On October 20, 2014, the Centers for Disease Control and Prevention (CDC) strengthened previous infection control guidance on personal protective equipment (PPE) for healthcare workers caring for patients with Ebola in U.S. hospitals: Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing).
Healthcare workers caring for patients with Ebola are now advised to wear PPE that does not expose any skin. This means that goggles should no longer be used. The CDC now advises use of coveralls and single-use, disposable hoods. Specific PPE recommendations to avoid skin exposure include:
- Double gloves.
- Boot covers that are waterproof and go to at least mid calf or leg covers.
- Single-use fluid-resistant or impermeable gown that extends to at least mid calf or coverall without intergraded hood.
- Respirators, including either N95 respirators or powered air purifying respirator (PAPR).
- Single-use, full-face shield that is disposable.
- Surgical hoods to ensure complete coverage of the head and neck.
- Apron that is waterproof and covers the torso to the level of the mid calf should be used if Ebola patients have vomiting or diarrhea.
The CDC cautions that PPE is only one component of infection control. The new guidelines also call for on-site monitors, which supervise “at all times, and each step of every PPE donning/doffing procedure” to ensure compliance with PPE protocols.