• Can J Anaesth · Jul 2020

    Letter

    Common breaches in biosafety during donning and doffing of protective personal equipment used in the care of COVID-19 patients.

    Toronto anaesthesiologists Muñoz-Leyva & Niazi share observations from PPE training simulations, identifying the 'high risk' moments where frequent exposures and PPE failures are seen.

    Why is this important?

    For all the understandable concern over adequate access to PPE and discussion of appropriate levels of protection, HCW safety is entirely dependent on the effective use of this protective equipment.

    Identifying common areas of 'biosafety breach' allows both clinicians and PPE supervisors to apply added attention to these steps. These areas can be conceptualised as offering a disproportionate safety benefit for the time and resources deployed in ensuring compliance at these moments.

    Which areas did they identify as most important?

    Donning

    1. N95 mask fit-testing and fit-checking; notably shaving facial hair to ensure a face-mask interface seal.
    2. Use of extended-cuff gloves with gown cuff tucked securely into glove.
    3. Time management: PPE donning should never be rushed, even in critical medical emergencies.

    Doffing

    1. Glove removal is a high-risk step. When removing the second, inner glove, ensure as little contact as possible with the glove sleeve by the ungloved hand.
    2. Gown removal is the next highest risk step. Do not touch the front of the gown, especially with ungloved hands.
    3. Mask removal avoid touching front of mask; avoid any snapping of straps.
    4. Perform alcohol-based hand-hygiene after each article is removed.

     

    summary
    • Felipe Muñoz-Leyva and Ahtsham U Niazi.
    • Department of Anesthesiology & Pain Medicine, Toronto Western Hospital, University Health Network (UHN), University of Toronto, Toronto, ON, Canada. felipemunoz44@gmail.com.
    • Can J Anaesth. 2020 Jul 1; 67 (7): 900-901.

    no abstract available

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    This article appears in the collection: Anaesthesiology, Personal Protective Equipment (PPE) and COVID.

    Notes

    summary
    1

    Toronto anaesthesiologists Muñoz-Leyva & Niazi share observations from PPE training simulations, identifying the 'high risk' moments where frequent exposures and PPE failures are seen.

    Why is this important?

    For all the understandable concern over adequate access to PPE and discussion of appropriate levels of protection, HCW safety is entirely dependent on the effective use of this protective equipment.

    Identifying common areas of 'biosafety breach' allows both clinicians and PPE supervisors to apply added attention to these steps. These areas can be conceptualised as offering a disproportionate safety benefit for the time and resources deployed in ensuring compliance at these moments.

    Which areas did they identify as most important?

    Donning

    1. N95 mask fit-testing and fit-checking; notably shaving facial hair to ensure a face-mask interface seal.
    2. Use of extended-cuff gloves with gown cuff tucked securely into glove.
    3. Time management: PPE donning should never be rushed, even in critical medical emergencies.

    Doffing

    1. Glove removal is a high-risk step. When removing the second, inner glove, ensure as little contact as possible with the glove sleeve by the ungloved hand.
    2. Gown removal is the next highest risk step. Do not touch the front of the gown, especially with ungloved hands.
    3. Mask removal avoid touching front of mask; avoid any snapping of straps.
    4. Perform alcohol-based hand-hygiene after each article is removed.

     

    Daniel Jolley  Daniel Jolley
    pearl
    0

    Awareness of the high-risk steps during PPE donning and doffing offers disproportionate safety benefits.

    Daniel Jolley  Daniel Jolley
     
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