What PPE For Airborne Precautions？

Facing airborne infections like tuberculosis or COVID-19, using the correct PPE can save lives. Want to know what to wear and how it keeps you safe? Let’s break it down in a simple and clear way!

What PPE For Airborne Precautions？

If you work with airborne pathogens, I recommend using specific personal protective equipment (PPE). This gear helps stop you from getting infected.

• N95 Respirators or Stronger Breathing Protection: I suggest using a fit-tested, NIOSH-approved N95 respirator as the basic protection for airborne risks. In my experience, this is a good starting point. For higher-risk situations, such as procedures that create aerosols, you need more. Full-facepiece Powered Air-Purifying Respirators (PAPRs) offer an assigned protection factor (APF) of up to 1,000. Full-facepiece Self-Contained Breathing Apparatus (SCBA) gives an APF of up to 10,000. These provide better protection.
• Eye Protection: I advise using face shields or goggles. You’ll need them during procedures that create aerosols or if there’s a chance of fluid splashes.
• Gloves: You should always wear gloves for any contact with patients. I think it’s good practice for healthcare workers to change gloves between patients. They also need to clean their hands before putting on gloves and after taking them off.
• Protective Clothing: I recommend wearing a surgical gown or disposable coverall if you might be exposed to body fluids. It’s also often a standard rule in many situations with airborne pathogens.

Key Examples of Airborne Precaution Use

Some diseases need airborne precautions. These include tuberculosis, measles, chickenpox (varicella), disseminated herpes zoster, and smallpox. Based on my experience during the COVID-19 pandemic, strict airborne precautions became very common. This included N95 or better respirators, eye protection, gowns, and gloves. Healthcare settings used these for any suspected or confirmed cases.

Protection Levels and Environmental Controls

Here are the protection levels: – An N95 respirator gives an assigned protection factor (APF) of 5. – A full facepiece PAPR has an APF of 1,000. – A full facepiece SCBA has an APF of 10,000.

Airborne pathogens can float in the air for hours. They might also travel more than 6 feet. Because of this, I suggest placing patients in negative-pressure Airborne Infection Isolation Rooms (AIIR). These rooms are set up for 6-12 air changes every hour.

You must wear all PPE before you go into a patient’s room. You must take it off after you leave. I strongly recommend strict hand cleaning before and after using PPE.

Practical PPE Summary Table

Additional Safety Measures

• I recommend that patients needing airborne precautions stay in negative pressure rooms as much as possible.
• If you need to move a patient outside the isolation room, I suggest the patient wear a surgical mask. This helps stop the spread of infection.
• Following PPE and hand hygiene rules greatly reduces infections in healthcare places. My experience shows this is very effective.

When and Where I Recommend Using Airborne PPE

I believe Airborne PPE is essential in certain healthcare settings and at specific times. This is because tiny germs that travel through the air can float for a while and can easily make people sick.

• Airborne Infection Isolation Rooms (AIIRs): I advise healthcare workers to use N95 or better respirators when they work in AIIRs. These rooms have what we call negative pressure. This feature helps filter out harmful particles from the air. The rooms provide 6 to 12 air changes each hour. This greatly lowers the chance of germs spreading.
• No AIIRs Available?: If you do not have an AIIR, I suggest you place the patient in a private room. Please keep the door closed. You should do this until it’s possible to move the patient to a facility that has the correct type of room.
• Important Times I Recommend Using Airborne Rules:
  • I suggest applying these rules when you treat patients with airborne illnesses, such as anthrax, tuberculosis, measles, chickenpox, or widespread herpes zoster.
  • You should use these rules when working with tiny germs, those 5 micrometers or smaller. From my experience, these germs can float in the air for a long time and travel quite far.
  • During patient transport: I strongly advise that patients must wear a mask. They should also cover any skin sores completely. In my view, healthcare workers will need respiratory PPE if patients cannot follow these steps for masking and covering skin lesions.
  • I recommend you use them whenever you go into the room of any patient who is under airborne precautions.

