Standard and extended precautions
how to select and use PPEs
Disease Control and Prevention Center
National Center for Global Health and Medicine(WHO Collaboration Center)

Shinichiro Morioka, M.D.

Standard Precautions
Assumes blood and body fluid of ANY patient could
be infectious
Recommends PPE and other infection control practices
to prevent transmission in any healthcare setting
Decisions about PPE use determined by type of clinicalinteraction with patientSelection and use

You should ask yourself the following questions:✓ Who is exposed and to what?

Factors Influencing PPE Selection• Type of exposure anticipated– Splash/spray versus touch– Category of isolation precautions• Durability and appropriateness for the task
• FitPPE for Standard Precautions
Gloves – Use when touching blood, body fluids,secretions, excretions, contaminated items; fortouching mucus membranes and nonintact skinGowns – Use during procedures and patient care
activities when contact of clothing/ exposed skinwith blood/body fluids, secretions, or excretions isanticipatedPPE for Standard Precautions

Mask and goggles or a face shield – Use during
patient care activities likely to generate splashes orsprays of blood, body fluids, secretions, or excretions

Types of PPE Used in Healthcare Settings• Gloves – protect hands• Gowns/aprons – protect skin and/or clothing• Masks and respirators– protect mouth/nose– Respirators – protect respiratory tract from airborne
infectious agents• Goggles – protect eyes
• Face shields – protect face, mouth, nose, and eyes

“Contaminated” and “Clean” Areas of PPE• Contaminated – outside front• Areas of PPE that have or are likely to have been in contact
with body sites, materials, or environmental surfaces where theinfectious organism may reside• Clean – inside, outside back, ties on head and back
• Areas of PPE that are not likely to have been in contact withthe infectious organism

Sequence for Removing PPE• Gloves• Face shield or goggles• Gown• Mask or respirator

How to Remove Gloves (1)• Grasp outside edge near wrist• Peel away from hand, turning
glove inside-out• Hold in opposite gloved handHow to Remove Gloves (2)• Slide ungloved finger
under the wrist of theremaining glove• Peel off from inside,creating a bag for bothgloves• Discard

PPE for Extended Precautions• Extended Precautions include– Contact Precautions– Droplet Precautions– Airborne Infection Isolation

Concept of extended precautions

Patient room
Bed

Use of PPE for Extended Precautions• Contact Precautions – Gown and gloves for contact withpatient or environment of care (e.g., medical equipment,environmental surfaces)• In some instances these are required for entering patient’s environment• Droplet Precautions – Surgical masks within 3 feet ofpatient• Airborne Infection Isolation – Particulate respirator**Negative pressure isolation room also required

Hand Hygiene• Required for Standard and Expanded Precautions• Perform…
– Immediately after removing PPE– Between patient contacts• Wash hands thoroughly with soap and water or use
alcohol-based hand rub

PPE Use in Healthcare Settings:
Final Thoughts• PPE is available to protect you fromexposure to infectious agents in thehealthcare workplace• Know what type of PPE is necessary forthe duties you perform and use it correctlyOpen discussion