In any medical situation, one of the most important aspects to consider is how to protect yourself as a provider. While scene safety is extensively discussed in the EMS world, personal protective equipment (PPE) is equally as important to staying safe. Yet, it is usually just glossed over; the discussion only going so far as to “make sure you have gloves and a mask.” This article will dive deeper into the necessary medical PPE for bloodborne pathogens, why it’s important, and when to use it. Keep in mind that local organizations may have different requirements and that chemical and hazmat protection is beyond the scope of this article.
Sterile vs. Non-Sterile
One of the first distinctions to make when talking about PPE is whether you are protecting yourself or your patient. Sterile items such as gloves and gowns used in a surgical setting help prevent wound infection. Unless you’ve been specifically trained in sterile technique, you should never put yourself in a situation where it’s necessary to use sterile PPE. To the contrary, most PPE items are meant to protect the medical provider from infectious elements in the environment or from the patient.
The first thing every medical provider thinks of when describing personal protective equipment is gloves. Currently, many healthcare organizations recommend nitrile gloves to prevent an allergic reaction to latex by either the patient or the provider.
Perform proper hand hygiene prior to donning your gloves, and immediately after removal. The gloves should fit well: not too tight to restrict movement, but not so loose as to get in the way of providing care. Gloves should be replaced if cut; between episodes of patient contact; and whenever transitioning from patient care to touching other things, such as your cell phone or a computer. Obviously, gloves should never be reused and should be discarded in a proper medical waste bin where available.
In many cases, gloves may be the only PPE you need to adequately protect both yourself and your patient. They are widely and cheaply available from most medical supply stores and even Amazon. Steer away from dark-colored or black gloves, as they may make it difficult to detect blood.
Eye protection should be worn any time a patient’s body fluids may come into contact with your face or eyes. Examples are situations that include profuse arterial bleeds, vomit, and any other scenario that requires you to get very close to a bleeding wound. Although normal glasses or sunglasses may provide some protection, it is important to have full coverage of the orbital area to achieve maximum safety. Many glasses are cheap and disposable, although some are more expensive and can be reused (after proper autoclaving, UV, or chemical sterilization) and fit over prescription eyewear.
Situations that require a face mask are similar to those that call for eye protection. Different masks filter out different particles, so it is important to keep an eye on a mask’s safety rating (N-95 is a common example). A situation involving bloodborne pathogens calls for a mask that is impermeable to bodily fluids.
Like gloves, masks are available widely and cheaply, and should not be reused. Some masks require a proper fitting. Facial hair can change the efficacy of the mask by disrupting the seal.
A great alternative to glasses and a mask is the face shield, which provides coverage to the eyes and the mucous membranes of the nose and mouth.
While slightly more unwieldy than the glasses/mask combo, a face shield allows for slightly greater protection and is often utilized in trauma settings where large amounts of blood are likely to come into contact with the provider. Again, while most face shields are disposable, higher-quality and/or reusable ones may be more comfortable or have added features like a headlight for deep surgical fields.
Proper use of PPE for your clothing and shoes can both save your garments and protect those around you.
Gowns and shoe covers should always be impermeable to fluids and are almost always disposable to circumvent the difficulty of laundering biohazardous waste. If you are acting as a first responder, a gown is probably overkill, but if you are employed to respond to medical emergencies, you should be prepared to correctly don a gown and booties.
Although selecting and using the correct PPE for a given situation is important, it’s useless without frequent (and correct) handwashing skills and proper donning and doffing of equipment.
Whenever you enter a situation that may put you as a healthcare provider at risk, make sure you fully understand how to use your PPE to allow you to stay safe and stay protected.
Disclaimer: The content in this article is the opinion of the writer and does not necessarily reflect the policies or opinions of US Patriot Tactical.
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