How Standard, Droplet, and Airborne Precautions Differ, In My Experience

• Standard Precautions: I recommend you always practice good hand hygiene. You should also wear gloves. Sometimes, based on the situation, I believe you might need medical gowns when you are near any materials that could be infectious.
• Droplet Precautions: I suggest using surgical masks. These masks protect you from germs like the flu. Such germs usually spread in larger droplets from coughs or sneezes, typically traveling within a 3-6 foot range.
• Airborne Precautions: For airborne precautions, I recommend you wear an N95 respirator (or a better one). It’s important that this respirator fits you well and has NIOSH approval. You should use this for tiny germs, 5 micrometers or smaller because these germs can stay in the air for a long time.

Key Steps I Recommend for Healthcare Workers

• Before you enter an airborne isolation area, I strongly suggest you always put on an N95 respirator (or a higher-level one) that is fit-tested and NIOSH-approved.
• I recommend you perform a fit check each time before using a particulate respirator. This is a crucial step.
• In my opinion, you should move patients who require airborne precautions when it is truly essential. During transport, I advise you to make sure the patient wears a surgical mask. Also, see that their skin lesions are thoroughly covered.
• If healthcare staff are susceptible to diseases like measles, I advise they should avoid entering those patients’ rooms. This is particularly important if other staff members who are immune are available to care for these patients.
• If someone who is not immune has had unprotected exposure to an airborne infectious disease, I suggest you ensure they receive immunization quickly.

My Advice on Point of Care Risk Assessment

Before you go into a patient’s room, I recommend you conduct a risk assessment. This will help you determine if airborne precautions are needed. I also want you to be aware that, in some cases, you might need to use both airborne and contact precautions. This decision will depend on the specific disease the patient has.

My Guide to Putting On and Taking Off Airborne PPE

My Step-by-Step Guide to Putting On PPE for Airborne Precautions

To protect yourself fully against airborne germs, I recommend you follow these exact steps when putting on your personal protective equipment(PPE):

1. Start with Hand Hygiene: I always wash or sanitize my hands before I touch any PPE.
2. Put on N95 or Higher-Level Respirator: I place the respirator on my face. I make sure it covers both my nose and mouth.
3. Position and Adjust for Full Coverage: I adjust the straps and mask for a snug fit. This ensures it covers your entire face surface properly.
4. Do the Required Seal Checks:
   • I suggest you perform both positive and negative pressure seal checks. I’ll give you details on this below.
5. Wear Additional PPE if Needed: After the respirator, I put on a gown, gloves, and eye protection, like goggles or a face shield, if the situation requires it.

My Safe Way to Take Off PPE and Avoid Contaminating Yourself

Taking off PPE in the right order is very important. In my experience, this helps you avoid exposure:

1. Remove Gloves First: I use the glove-in-glove technique. This way, I avoid touching the outside of the gloves.
2. Perform Hand Hygiene: I clean my hands right after I take off my gloves.
3. Take Off Gown: I pull the gown away from my body. Then, I roll it inward before I dispose of it.
4. Remove Eye Protection with Care: I am gentle when removing eye protection. I make sure not to touch the front surface. I remove goggles or a face shield from the back or sides.
5. Remove Respirator: I touch just the straps—I never touch the front of the respirator. Then, I dispose of it or store it as appropriate.
6. Final Hand Hygiene: I perform a thorough hand cleaning after all PPE is removed.
7. Avoid Face Contact: Throughout this process, I make sure not to touch my face until my hand hygiene is complete.

Why Do I Think Respirator Fit Testing and Seal Checks Are Important?

You Must Get an Annual Fit Test

I believe every healthcare worker needs a fit test with the same make, model, and size respirator they will use at work. This test usually takes about 15–20 minutes. I recommend you complete it at least once a year, or whenever you get a different respirator.

How I Perform Seal Checks

I do these checks before each use:

• Positive Pressure Check: – I cover the respirator surface. – I breathe out softly. – I check that no air escapes and that positive pressure is maintained. If I find leaks, I adjust the respirator and repeat the check. –
• Negative Pressure Check: – I cover the entire respirator. – I breathe in softly. This should create a slight vacuum, causing the mask to collapse a bit toward my face. – I hold my breath for ten seconds to check for a tight seal. If it’s not tight, I inspect the mask for any defects.

