During outbreaks and pandemics, such as COVID-19 or influenza, appropriate use of personal protective equipment (PPE) and hand hygiene are critical in protecting yourself, your practice team members and your patients and preventing further of viruses.
This video demonstrates how to remove and dispose of PPE.
Dr Penny Burns, FRACGP
Dr Jonathan Adams, FRACGP
Once you're ready to remove your PPE at the end of the clinical examination, you need to move to a designated dirty zone at an appropriate distance from the patient. The distance will depend on the presentation of the patient and maybe outside the examination room. A clinical waste bin, as well as hand sanitising equipment will need to be available where you take off your PPE.
The first step to removing PPE is to take off your gloves. The outside of the glove should be treated as contaminated. Pinch the cuff of one glove. Use that to carefully peel off the first glove, taking care not to contaminate your skin at any point and keep hold of the glove. Take your now ungloved hand and slide your finger carefully under the remaining glove. Peel off the second glove turning it inside out over the first as you do so. The remove gloves should now be placed in a clinical waste bin.
Some guidelines recommend hand hygiene after each step when removing PPE. Hand hygiene is important at any high-risk step or if contamination has occurred. To be clear, do perform hand hygiene between steps if you've contaminated your hands in any way.
With your now ungloved and clean hands, grasp the headband or the inside of the side arms of your eyewear from the back and lift them away from your face. Do not touch the outside of the eyewear - that should be treated as contaminated. If they are disposable discard the eyewear into a clinical waste bin. If they are reusable, place them in a designated container for later disinfection.
When taking off the gown, the front and sleeves should be treated as contaminated. Unfasten your gown starting with the bottom closure, followed by the top closure. Taking care that your sleeves don't contact your body, slip your hands underneath the gown at the neck near the shoulders and peel away from the shoulders and over the hands. Making sure to only touch the inside of the gown, turn it inside out and fold or roll into a bundle. Discard the gown into a clinical waste bin.
The front of the mask should be treated as contaminated and never be touched. Grasp the bottom ties or elastic, followed by the top and pull them over the head to remove the mask. Discard the mask into a clinical waste bin at this stage.
You should perform thorough hand hygiene. Firstly rub the palms together. Rub the back of each hand. Rub between your fingers ensuring you get all the way down to the webbing. Rub your fingernails on the opposite palm. Rub around each thumb and finally finish by rubbing the sanitiser over your entire wrist.
You have now safely removed and disposed of your PPE.