4.1.1 Face shield and goggles = Contamination of mucous membranes of the eyes, nose, and mouth are likely in a scenario of droplets generated by cough, sneeze of an infected person or during aerosol-generating procedures carried out in a clinical setting. Inadvertently touching the eyes/nose/mouth with a contaminated hand is another likely scenario. Hence protection of the mucous membranes of the eyes/nose/mouth by using face shields/ goggles is an integral part of standard and contact precautions. The flexible frame of goggles should provide a good seal with the skin of the face, covering the eyes and the surrounding areas and even accommodating for prescription glasses.
4.1.2 Masks = Respiratory viruses that include Coronaviruses target mainly the upper and lower respiratory tracts. Hence protecting the airway from the particulate matter generated by droplets/aerosols prevents human infection. Contamination of mucous membranes of the mouth and nose by infective droplets or through a contaminated hand also allows the virus to enter the host. Hence the droplet precautions/airborne precautions using masks are crucial while dealing with a suspect or confirmed case of COVID-19/performing aerosol-generating procedures. Masks are of different types. The type of mask to be used is related to the particular risk profile of the category of personnel and his/her work. There are two types of masks which are recommended for various categories of personnel working in hospital or community settings, depending upon the work environment:
1. Triple-layer medical mask
2. N-95 Respirator mask
4.1.2.1 Triple-layer medical mask
A triple layer medical mask is a disposable mask, fluid-resistant, provides protection to the wearer from droplets of infectious material emitted during coughing/sneezing/talking.
4.1.2.2. N-95 Respirator mask
An N-95 respirator mask is a respiratory protective device with high filtration efficiency to airborne particles. To provide the requisite air seal to the wearer, such masks are designed to achieve a very close facial fit.
Such a mask should have high fluid resistance, good breathability (preferably with an expiratory valve), clearly identifiable internal and external faces, duckbill/cup-shaped structured design that does not collapse against the mouth.
If correctly worn, the filtration capacity of these masks exceeds those of triple-layer medical masks. Since these provide a much tighter air seal than triple-layer medical masks, they are designed to protect the wearer from inhaling airborne particles.
4.1.3 Gloves = When a person touches an object/surface contaminated by COVID-19 infected person and then touches his own eyes, nose, or mouth, he may get exposed to the virus. Although this is not thought to be a predominant mode of transmission, care should be exercised while handling objects/surfaces potentially contaminated by suspect/confirmed cases of COVID-19.
Nitrile gloves are preferred over latex gloves because they resist chemicals, including certain disinfectants such as chlorine. There is a high rate of allergies to latex and contact allergic dermatitis among health workers. However, if nitrile gloves are not available, latex gloves can be used. Non-powdered gloves are preferred to powdered gloves.
4.1.4 Coverall/Gowns = Coverall/gowns are designed to protect the torso of healthcare providers from exposure to the virus. Although coveralls typically provide 360-degree protection because they are designed to cover the whole body, including back and lower legs and sometimes head and feet as well, the design of medical/isolation gowns do not provide continuous whole-body protection (e.g., possible openings in the back, coverage to the mid-calf only).
By using appropriate protective clothing, it is possible to create a barrier to eliminate or reduce contact and droplet exposure, both known to transmit COVID-19, thus protecting healthcare workers working in close proximity (within 1 meter) of suspect/confirmed COVID-19 cases or their secretions.
Coveralls and gowns are deemed equally acceptable as there is a lack of comparative evidence to show whether one is more effective than the other in reducing transmission to health workers. Gowns are considerably easier to put on and for removal. An apron can also be worn over the gown for the entire time the health worker is in the treatment area. Coveralls/gowns have stringent standards that extend from preventing exposure to biologically contaminated solid particles to protecting from chemical hazards.
4.1.5 Shoe covers = Shoe covers should be made up of impermeable fabric to be used overshoes to facilitate personal protection and decontamination.
4.1.6. Headcovers = Coveralls usually cover the head. Those using gowns should use a headcover that covers the head and neck while providing clinical care for patients. Hair and hair extensions should fit inside the headcover.
Points to remember while using PPE:-
1. PPEs are not an alternative to basic preventive public health measures such as hand hygiene, respiratory etiquettes which must be followed at all times.
2. Always (if possible) maintain a distance of at least 1 meter from contacts/suspect/confirmed COVID-19 cases
3. Always follow the laid down protocol for disposing of off PPEs as detailed in infection prevention and control guidelines.
