PPE for Ebola?

Nurses COVID

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I'm sure we've all seen healthcare workers in the news caring for Ebola patients and cleaning up waste. They are always covered in what looks like head to toe hazmat suits. I've heard doctors who cared for Ebola patients being interviewed stating that every inch of skin was covered.

So why am I being told in my US hospital that it's "just droplet isolation" and we'll be given plastic gowns (we normally wear something that resembles cheesecloth and is not waterproof)? Why are hazmat teams cleaning up the apartment where the Texas Ebola patient stayed and wrapping his car in plastic? I am feeling very uncomfortable with what I'm seeing everyone else doing when caring for these patients vs what my hospital is (very informally at that, no one was actually come around to educate us on what to do should we receive a r/o Ebola patient) recommending. My legs would still be only covered by scrubs, what if the patient vomited on me?

I've also read a few posters on here mention triple gloving. There was absolutely no mention what so ever of this at my institution. The administrator I briefly (an informally) spoke with said it's "just droplet isolation", which I refuse to believe.

What are other hospitals recommending? Are you comfortable with these recommendations?

Specializes in RN CRRN.

I posted this somewhere else but on the CDC website under the Ebola info there is a section for healthcare workers. If you dig in there you will find a PDF on Donning and Doffing PPE. There is one example (with pictures) on donning. There are Two Examples (with pictures) for Doffing.

The First Doffing Example has you

1) Remove Gloves, wash hands then

2) Remove Face Shield and Mask, (i.e. reaching up towards your face with dirty possibly wet gown sleeves) then

3) Remove Gown.

That means you are reaching up to remove a mask and shield with dirty sleeves of your iso gown. Who wants to flick some Ebola into their eyes? Not Me. T

he Second Doffing Example has us

1) Remove Gown and Gloves at the same time by peeling them off inside out (see PDF pictures) wash hands, then

2) Remove Face Shield and Mask. No reaching up to face with droplets of who knows what on your sleeves

I don't know about you but they need to get rid of the first example if they do not want more Ebola cases of HCWs.

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Specializes in RN CRRN.
I think the CDC recommendations are a joke and if Ebola came to my hospital I would refuse to work with anything less then what they are outfitting the healthcare workers in Africa with. We are entitled to safe working conditions under the rules of OSHA. I pray they did not send any workers in to assist in toileting with just a gown, gloves, mask and goggles when they on the other hand send men in with hazmat suits to touch the carpets and furnishings in the home. It is dumbfounding.

Exactly. It is ridiculous. Funny how the media isn't in the hospital to see how little the RNs had to work with.

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This is a biocontainment unit in Nebraska. Ebola - Biocontainment Unit - Nebraska Medicine | Omaha, NE

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Specializes in L&D, Women's Health.
I posted this somewhere else but on the CDC website under the Ebola info there is a section for healthcare workers. If you dig in there you will find a PDF on Donning and Doffing PPE. There is one example (with pictures) on donning. There are Two Examples (with pictures) for Doffing.

The First Doffing Example has you

1) Remove Gloves, wash hands then

2) Remove Face Shield and Mask, (i.e. reaching up towards your face with dirty possibly wet gown sleeves) then

3) Remove Gown.

That means you are reaching up to remove a mask and shield with dirty sleeves of your iso gown. Who wants to flick some Ebola into their eyes? Not Me. T

he Second Doffing Example has us

1) Remove Gown and Gloves at the same time by peeling them off inside out (see PDF pictures) wash hands, then

2) Remove Face Shield and Mask. No reaching up to face with droplets of who knows what on your sleeves

I don't know about you but they need to get rid of the first example if they do not want more Ebola cases of HCWs.

Dr. Gupta demonstrated donning/doffing PPE . . . and contimated himself.

CNN's Dr. Sanjay Gupta suits up in Ebola protective gear - CNN.com Video

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I think you need to do some more research. If you listened to or read transcripts from the CDC's conference call for healthcare professionals where they had doctors from both Nebraska and Emory (the two hospitals with special biocontainment units who have taken Ebola patients so far), they touched on why some people wear Hazmat suits. It basically depends on the situation. They said the EMS providers in the ambulance wore Hazmat suits because the ambulance is a very contained space, can be very hot, and it was found that workers wearing hospital-type PPE would end up sweating a ton and reaching up to wipe sweat from their brow. The Hazmat suits circulate cool air inside to help with that. It's the same situation in Africa...that and the fact that they don't have disposable PPE in a lot of places there, so Hazmat suits are safer.

My hospital has chosen not to use Hazmat suits because it was found that it was too difficult for healthcare workers to take them off correctly without contaminating themselves, and it was safer to use equipment we are more familiar with (like surgical gowns) that do the job just as well.

