Transcription [English]

OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

[Module 1: How-to-guide for putting on and removing PPE according to droplet/contact

precautions for COVID-19 ]
Presenter: [Alice Simniceanu]

{0:00:07 0:00:58}
[Introduction] Hello and welcome to the personal protective equipment training video. Based on the current
available evidence, we know that COVID-19 virus is transmitted through droplet and contact transmission.
Droplet transmission occurs when a person is in close contact with someone who has respiratory symptoms.
Droplet transmission may also occur through the contaminated environment around the infected person. It can
occur through indirect contact, when an individual touches a contaminated surface and then their face. The
people most at risk of infection are those who are in close contact with a COVID patient or healthcare workers
who care for COVID patients. And therefore, we made this video to demonstrate how you can best protect
yourself as a healthcare worker when coming into contact with these patients.

{0:00:58 0:02:19}
[Hand hygiene] To begin, ensure you remove all jewelry and personal items and that your hair is tied back if
applicable. Make sure you consider the risk involved in the care you are going to provide to the patient to
ensure you are using the appropriate PPE for the precautions needed. Step one is to perform hand hygiene.
You can clean your hands by rubbing them with an alcohol-based solution. It is the fastest and most effective
method and better tolerated by your skin than other methods. Follow the WHO technique that ensures all the
surfaces of the hands are carefully covered by the product and will eliminate the microorganisms on your
hands. Follow the following steps: 1. Apply the product into a cupped hand. Next, rub the hands together,
rubbing palm to palm. Rub the back of each hand with interlaced fingers. And then palm to palm with interlaced
fingers. Next, rotate the hands in a cupped shape. And then rub your hands rotationally. The final step is to
rub the tips of your fingers and nail beds in each palm and continue rubbing until hands are completely dry.
Congratulations. Now your hands are clean and safe to proceed with the PPE.

{0:02:20 0:03:47}
[Putting on PPE before entering patient’s room] So now that you're ready to put on the equipment, check
the integrity of the equipment and do not use any damaged equipment. Now you're ready to put on the gown.
So tie back the long hair if applicable and inspect the equipment for damage prior to putting on each piece.
Put on your gown, tie it around the neck and the waist, and secure it around the back. Ensure all clothing is
covered by the gown. Next, place the medical or surgical mask and ensure it is over your nose and mouth.
You can pinch the metal piece to ensure a tight fit around the nose. Try not to touch the mask once it is secured
on your face and if you must do so, perform hand hygiene before and after touching the mask. Next, you are
ready to put on the eye protection. This involves either goggles or a face shield which can be placed over the
mask with the top of the goggles resting in the middle of your forehead. Finally, put on a pair of gloves and
ensure they are placed over the cuff of the gown and that no skin is exposed. You must check each piece of
equipment at the end thoroughly and ensure the equipment is placed on correctly. It might be helpful to have
a colleague who is competent in this procedure and could perform a visual inspection. You are now ready to
enter the patient's room.

1
Transcription [English]
OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

{0:03:49 0:06:00}
[Taking off PPE after exiting patient’s room] You are now ready to remove your PPE. Keep in mind the
removal of the PPE poses the highest risk of transmission to healthcare workers. Make sure to avoid any
contact between potentially contaminated PPE and the clothes, skin and especially your face. Respect the
order indicated in front of a colleague or mirror if possible. The first step is to remove the gloves, using the
glove-to-glove and skin-to-skin technique. This is the most soiled item which needs to be removed first and
discarded safely. Next, remove the gown by undoing the ties and ensure the gown is pulled away from the
body, ensuring there is no contamination of your clothes or the environment. Turn the gown inside out and
dispose of safely in the garbage or laundry hamper. Next, perform hand hygiene with alcohol-based hand for
20 seconds before touching your face to remove the eye protection. Next, to remove the eye protection. You
can do this by leaning forward and pulling them away from your face. Next, remove the mask or respirator by
pulling it from the straps in the rear and disposing of it in a disposal container or garbage. Avoid touching the
mask. Now as a final step, perform your final hand hygiene with alcohol-based hand rub or with soap and
water if they are visibly soiled. Now you are ready to return to the rest of the healthcare environment with clean
hands.

Course notes: The following text is to accompany the video, and does not appear in the spoken text:

• PPE is part of a larger infection prevention and control approach and should be accompanied
by educational posters and training.
• Only clinical staff who are trained and competent in the use of PPE should be allowed to
enter the patient’s care area.
• Safe putting on and removal of PPE should be done outside of the patient's room, ideally in a
dedicated area and either under the supervision of a trained observer or colleague.