Specifications of Personal Protection Equipment (PPE):-
(for Contact & Airborne precautions)
1. PPE Kit
1.1 Gloves
• Nitrile
• Non-sterile
• Powder-free
• Outer gloves preferably reach mid-forearm (minimum 280 mm total length)
• Different sizes (6.5 & 7)
• Quality compliant with the below standards, or equivalent:
- a. EU standard directive 93/42/EEC Class I, EN 455
- b. EU standard directive 89/686/EEC Category Ill, EN 374
- c. ANSI/SEA 105-2011
- d. ASTM D6319-10
1.2 Coverall (medium and large)*
• Impermeable to blood and body fluids
• Single-use
• Avoid culturally unacceptable colors e.g. black
• Light colors are preferable to better detect possible contamination
• Thumb/finger loops to anchor sleeves in place
• Quality compliant with the following standard
a. Meets or exceeds ISO 16603 class 3 exposure pressure, or equivalent
1.3 Goggles
• With transparent glasses, zero power, well-fitting, covered from all sides with elastic band/or adjustable holder.
• Good seal with the skin of the face
• Flexible frame to easily fit all face contours without too much pressure
• Covers the eyes and the surrounding areas and accommodates for prescription glasses
• Fog and scratch-resistant
• Adjustable band to secure firmly so as not to become loose during clinical activity
• Indirect venting to reduce fogging
• Maybe re-usable (provided appropriate arrangements for decontamination are in place) or disposable
• Quality compliant with the below standards, or equivalent:
a. EU standard directive 86/686/EEC, EN 166/2002
b. ANSI/SEA Z87.1-2010
1.4. N-95 Masks
• The shape that will not collapse easily
• High filtration efficiency
• Good breathability, with an expiratory valve
• Quality compliant with standards for medical N95 respirator:
a. NIOSH N95, EN 149 FFP2, or equivalent
• Fluid resistance: minimum 80 mmHg pressure based on ASTM F1862, ISO 22609, or equivalent
• Quality compliant with standards for a particulate respirator that can be worn with the full-face shield.
1.5. Shoe Covers
• Made up of the same fabric as of coverall
• Should cover the entire shoe and reach above ankles
1.6. Face Shield
• Made of clear plastic and provides good visibility to both the wearer and the patient
• Adjustable band to attach firmly around the head and fit snuggly against the forehead
• Fog resistant (preferable)
• Completely covers the sides and length of the face
• Maybe re-usable (made of a material which can be cleaned and disinfected) or disposable
• Quality compliant with the below standards, or equivalent:
a. EU standard directive 86/686/EEC, EN 166/2002
b. ANSI/SEA Z87.1-2010
2. Triple Layer Medical Mask
• Three-layered medical masks of non-woven material with a nose piece, having a filter efficiency of 99% for 3-micron particle size.
a. ISI specifications or equivalent
3. Gloves
• Nitrile
• Non-sterile
• Powder-free
• Outer gloves preferably reach mid-forearm (minimum 280mm total length)
• Different sizes (6.5 & 7)
• Quality compliant with the below standards, or equivalent:
1. EU standard directive 93/42/EEC Class I, EN 455
2. EU standard directive 89/686/EEC Category Ill, EN 374
3. ANSI/SEA 105-2011
4. ASTM D6319-10
4. Body Bags - Specifications
1) Impermeable
2) Leakproof
3) Air sealed
4) Double sealed
5) Disposable
6) Opaque
7) White
8) U shape with Zipping
9) 4/6 grips
10) Size: 2.2 x 1.2 Mts
11) Standards:
a) ISO 16602:2007
b) ISO 16603:2004
c) IS016604:2004
d) ISO/DIS 22611:2003
All items to be supplied need to be accompanied with a certificate of analysis from national/ international organizations/labs indicating conformity to standards.
All items: Expiry 5 years
Thanks & Regards,
Gourav Kala,
Certified Fitness & Wellness Coach,
+91-9999944773
Special Thanks to:-
Mr. Nitin Kumar ( 9991154544) as a CNF Distributor of Personal Protective Equipment (PPE) Kits is Tripulse International Pvt Ltd, Faridabad
Mr. Nalin Verma ( 9991188888) as a CNF Distributor of Personal Protective Equipment (PPE) Kits is Bhavya Enterprises, Rohtak
Disclaimer: The article is based on general information regarding the Personal Protective Equipment (PPE) Kits. Please consult your medical professional before using it as per self conditions.
(The author is Nutritionist certified from The Health Sciences Academy and user of Personal Protective Equipment (PPE) Kits. Views expressed are personal.)
