stated barrier performance level.
Proper Use: Donning and Doffing
The effectiveness of an isolation gown depends entirely on the correct sequence of putting it on (donning) and taking it off (doffing) to prevent self-contamination. When donning, the wearer slides their arms through the sleeves, ensuring the garment covers the torso completely, and fastens the ties at the neck and waist. The gown must be tied securely to remain in place and provide full coverage over the back, especially for full-wrap styles.
The removal process (doffing) is the most contamination-prone step and requires careful technique. Since the outside is contaminated, the wearer must only touch the inside surface during removal. The ties are untied, and the gown is pulled away from the body, turning the sleeves inside out. It is then rolled downward into a bundle, keeping the contaminated outer surface facing inward, before being discarded into a designated waste receptacle.
Isolation Gowns vs. Other Medical Apparel
Isolation gowns differ from other protective garments, such as surgical gowns and patient gowns, primarily in their intended use and degree of protection. A surgical gown is regulated as a Class II medical device and is specifically designed for use in operating rooms and other sterile environments. These gowns usually possess higher fluid resistance and are packaged as sterile to maintain a sterile field during invasive procedures.
In contrast, a standard isolation gown is typically non-sterile, classified for non-surgical settings, and aims for general protection against contamination. Patient gowns are designed for patient modesty, comfort, and easy access for medical examinations, but they offer no meaningful barrier protection. The key difference is the critical zone: an isolation gown requires the entire garment to meet the barrier level, while a surgical gown’s barrier focuses on areas most likely to be impacted during an operation, such as the front and sleeves.