Blog by the Centers for Disease Control and Prevention

SEQUENCE FOR PUTTING ON PERSONAL PROTECTIVE EQUIPMENT (PPE)

The type of PPE used will vary based on the level of precautions required, such as standard and contact, droplet or airborne infection isolation precautions. The procedure for putting on and removing PPE should be tailored to the specific type of PPE.

  1. GOWN

    • Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back Fasten in back of neck and waist
  2. MASK OR RESPIRATOR

    • Secure ties or elastic bands at middle of head and neck Fit flexible band to nose bridge Fit snug to face and below chin Fit-check respirator
  3. GOGGLES OR FACE SHIELD

    • Place over face and eyes and adjust to fit
  4. GLOVES

    • Extend to cover wrist of isolation gown

USE SAFE WORK PRACTICES TO PROTECT YOURSELF AND LIMIT THE SPREAD OF CONTAMINATION

  • Keep hands away from face
  • Limit surfaces touched
  • Change gloves when torn or heavily contaminated
  • Perform hand hygiene

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 1

There are a variety of ways to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Here is one example. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GLOVES

    • Outside of gloves are contaminated!
    • If your hands get contaminated during glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Using a gloved hand, grasp the palm area of the other gloved hand and peel off first glove
    • Hold removed glove in gloved hand
    • Slide fingers of ungloved hand under remaining glove at wrist and peel off second glove over first glove
    • Discard gloves in a waste container
  2. GOGGLES OR FACE SHIELD

    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band or ear pieces
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container
  3. GOWN

    • Gown front and sleeves are contaminated!
    • If your hands get contaminated during gown removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Unfasten gown ties, taking care that sleeves don’t contact your body when reaching for ties
    • Pull gown away from neck and shoulders, touching inside of gown only
    • Turn gown inside out
    • Fold or roll into a bundle and discard in a waste container
  4. MASK OR RESPIRATOR

    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container
  5. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 2

Here is another way to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GOWN AND GLOVES
    • Gown front and sleeves and the outside of gloves are contaminated!
    • If your hands get contaminated during gown or glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp the gown in the front and pull away from your body so that the ties break, touching outside of gown only with gloved hands
    • While removing the gown, fold or roll the gown inside-out into a bundle
    • As you are removing the gown, peel off your gloves at the same time, only touching the inside of the gloves and gown with your bare hands. Place the gown and gloves into a waste container
  2. GOGGLES OR FACE SHIELD
    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band and without touching the front of the goggles or face shield
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container
  3. MASK OR RESPIRATOR
    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container
  4. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

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HTS is excited to launch Breathe: A Pulmonary Intervention Program supported and directed by physical and occupational therapists. Breathe is focused on Percussion and Postural Drainage Therapy also known as chest physical therapy. Therapy interventions can be beneficial in the respiratory treatment and physical rehabilitation of patients with COVID-19, COPD, Pneumonia, Bronchitis, Asthma, ARDS, Lung Cancer and many other respiratory conditions.

Postural Drainage Can Help Patients Breathe Better!

Postural drainage can help treat breathing problems due to inflammation and mucus in the airways of the lungs. Postural Drainage Therapy uses percussion, gravity, vibration, and deep breathing to loosen and drain mucus from the lungs and stimulate a productive cough to clear airways. Unclogging the airways is vital to keeping lungs healthy.

  • Promote Drainage of Mucus and Secretions
  • Stimulate a Productive Cough
  • Optimize the Efficacy of Adjunctive Treatments, such as Inhaled Bronchodilators or Antibiotics
  • Improve Oxygen in the Body
  • Decrease the Risk of Chest Infection, such as Pneumonia

 

HTS Therapists are equipped with the knowledge and training to provide this critical treatment intervention to help patients breathe better!

For more information about the HTS Breathe Pulmonary Program, please contact your HTS Regional Director.

Blog by Sherry Roberts, RN, Clinical Consultant, Proactive Medical Review

COVID-19 is an acute, sometimes severe, respiratory illness caused by a novel coronavirus SARS-CoV2. Person-to-person spread occurs through contact with infected secretions, mainly via contact with large respiratory droplets, but can also occur via contact with a surface contaminated by respiratory droplets. Nursing facilities face higher risk of transmission due to high population density creating difficulty in maintaining avoidance precautions. Significantly, residents of nursing homes are at high risk for more severe disease because of age and underlying medical disorders.

Clinical Presentation

People with COVID-19 may have few to no symptoms, although some become severely ill and die. Symptoms can include fever, cough, and shortness of breath. The exact incubation time is not certain with estimates ranging from 1 to 14 days. The risk of serious disease and death in COVID-19 cases increases with age. COVID-19 can cause Pneumonia and ARDS (Acute Respiratory Distress Syndrome), Severe Acute Respiratory Syndrome (SARS), Acute Respiratory Failure and several other conditions.

Respiratory Assessment

If COVID-19 disease is suspected as part of the screening process, a  thorough respiratory assessment is essential, including careful auscultation to identify residents with a risk of significant lower respiratory illness.

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Proper Washing Guide for Homemade/Donated Cloth Masks

  • Before Your First Wear, Wash or Soak in Vinegar to Preserve the Color—Since They will be Washed Often
  • Washing Machine Recommended Versus Handwashing
  • If You Wash Multiple Masks Together, Tie the Strings Beforehand to Prevent Tangling
  • Feel Free to Throw in Regular Wash or Use a Garment Bag
  • Wash on Warm to Hot with Detergent: Click here to see a list of approved detergents to fight the Novel Coronavirus.
  • Dry in a Dryer