PART B PART B PhysicalPhysical Barrier Protection Barrier Protection

Personal Protective Equipment (PPE): Personal Protective Equipment (PPE): isis

important and includesimportant and includes

GlovesGloves

MasksMasks

EyewearEyewear

GownsGowns

GLOVESGLOVES

TypesTypes Clinical and Non-Clinical useClinical and Non-Clinical use

Types for clinical useTypes for clinical useSterile,Sterile, single use for surgical procedures single use for surgical procedures..

Non-sterile,Non-sterile, single use; to protect the single use; to protect the hands from contact with blood,saliva and hands from contact with blood,saliva and body fluidsbody fluids..

UseUseChange after each patient procedure Change after each patient procedure OR OR during multiple procedures on same during multiple procedures on same patientpatient

GlovesGloves

Types for non-clinical useTypes for non-clinical use

ReusableReusable::

–LatexLatex

–Non-latex (Nitrile, Neoprene)Non-latex (Nitrile, Neoprene)

UseUse

Whilst reprocessing equipment and for Whilst reprocessing equipment and for

housekeeping, cleaning chair, housekeeping, cleaning chair,

surfaces if contaminated by blood or surfaces if contaminated by blood or

body fluidbody fluid

Single use GlovesSingle use GlovesDisposableDisposable

Examination gloves should be Examination gloves should be

checked when donnedchecked when donned

Changed when holed or tornChanged when holed or torn

Hands must be washed or Hands must be washed or

decontaminated when gloves decontaminated when gloves

removedremoved

Single use GlovesSingle use Gloves

Single useSingle useLatexLatex examination gloves examination gloves

AdvantagesAdvantages of Latex gloves of Latex gloves::

EconomicalEconomical

Flexible and elastic, easy to Flexible and elastic, easy to don and removedon and remove

Can double glove if requiredCan double glove if required

Single use Single use Latex surgical glovesLatex surgical gloves

Excellent quality controlExcellent quality control

Can be worn for long Can be worn for long

periods of time, 60 minutes periods of time, 60 minutes

or more before glove or more before glove

integrity is potentially integrity is potentially

changedchanged

Single use Single use Non-latex Non-latex examination glovesexamination gloves

Nitrile examination Nitrile examination glovesgloves

IndicationsIndications

Latex sensitivity for OR Latex sensitivity for OR

patientpatient..

Single useSingle use Non-latex Non-latex examination glovesexamination gloves

Neoprene examination Neoprene examination glovesgloves

IndicationsIndications

Latex sensitivity for health care Latex sensitivity for health care

worker and patientworker and patient

Single use Non latex Single use Non latex surgical gloves - surgical gloves - Neoprene glovesNeoprene gloves

AdvantagesAdvantages

More elasticity than nitrile glovesMore elasticity than nitrile gloves

Excellent quality controlExcellent quality control

Easy to wearEasy to wear

Durable for long proceduresDurable for long procedures

But, more expensive than nitrile glovesBut, more expensive than nitrile gloves

MASKSMASKS

Surgical maskSurgical mask..Particulate filter [N95], for airborne Particulate filter [N95], for airborne

diseasesdiseases..

A mustA must

when a possibility of splashing or when a possibility of splashing or splattering of blood or other body fluids splattering of blood or other body fluids to the faceto the face..

Protection from Aerosol contaminationProtection from Aerosol contamination..

MasksMasks

Masks should be used to reduce the amount of Masks should be used to reduce the amount of droplets that will be inhaled during the operative droplets that will be inhaled during the operative procedureprocedure..

Masks should be replaced after each patient or at Masks should be replaced after each patient or at least every 30 minutes after donning to ensure the least every 30 minutes after donning to ensure the protective mechanism of the mask is not protective mechanism of the mask is not

compromisedcompromised . .

MASKS DO’S & DON'TSMASKS DO’S & DON'TS DODO::

Fit and wear according to Fit and wear according to manufacturer’s instructionsmanufacturer’s instructions

Cover both the mouth and noseCover both the mouth and noseRemove ASAP if moist or soiledRemove ASAP if moist or soiledRemove and discarded as soon Remove and discarded as soon

as practicable after useas practicable after use

DON’TDON’T::Touch the mask once onTouch the mask once on

Hang around neckHang around neck

EYE PROTECTIONEYE PROTECTION

Optically clear and anti-fogOptically clear and anti-fog

Close fittingClose fitting

Shielded at the sidesShielded at the sides

GOWNS AND PLASTIC APRONSGOWNS AND PLASTIC APRONS

Impermeable, water repellent gowns Impermeable, water repellent gowns and/or plastic aprons protect the and/or plastic aprons protect the worker from contamination with blood worker from contamination with blood and body substancesand body substances..

Use for specific activity (do not leave Use for specific activity (do not leave on all day!)on all day!)..

Remove as soon as possible after Remove as soon as possible after contamination or usecontamination or use . .

Bag for laundering or disposalBag for laundering or disposal..

Principles of infection control:Standard PrecautionsPrinciples of infection control:Standard Precautions Barrier Protection: Barrier Protection: Environmental barriersEnvironmental barriers

Clinical area should be clearly divided into Clinical area should be clearly divided into

clean, clerical and dirty areasclean, clerical and dirty areas . .

Environmental barriers may be more Environmental barriers may be more

effective than manual decontamination effective than manual decontamination

(cleaning)(cleaning)

Environmental barriers can save time by Environmental barriers can save time by

decreasing “change-over time” between decreasing “change-over time” between

patientspatients..

Some viruses can survive in saline Some viruses can survive in saline

solution for as long as six dayssolution for as long as six days

Barriers on surfacesBarriers on surfaces

What can be caught from a What can be caught from a surfacesurface??

Head liceHead liceFungal organismsFungal organismsSARSSARSMRSA MRSA [[methicillin resistant methicillin resistant staphylococcus aureus]staphylococcus aureus]

When to use barriers on surfacesWhen to use barriers on surfaces

Areas in the zone of contaminationAreas in the zone of contamination..

Difficult to clean areasDifficult to clean areas . .

Plastic bag

Barriers on surfaces Barriers on surfaces Difficult to clean areasDifficult to clean areas

Spittoons can be difficult to Spittoons can be difficult to cleanclean

Patients often miss the Patients often miss the spittoon and spit on floor spittoon and spit on floor or surrounding or surrounding environment, especially if environment, especially if numbnumb

Young children find it Young children find it difficult to rinse and spitdifficult to rinse and spit

Barriers on surfaces Barriers on surfaces Difficult to clean areas Difficult to clean areas

Alternatives to a spittoon includeAlternatives to a spittoon include::–Denture cupDenture cup

–A Funnel attached to the suction A Funnel attached to the suction whereby the funnel can be removed whereby the funnel can be removed after each patient, cleaned and after each patient, cleaned and sterilisedsterilised

–No rinsing, lavage with triple syringe No rinsing, lavage with triple syringe and remove water with suctionand remove water with suction

Environmental cleaningEnvironmental cleaning

Foot controlsFoot controls use limit use limit contaminationcontamination..

Floors should be easily Floors should be easily washedwashed and made of and made of impermeable materialimpermeable material . .

Carpet Carpet should notshould not be used in be used in a treatment areaa treatment area..

Neutral detergentNeutral detergent should be should be used for environmental used for environmental cleaningcleaning;;

–Doesn’t smearDoesn’t smear–Doesn’t corrode equipmentDoesn’t corrode equipment

PART C PART C

INSTRUMENT RE-PROCESSINGINSTRUMENT RE-PROCESSING(cleaning)(cleaning)