The World Health Organization (WHO) defines personal protective equipment

(PPE) as garments placed to protect the health care workers or any other people from

getting infected. PPE typically includes face protection, goggles and mask or face

shield, gloves, gown or coverall, head cover, and rubber boots.

According to the Occupational Safety and Health Administration (OSHA), the

protection of healthcare workers from infectious disease exposures in the workplace

requires a combination of controls:

1. Training and administrative controls: This can be achieved by providing them

with appropriate safety and infection control training and administrative controls such as

establishing and applying isolation policies and procedures.

2. Engineering controls: such as negative pressure rooms for patients with

airborne diseases such as Tuberculosis (TB)

3. Work practice control: for example, not recapping needles.

4. Personal Protective Equipment (PPE): PPE is very important for protecting

healthcare workers from disease transmission even though it is at the end of the

hierarchy.

Types of PPE:

1. Gloves: Protects the hands from microbes and minimizes the possible spreading

of microbes.
2. Masks: Cover the mouth and nasal area to minimize the inhalation of smaller

microbes.

3. Eye protection: Includes face shields as well as goggles that protect the mucous

membranes of the eyes from contact with bodily fluids

4. Clothing: Includes gowns, aprons, head covering, and shoe covers.

PPE must be worn on all staff working in a physiotherapy department, clinic or

treatment room in a long-term care facility.

General PPE Guidelines according to OSHA:

1. Wear gloves when handling chemicals and/or body fluids.

2. Wear safety shoes/boots/covers if hazardous or infectious substances are likely

to splash.

3. Wear an apron/gown/coveralls if hazardous or infectious substances are likely to

splash.

4. Use a respirator when hazardous or infectious substances are airborne such as

tuberculosis.

5. Wear hearing protection for loud noises such as from equipment.

6. Remove PPE carefully to avoid contaminating the self.

7. Dispose PPE in designated containers before leaving the area.

 Different Types of Personal Protective Equipment

Medical Gloves are one part of an infection-control strategy and used to protect

the wearer and/or the patient from the spread of infection or illness during medical

procedures and examinations.

Do’s and Don’ts of Glove Use

The way you use the gloves influences the risk of infections and disease

transmission in a healthcare setting. The following are the most important do’s and

don’ts of glove use:

• Work from clean to dirty: This refers to touching clean body sites or surfaces

before you touch dirty or heavily contaminated areas.

• Limit opportunities for “touch contamination” - Avoid unnecessarily touching

environmental surfaces with contaminated gloves

• Always change gloves after use for each patient, and discard them in the

nearest appropriate receptacle.

• The CDC does not recommend the use of double gloves when providing care to

a suspected or confirmed COVID-19 patient.

Gowns or Aprons

Isolation gowns are generally the preferred PPE for clothing, but aprons are

occasionally used where limited contamination is anticipated. If contamination of the

arms can be anticipated, a gown should be selected. If fluid penetration is likely, a

fluid-resistant gown should be used. Clean gowns are generally used for isolation

precautions. A sterile gown is best for both patient and healthcare worker protection.

For contact precaution, long-sleeved water-resistant gowns and gloves are

recommended.

Face Protection

Masks should fully cover the nose and mouth and prevent any fluid penetration.

Masks also have a flexible nose piece and can be secured to the head with string ties or

elastic. Not all masks and filtering facepieces offer the same protection and it is

important to understand the use and limitations of each one. The best way to prevent

illness is to avoid being exposed to this virus. However, as a reminder, CDC always

recommends everyday preventive actions, such as hand washing, to help prevent the

spread of respiratory diseases.

Goggles provide barrier protection for the eyes and should fit comfortably over

and around the eyes. Goggles with anti-fog features will help maintain clarity of vision.

The face shield should cover the forehead, extend below the chin, and wrap around the

side of the face. The most commonly used respirators in healthcare settings are the

N95, N99, or N100 particulate respirators. If your respirator is damaged or if breathing

becomes difficult, you should remove the respirator and replace it with a new one. To

safely discard your N95 respirator, place it in a plastic bag and put it in the trash.
Before Donning PPE

• Ensure you are hydrated and have used the bathroom as the PPE may need to

be worn for an extended period.

• Don your PPE with a colleague who can assist and provide a final check.

• Perform thorough hand hygiene.

Sequence for Donning PPE

1. Gown or apron;

2. Mask or respirator;

3. Goggles or face shields;

4. Gloves

Sequence for Doffing PPE

1. Gloves

2. Face shield or goggles

3. Gown

4. Mask or respirator

5. Hand hygiene
The Location for Doffing PPE

If only gloves are worn as PPE, it is safe to remove and discard them in the

patient's room (in the appropriate bin or receptacle). When a gown or full PPE is

worn, PPE should be removed at the doorway or in an anteroom. Respirators should

always be removed outside the patient room after the door is closed. Hand hygiene

should be performed after all PPE is removed.

There is a risk of contamination of skin and clothing during the removal of

contaminated gloves or gowns. It is important to pay attention to the method of

removing PPE, in order to avoid contamination and disease transmission. Educating

healthcare workers in the correct way to remove PPE by practice can reduce the risk

of infection.