Real footage through Nurse's Perspective
1. Caretaker suits up in front a mirror, typically starting out in scrubs.
2. Second person observing to do body checks
3. Put on Boot made of rubber that reach above the ankles
4. Put on thin latex gloves
5. Put on Hazmat suit
6. Put on Surgical Mask - blocks microbes from entering and exiting the resporatory system
7. Put on Hood goes over the head with built in mask.
8. Put on Water proof apron
9. Put on Goggles, sprayed with antifogging agent
10. Put on Second set of gloves, thick rubber ones.
11. (Optional) Decontamination Sprayer
(First gut reaction: Why are there so many layers? Can we minimize the layers into one body suit (I'm thinking something like Fire Retardant Clothing (FRC) with sewed on gloves)
Hot Zone - ready to treat patients (Limited to only one hour due to heat -- through out the day this means they go through this process a lot!)
- Getting patients from the truck
- Lifting patients to a crowded room - or putting them two toa bed
- Lifting workers from bed to give them water. Screwing off the water top
- Flies might enter the goggles - tempting user to adjust, opening a risk
- Itching, which also may expose caretakers
- IV needles, if puncture suit is of great risk.. "placing an IV, you get nervous... then get fogged up and you could start pulling at your equipment"
Doffing/taking it off - Many articles point to this as the most risk
1. Burn all books/articles/notebooks
2. Workers wash glove covered hands in clorine solution (used every time below when 'wash') and walk through a clorine foot bath - interesting to note, looks like they do some sort of assembly line
3. Apron and suit get sprayed front at back (almost like a car wash!)
4. Outer gloves are dosed or thrown away
5. Off come the goggles
6. Latex gloves are disinfected
7. Head cover is thrown away
8. Remove heavy overalls, which are thrown away
9. Latex gloves are washed again
10. Gloves come off, bare hands are washed again
11. Boots come off to dry, usually upside down on stick in the ground
12. Looks like they are then doused with water to cool off.
(Why is a second person not mentioned here for taking it off?)
- Wanting to help, deep compassion "somebody has to do it, and I think it's important to give care where there's a need.""
- Strong Mind to deal with unrelenting waves of patients coming in, praying that some live some don't, watching many die
- Consoled that some do live, also will hum to self to confirt themselves in such harsh conditions
- Repeat this day by date
1. Many workers only have one day of training before working (too little research)
2. Complicated procedure to doff; different ways of representing same steps "The CDC’s official poster outlining protective-gear removal has a note at the bottom telling workers to use hand hygiene immediately after removing all protective gear, but it doesn’t depict hand washing after every individual step, as the WHO poster does."
Univerisity of Maryland to doffing PPE
CDC poster to doffing of PPE
WHO poster to doffing PPE
Dr. Donovan on Training for lowering risk for health care workers.
Dr. Sugerman - views on Ebola training
How might we we:
- make it easy for caretakers to take suits on and off?
- make it more comfortable (heat, itching) or prolong time in the "hot zone" as to reduce the number of times a person must "doff' (the high risk portion of the ?
- how can we boost moral of caretakers?
- train caretakers easily and effectively (posters, videos, numbering the equipment), esp for those who you only have one day to train?