2
SCRIPT FOR PPE VIDEO

Welcome to this Personal Protective Equipment training video

Based on the current available evidence, the COVID-19 virus is transmitted between people
through droplet transmission when susceptible individuals come into contact with
the respiratory secretions from a symptomatic person’s cough or sneeze.
It could also be transmitted through direct and indirect contact with contaminated surfaces and then
touching your face .

The people most at risk of infection are those who are in close contact with a COVID-19 patient or who
care for COVID-19 patients.
Therefore, we made this video to demonstrate how you can best protect yourself as a healthcare worker
when coming into contact with a suspected or confirmed COVID-19 patient.

Introduction

This is a guide for healthcare workers involved in patient care activities in a health care setting.

It aims to show the type of personal protective equipment or PPE needed to correctly protect
oneself according to risk assessment, and the procedure to be carefully followed to put them
on and to remove them.

It will cover:
• How to put on PPE correctly
• How to remove PPE correctly and safely to avoid cross contamination to the healthcare
worker and the environment

PPE is part of a larger infection prevention and control approach and should be accompanied by
educational posters and training.

Only clinical staff who are trained and competent in the use of PPE should be allowed to enter
the patient’s care area.
Safe putting on and removal of PPE should be done outside of the patients room, ideally in a
dedicated area and either using a mirror or under the supervision
of a trained observer (colleague).

The recommended PPE set includes:

• A long-sleeve, fluid resistant surgical gown
• Disposable medical gloves
• A medical mask, also known as a surgical mask, or respirator mask for
aerosol generating procedures
• Eye protection such as a face shield or goggles
Ensure you have all the necessary PPE and are able to put on the protective
equipment outside of the patient’s room.
DRESSING
To begin ensure you remove all jewelry and personal items and that your hair is tied back, if
applicable.
Make sure you consider the risk involved in the care you are going to provide to the patient to
ensure you are using appropriate PPE for the precautions needed.
1. Step 1 is to perform hand hygiene:
Either with
• The preferred method of alcohol hand rub for 20-30 seconds
• OR if not available or hands are visibly soiled, with water and soap for 40-60 seconds

Clean your hands by rubbing them with an alcohol-based solution. It is the fastest, and most
effective method and better tolerated by your skin.
Follow the WHO technique that ensures all the surfaces of hands are carefully covered by the
product and will eliminate the microorganisms on your hands.
Follow these steps:

STEPS: for 20 – 30 seconds

1. Apply the product into a cupped hand
2. Rub hands together, rubbing palm to palm
3. Rub the back of each hand with interlaced fingers
4. Palm to palm with interlaced fingers
5. Rotate the hands in a cupped shape
6. Rub thumbs rotationally
7. Rub tips of fingers and nail beds in each palm, continue rubbing until hands
are completely dry
8. And now your hands are clean and safe to proceed with the PPE
https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf?ua=1
 2. Now that you are ready to put on the PPE, check the integrity of the equipment; and do
not use any damaged equipment.
3. Now you are ready to put on the gown ; Tie back long hair if applicable.
Inspect equipment for damage prior to donning each piece
Put on your gown, tie around the neck and around the waist, and secure it around the back
Ensure all clothing is covered by the gown
4. . Now, place the medical or surgical mask on; ensure it is over your nose and mouth.
Pinch the metal piece to ensure a tight fit. Try not to touch the mask once it is secured
on your face. If you must do so, perform hand hygiene before and after touching the
mask.

OPTION FOR RESPIRATOR:

OR if you are performing an aerosol generating procedure or you need to follow airborne
precautions, put on a N95 /FFP2 / FFP3 respirator instead of medical mask and perform a
seal check.
• Lift your chin and pull the bottom strap over your head and
position it around the back of your neck below the ears. Ensure strap is on
bare skin only. Pull the top strap over your head resting it high at the back
of your head. Ensure the straps are not overlapping or crossed.
• Place fingertips of both hands at the top of the
metal nosepiece. Mould the nosepiece (using two fingers on each hand) to
the shape of your nose applying pressure on sides of nose to ensure seal.
• Perform a seal check by placing your hands at the top and side of your face
– without touching the mask. Now exhale sharply. There should be no
air escaping from the sides of the mask, this would indicate a positive pressure
inside the respirator.
• If there is leakage of air, adjust position
and/or tension of the straps. Retest the seal. Repeat the
steps until respirator is sealed properly.
• Perform a negative seal check: Inhale deeply. If no leakage, negative
pressure will make respirator cling to your face. Leakage will result in loss of
negative pressure in the respirator due to air entering through gaps in the seal.

