COVID-19: donning and doffing PPE

Donning PPE

The following guide is from Public Health England. You can find a copy of the guide here.

– Ensure that it is the correct size for you
– Do not use the inside tie
– Fasten the necktie/velcro and waist ties
– Make sure the gown is securely fitted at the neck and waist ties

– If you wear glasses remove these before donning the respirator, clean them with an alcohol wipe and replace them before donning the visor
– Put on the respirator and check for fit
– This MUST be the respiratory type that you have been fit-tested to use
– The respiratory must be compatible with other facial protection
– If you have not been fit-tested for the particular mask you must not enter the patient’s room
– Position the upper straps on the crown of your head above the ears
– Position the lower strap at the nape of the neck
– Ensure that the respirator is flat against your cheeks
– With both hands, mould the nose piece from the bridge of the nose, firmly pressing down on both sides of the nose with your fingers until you have a good facial fit
– Always perform a fit check before entering the work area – no air leaking from the edges of the respirator
– If you are wearing a non-valve respirator, exhale sharply to test
– For a valved product, inhale sharply
– For either of the above if air leaks around the nose or edges re-adjust the mask and try again. If you are unable to obtain a successful fit check DO NOT enter the work area
– If you wear glasses, put them back on now before going onto the next stage

– This could be a full-face visor or goggles
– If you’re using a visor ensure that it covers your entire face including your chin – adjust the headband if necessary
– Get your buddy to check. If a buddy is not available, check yourself in a mirror to ensure that it is fitted

– Put on a pair of gloves that are the correct size for your hands
– Ensure the gloves cover the cuff of the gown

Complete a final PPE check:

• Check that the gown ties at the neck and waist are secure
• The respirator is correctly fitted
• The visor is in position
• The gloves cover the cuffs

You can watch a video demonstration from Public Health England here.

Doffing PPE

Key facts

• PPE should be removed in an order that minimises the potential for cross-contamination
• PPE must be removed before leaving the patients room (apart from your mask)
• Your mask must always be removed when you are outside the patient’s room
• If you need to leave the room for example to visit the toilet – make sure you leave yourself enough time to appropriately doff the PPE – this should not be rushed
• Where possible the process should be supervised by a buddy at a distance of two metres
• If you are aware of any PPE breach or high-exposure contamination to PPE, inform your buddy before removing PPE

The following guide is from Public Health England. You can view a full copy of the guide here.

1. Gloves: always remember the outside of the gloves are likely to be contaminated.

To safely remove gloves you need to:
– Grasp the outside of the glove with the opposite gloved hand and peel off
– Hold the removed glove in the gloved hand

– Slide your fingers under the other glove
– Peel the remaining glove off over the other glove
– Dispose of the gloves into the clinical waste bin

Clean your hands, wrists and forearms with alcohol hand gel or rub

2. Gloves: always remember that the front of the gown and sleeves are likely to be contaminated

– Always remove the gown slowly and carefully
– Undo the neck tie
– Undo the waist tie

Pull the gown away from the neck and shoulders touching the INSIDE of the gown ONLY, using a peeling motion

– Turn the gown inside out
– Fold or roll into a bundle and discard into the clinical waste bin

3. Eye Protection: always remember the outside of the eye protection is likely to be contaminated

– To remove the visor, stand straight and do not bend forwards as this brings the bottom of the visor into contact with the (clean) upper body
– Find the elastic strap at the back of the head, close your eyes and lift the strap upwards then over your head using both hands
– Place the visor into the clinical waste bin
– Leave the patient’s room still wearing your respirator
– Clean hands, wrists and forearms again with alcohol hand gel/rub

– To remove goggles, find the elastic strap at the back of your head, close your eyes and lift strap upwards then over your head using both hands
– Discard into a clinical waste bin or into a receptacle for reprocessing/decontamination

4. Mask: always remember DO NOT touch the front of the respirator as it will be contaminated.

– If you wear glasses, remove them before doffing the respirator
– Clean them with an alcohol wipe and do not put them back on until you have completed doffing and washed your hands
– Carefully and slowly remove the respirator without touching the front
– Reach to the back of the head with both hands to find the bottom strap and bring it up to the top strap
– Lift both straps over the top of the head
– Let the respirator fall away from your face and drop into the clinical waste bin

5. Wash your hands, wrists and forearms with soap and water

You can watch a video demonstration from Public Health England here.