9  Contact23
Contact PPE includes a single pair of disposable patient examination gloves. Change gloves if they become torn or heavily contaminated. A more conservative approach would include double gloving and frequent changing of outer gloves when soiled or torn, with full removal when at risk tasks are completed. In addition, a disposable isolation gown is required. Many facilities are using clothing that has a hood integrated into a zip-up gown or full jumpsuit-type clothing, with a face shield worn along with an N95; a procedure or surgical mask that has a built-in face shield could be worn over an N95 for the eye protection if goggles or face shields aren't available (see photos). All personnel must be mindful of not touching their face while working.
Upon completion of patient care activities in the negative pressure respiratory isolation room, clinicians should remove gown first, then mask and face shield, and discard PPE; then remove gloves and perform hand hygiene. Used PPE should be discarded in accordance with routine procedures.
Ancillary personnel (ambulance drivers, medics, and techs/aids who help move patients onto stretchers), should wear all above-recommended PPE. After completing patient care/transport duties, and before entering clean areas, personnel should remove and dispose of their PPE and perform hand hygiene to avoid contaminating clean areas.
In addition to the PPE described above, EMS clinicians should exercise caution if an aerosol-generating procedure, such as bag valve mask (BVM) ventilation, oropharyngeal suctioning, endotracheal intubation, nebulizer treatment, continuous positive airway pressure (CPAP), bi-phasic positive airway pressure (biPAP), or resuscitation involving emergency intubation or cardiopulmonary resuscitation (CPR) is necessary. BVMs, and other ventilatory equipment, should be equipped with HEPA filtration to filter expired air.