3. Next, put on the eye protection - goggles

OPTION face shield –

which can be placed over the mask with the top resting in the middle of your
forehead

4. Finally, put on a pair of gloves; ensure they are placed over the cuff of the gown
and that no skin is exposed
 You must check each piece of equipment at the end thoroughly and ensure that the equipment
is placed on correctly. It might be helpful to have a buddy, a colleague who is competent in this
procedure and could perform visual inspection

Now you are ready to enter the patient’s room!

------
REMOVING PPE

The removal of PPE poses the highest risk of transmission to health care workers.

Make sure to avoid any contact between potentially contaminated PPE and the clothes, skin,
or your face.

Respect the order indicated in front of a colleague or mirror, if possible.

STEPS
1. The first step is to remove gloves using the glove to glove and skin to skin
technique. This is the most soiled item which needs to be removed first and discarded
safely.

2. Next, remove the gown by undoing the ties and ensure the gown is pulled away from
the body ensuring there is no contamination of your clothes or the environment.
Turn the gown inside out and dispose of safely in the garbage or laundry hamper.
3. Next, perform hand hygiene with alcohol based handrub for 20 seconds before
touching your face to …
4. Remove the eye protection by leaning forward and pulling them away from
your face; whether that is the faceshield or goggles.
• Ensure you clean the goggles or the faceshield if they are reusable and place them in a
clean container.
5. Next, Remove the mask or N95/FFP2 / FFP3 by pulling it from the rear and dispose of
it in the disposal container or garbage.

• Ensure you are taking the mask off with the straps, avoid touching the mask.

6. Now as a final step perform hand hygiene with alcohol based handrub or with soap
and water if they are visibly soiled.
Transcription [English]
OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

[Module 2: How-to-guide for putting on and removing PPE according to airborne/contact

precautions for COVID-19 aerosol generating procedures]
Presenter: [Alice Simniceanu]

{0:00:07 0:00:57}
[Introduction] Hello and welcome to the personal protective equipment training video. Based on the current
available evidence, we know that COVID-19 virus is transmitted through droplet and contact transmission.
Droplet transmission occurs when a person is in close contact with someone who has respiratory symptoms.
Droplet transmission may also occur through the contaminated environment around the infected person. It can
occur through indirect contact, when an individual touches a contaminated surface and then their face. The
people most at risk of infection are those who are in close contact with a COVID patient or healthcare workers
who care for COVID patients. And therefore, we made this video to demonstrate how you can best protect
yourself as a healthcare worker when coming into contact with these patients.

{0:00:58 0:02:19}
[Hand hygiene] To begin, ensure you remove all jewelry and personal items and that your hair is tied back if
applicable. Make sure you consider the risk involved in the care you are going to provide to the patient to
ensure you are using the appropriate PPE for the precautions needed. Step one is to perform hand hygiene.
You can clean your hands by rubbing them with an alcohol-based solution. It is the fastest and most effective
method, and better tolerated by your skin than other methods. Follow the WHO technique that ensures all the
surfaces of the hands are carefully covered by the product and will eliminate the microorganisms on your
hands. Follow the following steps: 1. Apply the product into a cupped hand. Next, rub the hands together,
rubbing palm-to-palm. Rub the back of each hand with interlaced fingers. And then, palm-to-palm with
interlaced fingers. Next, rotate the hands in a cupped shape. And then, rub your hands rotationally. The final
step is to rub the tips of your fingers and nail beds in each palm and continue rubbing until hands are completely
dry. Congratulations. Now your hands are clean and safe to proceed with the PPE.