The Hazmat suits for people going into the patients' homes really isn't necessary; Ebola doesn't live long on surfaces at all...they couldn't find any virus on surfaces in patients' rooms in both Emory and Africa, except for a bloody glove. I think people are wearing that stuff in the patients' homes out of an abundance of caution since they don't know what bodily fluids could be where when they go in there. Personally I think it would be fine to just not let anyone in the apartment for a week or so and leave it at that, but the public would probably freak out that not enough was being done.

It's important to know the research behind all this to better educate yourself.

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Specializes in RN CRRN.

The rooms at Emory and Omaha use Ultraviolet light to kill germs I do believe, other places have UV robots, so no some places may have limited amount of residual ebola on surfaces. The fact is, she got ebola wearing a gown, gloves, mask and face shield...

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Specializes in RN CRRN.
I think you need to do some more research. If you listened to or read transcripts from the CDC's conference call for healthcare professionals where they had doctors from both Nebraska and Emory (the two hospitals with special biocontainment units who have taken Ebola patients so far), they touched on why some people wear Hazmat suits. It basically depends on the situation. They said the EMS providers in the ambulance wore Hazmat suits because the ambulance is a very contained space, can be very hot, and it was found that workers wearing hospital-type PPE would end up sweating a ton and reaching up to wipe sweat from their brow. The Hazmat suits circulate cool air inside to help with that. It's the same situation in Africa...that and the fact that they don't have disposable PPE in a lot of places there, so Hazmat suits are safer.

My hospital has chosen not to use Hazmat suits because it was found that it was too difficult for healthcare workers to take them off correctly without contaminating themselves, and it was safer to use equipment we are more familiar with (like surgical gowns) that do the job just as well.

The Hazmat suits for people going into the patients' homes really isn't necessary; Ebola doesn't live long on surfaces at all...they couldn't find any virus on surfaces in patients' rooms in both Emory and Africa, except for a bloody glove. I think people are wearing that stuff in the patients' homes out of an abundance of caution since they don't know what bodily fluids could be where when they go in there. Personally I think it would be fine to just not let anyone in the apartment for a week or so and leave it at that, but the public would probably freak out that not enough was being done.

It's important to know the research behind all this to better educate yourself.

I think our hospital rooms are pretty confined spaces as well. I think I could stand sweating in a suit vs a paper or plastic gown with neck exposed, gloves that rip easily and someone vomiting on you, as well as possibly having the virus aerolize in the air by suctioning etc...

Killing Super Bugs with a Robot - The Nebraska Medical Center

Killing Super Bugs with a Robot - The Nebraska Medical Center

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Specializes in OR, Nursing Professional Development.

At least one specialty organization is recommending all forms of isolation precautions:

AORN recommendations for the patient with suspected or confirmed ebola undergoing surgery: standard, contact, droplet, and airborne precautions.

http://www.aornjournal.org/pb/assets...iderations.pdf

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Dr. Gupta demonstrated donning/doffing PPE . . . and contimated himself.

CNN's Dr. Sanjay Gupta suits up in Ebola protective gear - CNN.com Video

I think you need to do some more research. If you listened to or read transcripts from the CDC's conference call for healthcare professionals where they had doctors from both Nebraska and Emory (the two hospitals with special biocontainment units who have taken Ebola patients so far), they touched on why some people wear Hazmat suits. It basically depends on the situation. They said the EMS providers in the ambulance wore Hazmat suits because the ambulance is a very contained space, can be very hot, and it was found that workers wearing hospital-type PPE would end up sweating a ton and reaching up to wipe sweat from their brow. The Hazmat suits circulate cool air inside to help with that. It's the same situation in Africa...that and the fact that they don't have disposable PPE in a lot of places there, so Hazmat suits are safer.

My hospital has chosen not to use Hazmat suits because it was found that it was too difficult for healthcare workers to take them off correctly without contaminating themselves, and it was safer to use equipment we are more familiar with (like surgical gowns) that do the job just as well.

The Hazmat suits for people going into the patients' homes really isn't necessary; Ebola doesn't live long on surfaces at all...they couldn't find any virus on surfaces in patients' rooms in both Emory and Africa, except for a bloody glove. I think people are wearing that stuff in the patients' homes out of an abundance of caution since they don't know what bodily fluids could be where when they go in there. Personally I think it would be fine to just not let anyone in the apartment for a week or so and leave it at that, but the public would probably freak out that not enough was being done.

It's important to know the research behind all this to better educate yourself.

If you do your research you will see this is a level 4 pathogen and they are now recommending full suits. Funny, the government was wrong.

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