Putting on/taking off protective equipment for COVID-19

In healthcare organizations providing medical care to patients with COVID-19, there is a division into areas.

• Green (lower-risk) areas - rooms where medical personnel can be without PPE.
• Red (high-risk) and Yellow (moderate-risk) areas - rooms where patients are located (regardless of their severity), departments and rooms where medical personnel must be in PPE. 
• Between Green and Red-Yellow areas there are Buffer zone that perform the function of a "gateway". As a rule, the Buffer zone is divided into three zones:
  • a zone for removing PPE, disinfecting and processing it;
  • an area for sanitization of the hospital staff;
  • an area for dressing medical and other workers in clean clothes after sanitization and transition to a green aera

Equipment for the practical skill:

Set of working clothes (to be worn under a set of protective clothing)

• pants
• jacket (shirt, t-shirt)
• socks
• shoes
• cap

 Protective clothing set:

• Goggles or face shield
• Respirator-mask protection class not less than ffp 2
• Protective coveralls (or hooded jacket and trousers)
• Gloves (two pairs)
• Shoe covers
• Armlets
• Apron
• Towel
• Case for pen, phone

 Order of the skill performance:

Putting on the protective equipment

Preparatory stage:

• Put on a set of work clothes
• If the hair is long, collect it in a bun, fix it, put on a disposable cap
• Check the presence and completeness of protective clothing
• Check the integrity of the coveralls and its fitting with the size
• Make sure that the buffer zone where protective clothing is put on is free
• Invite a second worker who is free from other work for mutual assistance and double control

Maine stage:

• Enter the gateway (no more than two people should be in the gateway at the same time)
• Perform hygienic hand antisepsis (see practical skill "Hygienic hand antisepsis")
• Put on protective gloves
• Put on protective coveralls:
  • Unzip it
  • Put on it
  • Put on the sleeves of the coveralls in sequence (it is forbidden to wear both sleeves at once)
  • Zip up the coverall, leaving the neck area free (avoid damaging the gloves when ziping the coverall)
  • Perform a few movements to make sure that the coveralls fit.
• Put on high shoe covers over your shoes (tie shoe covers if available)
• Put on a respirator (filtering face mask), make sure the respirator fits snugly against your face
• Put on the hood of the coveralls and fully zip up the coveralls
• Put on the face shield and adjust the fixing elements
• Put on a second pair of gloves over the cuffs of the coveralls.
• Put on armlets (if used)
• Put on an apron (if necessary)
• Take a towel and place it under the waistband of the apron (if necessary)
• Take a plastic case that can be hung around the neck and place the items necessary for work (pen, watch, phone, stethoscope) in it. It is recommended to wrap the phone hermetically in a transparent thin film beforehand

Final stage:

• Examine yourself in the mirror and ask a second worker to examine you for the correct equipment.

Taking off the protective equipment

Preparatory stage:

• Make sure that the buffer zone is free
• Invite a second woker who is free for mutual assistance and double control
• Enter the gateway (no more than two people should be in the gateway at the same time)
• Check the availability of disinfectants and antiseptics

Maine stage:

• Stand on a mat moistened with a disinfectant solution
• Treat outer gloves with a disinfectant solution
• Treat shoe covers with a disinfectant solution by irrigation
• Untie shoe covers (if necessary)
• Remove shoe covers by turning them clean side out and place in a PPE collection bag
• Treat outer gloves with a disinfectant solution
• Remove the face shield. If the face shield is reusable, clean it with a disinfectant solution and place the face shield in a collection container. If the face shield is disposable, place it in a PPE collection bag
• Treat outer gloves with a disinfectant solution
• Remove armlets by folding them from top to bottom with the clean side out and place in a PPE collection bag.
• Treat outer gloves with a disinfectant solution
• Unzip the coveralls carefully, avoiding damage to the gloves.
• Remove the hood by turning the clean side out.

• Continue removing the coveralls from the shoulders by placing your hands behind your back and folding the coveralls clean side out.

• Turn the sleeves inside the coveralls with the clean side out without taking your hands out of the sleeves.
• Take off your coveralls except for your hands

• Remove the coveralls from your hands along with the outer pair of gloves.

• Place coveralls with outer gloves in the PPE collection bag
• Clean the inner gloves with a disinfectant solution
• Remove the respirator and place it in a PPE collection bag
• Clean the inner gloves with a disinfectant solution
• Remove the disposable cap with both hands, turn it clean side out and place it in the PPE collection bag

• Clean the inner gloves with a disinfectant solution
• Remove the inner gloves by turning them clean side out and place them in a PPE collection bag

Final stage:

• Sanitize your hands and sanitize your wrists
• Proceed to the next area of the gateway