{0:02:20 0:04:39}
[Putting on PPE before entering patient’s room] So now that you're ready to put on the equipment, check
the integrity of the equipment and do not use any damaged equipment. Now you're ready to put on the gown.
So tie back the long hair if applicable and inspect the equipment for damage prior to putting on each piece.
Put on your gown, tie it around the neck and the waist, and secure it around the back. Ensure all clothing is
covered by the gown. If you are performing an aerosol generating procedure or you need to follow airborne
precautions, you can put on an N95, FFP2 or FFP3 mask instead of the medical mask. To place the mask on,
lift your chin and pull the bottom strap over your head and position it around the back of your neck, below the
ears. Pull the top strap over your head, resting it high at the back of your head. Ensure the straps are not
overlapping or crossed. Place fingertips of both hands at the top of the metal nose piece. Mold the nose piece
using two fingers on each hand to the shape of your nose, applying pressure on the sides of the nose to ensure
a good seal. You can perform a seal check by placing your hands at the top and sides of your face, without
touching the mask, and exhaling sharply. There should be no air escaping from the sides of the mask. This
would indicate a positive pressure inside the respirator. If there is leakage of air, adjust the position or the

1
Transcription [English]
OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

straps and retest the seal. Repeat these steps until the respirator is sealed properly. Next, you are ready to
put on the eye protection. This involves either goggles or a face shield which can be placed over the mask
with the top of the shield resting in the middle of your forehead. Finally, put on a pair of gloves and ensure they
are placed over the cuff of the gown and that no skin is exposed. You must check each piece of equipment at
the end thoroughly and ensure the equipment is placed on correctly. It might be helpful to have a colleague
who is competent in this procedure and could perform a visual inspection. You are now ready to enter the
patient's room.

{0:04:42 0:07:00}
[Taking off PPE after exiting patient’s room] You are now ready to remove your PPE. Keep in mind the
removal of the PPE poses the highest risk of transmission to healthcare workers. Make sure to avoid any
contact between potentially contaminated PPE and the clothes, skin and especially your face. Respect the
order indicated in front of a colleague or mirror if possible. The first step is to remove the gloves, using the
glove-to-glove and skin-to-skin technique. This is the most soiled item which needs to be removed first and
discarded safely. Next, remove the gown by undoing the ties and ensure the gown is pulled away from the
body, ensuring there is no contamination of your clothes or the environment. Turn the gown inside out and
dispose of safely in the garbage or laundry hamper. Next, perform hand hygiene with alcohol-based hand rub
for 20 seconds before touching your face to remove the eye protection. Next, remove the eye protection. You
can do this by leaning forward and pulling them away from your face. Ensure you clean the goggles or the
face shield if they are reusable and place them in a clean container. Next, remove the mask or respirator by
pulling it from the straps in the rear and disposing of it in a disposal container or garbage. Avoid touching the
mask. Now as a final step, perform your final hand hygiene with alcohol-based hand rub or with soap and
water if they are visibly soiled. Now you are ready to return to the rest of the healthcare environment with
clean hands.

Course notes: The following text is to accompany the video, and does not appear in the spoken text:

• PPE is part of a larger infection prevention and control approach and should be accompanied
by educational posters and training.
• Only clinical staff who are trained and competent in the use of PPE should be allowed to
enter the patient’s care area.
• Safe putting on and removal of PPE should be done outside of the patient's room, ideally in a
dedicated area and either under the supervision of a trained observer or colleague.

2
HOW TO GUIDE - PUTTING ON PPE
FOR CONTACT/DROPLET PRECAUTIONS

1 Perform hand hygiene

Alcohol based handrub
Rub hands for 20–30 seconds.
or
Water and soap
Wash hands for 40–60 seconds.

2 Put on the gown 3 Put on the mask

Medical mask.

4 Put on eye protection 5 Put on gloves

Put on face shield or goggles. Ensure glove is placed over the cuff of the gown.

Full PPE
HOW TO GUIDE - TAKING OFF PPE
FOR CONTACT/DROPLET PRECAUTIONS
Ensure that infectious waste containers are available for safe disposal of PPE. Separate containers should be available for reusable items.
Order is important

1 Remove gloves 2 Remove the gown

Ensure gown is pulled away from
the body during removal and that
clothing does not become
contaminated and dispose of
them safely.

3 Perform hand hygiene

Alcohol based handrub
Rub hands for 20–30 seconds.
or
Water and soap
Wash hands for 40–60 seconds.

4 Remove eye protection 5 Remove the mask

Remove face shield or goggles. Ensure you are taking the mask off from the
straps, avoid touching the mask.