You need to do both seal checks before use. OSHA standard 1910.134 mandates this. From my experience, this is vital to ensure no contaminated air leaks in. It also helps the respirator provide you with maximum protection.

CDC, WHO, and OSHA: My Guide to Using Airborne PPE Well

I recommend following the official guidelines from the CDC, WHO, and OSHA. This is key to getting the best protection from airborne germs in healthcare places. I believe these standards help keep you safe and control infections.

CDC and WHO Rules I Think You Should Follow

• You Must Protect Your Breathing: In my experience, healthcare workers need to wear an N95 respirator or better. Make sure it’s fit-tested and NIOSH-approved. You should put it on before going into any area where airborne germs might spread. I suggest you clean your hands before going in and after coming out of the room. Also, keep your respirator on until you leave and close the door.
• My Tips for Isolation Rooms:
  • I recommend that you place patients with airborne sicknesses—like tuberculosis, measles, or varicella—in an Airborne Infection Isolation Room (AIIR).
  • I’ve found these rooms need negative pressure. They also need 6–12 air changes each hour. This helps lower the chance of infection.
  • From my perspective, keeping room doors closed always is important. This helps keep airborne germs inside.
• Educating Everyone: Staff, Patients, and Visitors:
  • I believe facilities need to teach all staff, patients, and visitors about airborne safety steps. They also need to teach them how to use PPE correctly.
  • I suggest posting signs about breathing hygiene, how to apply PPE and hand washing. Make sure these signs are in languages that staff and visitors can read.
  • When it’s possible, visitors and staff who don’t need to be there should stay at least 3 feet apart. I think it’s best if necessary, that immune visitors are the ones allowed in patient rooms.
• Controlling Germs and Moving Patients:
  • My advice is for patients with airborne infections to stay on precautions for the whole time needed. For measles, this is 4 days after the rash starts. It might be longer for patients with weak immune systems.
  • I suggest moving patients for essential reasons. Patients should wear a surgical mask when being moved. It’s also a good idea to tell the staff who will receive them ahead of time.

OSHA Rules I Think Are Important for Respirator Safety

• Respirators: Fit-Tested and Certified is Key: I stress that all staff should use an N95 respirator or a better one. It must be NIOSH-approved and fit-tested. Following the OSHA Respiratory Protection Standard (29 CFR 1910.134) is something you have to do.
• My View on a Good Respiratory Protection Program:
  • Based on my experience, a good program has medical check-ups. It also includes yearly fit tests with the exact respirator model you use. Training on how to use and care for the respirator correctly is also vital.
  • I believe employees should use PPE after they finish fit testing and training for it.

Training, Paperwork, and Following the Rules: My Thoughts

• Learning and Keeping Records:
  • I think facilities should give current education on putting on and taking off PPE. They should also have clear signs about infection control.
  • From my perspective, staff need to finish and write down all needed training and fit tests. They should do this before they look after patients who need airborne precautions.
  • I recommend keeping good records. These should include dates for respirator fit tests, training details, and information on signs. You should also track compliance checks. Logs for hand washing and for who enters isolation rooms are also important, in my view.

Infection Control: What I’ve Seen Works (Based on Data)

• I’ve seen that AIIRs work best when they have 6–12 air exchanges per hour to reduce airborne pathogen risk.
• My experience shows hand hygiene is vital: CDC posters point out you should clean your hands before going into and after leaving isolation rooms. I also see the importance of always using N95 respirators and keeping room doors shut.
• I suggest annual retraining and documented fit testing for N95 respirators or better ones. From my viewpoint, these are key for staying compliant and keeping staff safe.

I believe these steps, which are based on evidence, and careful record-keeping, help a lot. They lower the chance of infections spreading in healthcare settings. This protects staff, patients, and everyone in the community, in my opinion.