A Practical Guide to a Safe Sequence of Donning and Doffing of Personal Protective Equipment in Relation to COVID-19

Abstract

When caring for patients with suspected or confirmed COVID-19 (coronavirus disease 2019), especially when involved in procedures that generate aerosol, personal protective equipment (PPE) with full-body coverage is recommended. The Centers for Disease Control and Prevention emphasizes and recommends the following principles with regard to donning and doffing of PPE: (1) training and education (rigorous and repeated training of the health care workers [HCWs]), (2) all HCWs must exhibit competency in the PPE donning and doffing, and (3) PPE doffing should be done in a manner that prevents self-contamination or self-inoculation with contaminated PPE or hands (remove the most contaminated PPE items first, perform hand hygiene at each stage of doffing, and discard disposable items in containers for biomedical waste).

General Principles

When caring for patients with suspected or confirmed COVID-19 (coronavirus disease 2019), especially when involved in procedures that generate aerosol, personal protective equipment (PPE) with full-body coverage is recommended. The Centers for Disease Control and Prevention emphasizes and recommends the following principles with regard to donning and doffing of PPE: (1) training and education (rigorous and repeated training of the health care workers [HCWs]), (2) all HCWs must exhibit competency in the PPE donning and doffing, and (3) PPE doffing should be done in a manner that prevents self-contamination or self-inoculation with contaminated PPE or hands (remove the most contaminated PPE items first, perform hand hygiene at each stage of doffing, and discard disposable items in containers for biomedical waste).

Procedure for Donning the PPE

The procedure for donning the PPE is as follows: (1) wear the PPE in a designated area before entering the patient care area, (2) undertake the procedure of putting on PPE under the guidance and supervision of a trained observer (colleague), (3) remove all personal items such as watch, jewelry, pen, cell phone, and so on, (4) use the restroom and drink sufficient water before starting to wear the PPE, (5) before donning, ensure that all required PPE are available, and (6) follow the steps as shown in Fig. 1 .

Fig. 1.

Donning of personal protective equipment (PPE).

Procedure for Doffing of PPE

The procedure for doffing of PPE is as follows: (1) doffing is done in a designated area, (2) always perform doffing under the guidance and supervision of a trained observer or colleague, and (3) ensure that PPE is discarded immediately into the appropriate bin, and (4) follow the steps shown in Fig. 2 .

Fig. 2.

Doffing of personal protective equipment (PPE).