6 Perform hand hygiene

Alcohol based handrub
Rub hands for 20–30 seconds.
or
Water and soap
Wash hands for 40–60 seconds.
Transcription [English]
OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

[Module 1: How-to-guide for putting on and removing PPE according to droplet/contact

precautions for COVID-19 ]
Presenter: [Alice Simniceanu]

{0:00:07 0:00:58}
[Introduction] Hello and welcome to the personal protective equipment training video. Based on the current
available evidence, we know that COVID-19 virus is transmitted through droplet and contact transmission.
Droplet transmission occurs when a person is in close contact with someone who has respiratory symptoms.
Droplet transmission may also occur through the contaminated environment around the infected person. It can
occur through indirect contact, when an individual touches a contaminated surface and then their face. The
people most at risk of infection are those who are in close contact with a COVID patient or healthcare workers
who care for COVID patients. And therefore, we made this video to demonstrate how you can best protect
yourself as a healthcare worker when coming into contact with these patients.

{0:00:58 0:02:19}
[Hand hygiene] To begin, ensure you remove all jewelry and personal items and that your hair is tied back if
applicable. Make sure you consider the risk involved in the care you are going to provide to the patient to
ensure you are using the appropriate PPE for the precautions needed. Step one is to perform hand hygiene.
You can clean your hands by rubbing them with an alcohol-based solution. It is the fastest and most effective
method and better tolerated by your skin than other methods. Follow the WHO technique that ensures all the
surfaces of the hands are carefully covered by the product and will eliminate the microorganisms on your
hands. Follow the following steps: 1. Apply the product into a cupped hand. Next, rub the hands together,
rubbing palm to palm. Rub the back of each hand with interlaced fingers. And then palm to palm with interlaced
fingers. Next, rotate the hands in a cupped shape. And then rub your hands rotationally. The final step is to
rub the tips of your fingers and nail beds in each palm and continue rubbing until hands are completely dry.
Congratulations. Now your hands are clean and safe to proceed with the PPE.

{0:02:20 0:03:47}
[Putting on PPE before entering patient’s room] So now that you're ready to put on the equipment, check
the integrity of the equipment and do not use any damaged equipment. Now you're ready to put on the gown.
So tie back the long hair if applicable and inspect the equipment for damage prior to putting on each piece.
Put on your gown, tie it around the neck and the waist, and secure it around the back. Ensure all clothing is
covered by the gown. Next, place the medical or surgical mask and ensure it is over your nose and mouth.
You can pinch the metal piece to ensure a tight fit around the nose. Try not to touch the mask once it is secured
on your face and if you must do so, perform hand hygiene before and after touching the mask. Next, you are
ready to put on the eye protection. This involves either goggles or a face shield which can be placed over the
mask with the top of the goggles resting in the middle of your forehead. Finally, put on a pair of gloves and
ensure they are placed over the cuff of the gown and that no skin is exposed. You must check each piece of
equipment at the end thoroughly and ensure the equipment is placed on correctly. It might be helpful to have
a colleague who is competent in this procedure and could perform a visual inspection. You are now ready to
enter the patient's room.

1
Transcription [English]
OpenWHO: [COVID-19: How to put on and remove personal protective equipment (PPE)]

{0:03:49 0:06:00}
[Taking off PPE after exiting patient’s room] You are now ready to remove your PPE. Keep in mind the
removal of the PPE poses the highest risk of transmission to healthcare workers. Make sure to avoid any
contact between potentially contaminated PPE and the clothes, skin and especially your face. Respect the
order indicated in front of a colleague or mirror if possible. The first step is to remove the gloves, using the
glove-to-glove and skin-to-skin technique. This is the most soiled item which needs to be removed first and
discarded safely. Next, remove the gown by undoing the ties and ensure the gown is pulled away from the
body, ensuring there is no contamination of your clothes or the environment. Turn the gown inside out and
dispose of safely in the garbage or laundry hamper. Next, perform hand hygiene with alcohol-based hand for
20 seconds before touching your face to remove the eye protection. Next, to remove the eye protection. You
can do this by leaning forward and pulling them away from your face. Next, remove the mask or respirator by
pulling it from the straps in the rear and disposing of it in a disposal container or garbage. Avoid touching the
mask. Now as a final step, perform your final hand hygiene with alcohol-based hand rub or with soap and
water if they are visibly soiled. Now you are ready to return to the rest of the healthcare environment with clean
hands.

Course notes: The following text is to accompany the video, and does not appear in the spoken text:

• PPE is part of a larger infection prevention and control approach and should be accompanied
by educational posters and training.
• Only clinical staff who are trained and competent in the use of PPE should be allowed to
enter the patient’s care area.
• Safe putting on and removal of PPE should be done outside of the patient's room, ideally in a
dedicated area and either under the supervision of a trained observer or colleague.