PPE Use in Healthcare Settings II: Doffing

Remove PPE in this sequence: gloves first, then face shield or goggles, followed by the gown, and finally the mask or respirator after exiting the patient's room. This order minimizes contamination risk because gloves are most contaminated and should be removed before touching other equipment. Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE.

Grasp the outside of the first glove's cuff and peel it off, holding it in your gloved hand. Insert your finger underneath the cuff of the second glove and peel it off, rolling it inside-out over the first glove. This technique prevents skin contact with contaminated surfaces and contains both gloves together for safe disposal.

The front surface of goggles and face shields is contaminated and poses infection risk if touched directly. Instead, grasp the earpieces or headband at the back or side of the head and lift them outward away from your face. This prevents transferring pathogens from the contaminated front surface to your skin or mucous membranes.

Untie the gown's ties and peel it away from your neck and shoulders. Turn the contaminated outer front and sleeves inward, roll the gown over itself, and discard it immediately. Never touch the outer surface of the gown during removal, as it is considered contaminated and must be handled to contain pathogens.

Avoid touching the front of the mask, as it is contaminated. Instead, grasp the ties or elastic bands, starting with the bottom tie or band, then the top. Lift the mask or respirator away from your face and discard it into a designated waste receptacle. This technique prevents direct contact with contaminated surfaces.

The outer front and sleeves of the isolation gown, the outer surface of gloves, goggles, mask, respirator, and face shield are all contaminated. These surfaces may have contacted pathogens and require careful handling during removal. Understanding contaminated zones helps healthcare workers avoid self-contamination and cross-contamination.

Perform hand hygiene immediately after removing each piece of PPE if your hands become contaminated. Most importantly, wash your hands or use an alcohol-based hand sanitizer immediately after removing all PPE. This final step eliminates any pathogens that may have contacted your hands during the doffing process.