COVID-19 / Coronavirus Outbreak: Doffing Personal Protective Equipment When Exiting A Patient Room

Coronavirus / COVID-19 Procedures
JoVE Journal
Coronavirus / COVID-19 Procedures
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Wunderlich, R., Schlotterer, M., Frey, A., Nikomanis, P. S., Liese, J., Häberle, H., Münch, A. COVID-19 / Coronavirus Outbreak: Doffing Personal Protective Equipment When Exiting A Patient Room. J. Vis. Exp. (159), e6429, (2020).

Abstract

In pandemic times, medical staff is becoming a key resource in fighting the infection. To achieve the best medical care, relevant techniques and procedures have to be taught to medical staff to reduce the risk of infection. Doffing the contaminated personal protective gear after treating COVID-19 patients has a high risk of forming infective aerosols which could lead to an infection of the medical staff. In this video, the manner of doffing of personal protective gear to minimize the risk of self infection is shown.

Protocol

An assistant should observe and assist with the doffing procedure of Personal Protective Equipment, until you are secure in your ability to carry this out independently.

These recommendations are based on guidelines from the Robert Koch-Institute and the World Health Organization. They apply solely to Covid-19.

NOTE: Personal Protective Equipment should be removed before exiting the patient's room.

  1. First, open the lower cord of the protective gown.
  2. Remove the gloves distally and dispose of them in the allocated black waste bin.
  3. Carry out a systematic and thorough hand disinfection. Use your elbow to attain three spurts of disinfectant, and rub it into your hands until dry.
  4. Open the neck cord. Do not rip the gown apart, as this will lead to dispersal of aerosol droplets or other contaminated materials. Pull the end of the sleeves over your hands and pull your arms through the sleeves, one after another. Importantly, only touch the protective gown from the inner or body contact surface.
  5. Roll the protective gown slowly together, only touching the inner side. Dispose of the protective gown in the allocated black waste bin.
  6. Disinfect your hands again using the same procedure as previously recommended.
  7. Remove the protective visor, carry out a wipe disinfection, and place the visor to the side to dry.
  8. The same procedure should be applied when doffing protective glasses.
  9. Remove the protective face mask by initially pulling the elastic straps away from each other and your head. Hold the protective mask from the lower edge so that the mask is not flicked, resulting in subsequent dissemination of aerosol. Hang the protective mask on the allocated hook.
  10. If you have used a cap, pull it upwards and off, and dispose of it.
  11. Disinfect your hands once more, including your forearms and elbows.
  12. Store the protective glasses in the breast pocket of your work clothes, remove the protective visor from the room, and hang it on the allocated stand.

Further recommendations:

  • Always remove your gloves and disinfect your hands.
  • Always disinfect your hands when exchanging gloves and always allow the disinfectant to fully dry.

Disclosures

No conflicts of interest declared.