美国CDC医疗机构内个人防护用品PPE选择和使用指南英文版

GuidancefortheSelectionandUseofPersonalProtectiveEquipment(PPE)inHealthcareSettings第1页PPEUseinHealthcareSettings:

ProgramGoalImprovepersonnelsafetyinthehealthcareenvironmentthroughappropriateuseofPPE.PPEUseinHealthcareSettings第2页PPEUseinHealthcareSettings:

ProgramObjectivesProvideinformationontheselectionanduseofPPEinhealthcaresettingsPracticehowtosafelydonandremovePPEPPEUseinHealthcareSettings第3页PersonalProtectiveEquipmentDefinition“specializedclothingorequipmentwornbyanemployeeforprotectionagainstinfectiousmaterials”(OSHA)PPEUseinHealthcareSettings第4页RegulationsandRecommendationsforPPEOSHAissuesworkplacehealthandsafetyregulations.RegardingPPE,employersmust:ProvideappropriatePPEforemployeesEnsurethatPPEisdisposedorreusablePPEiscleaned,laundered,repairedandstoredafteruseOSHAalsospecifiescircumstancesforwhichPPEisindicatedCDCrecommendswhen,whatandhowtousePPEPPEUseinHealthcareSettings第5页HierarchyofSafetyandHealthControlsTrainingandadministrativecontrolsEngineeringcontrolsWorkpracticecontrolsPersonalprotectiveequipmentPPEUseinHealthcareSettings第6页TypesofPPEUsedinHealthcareSettingsGloves–protecthandsGowns/aprons–protectskinand/orclothingMasksandrespirators–protectmouth/noseRespirators–protectrespiratorytractfromairborneinfectiousagentsGoggles–protecteyesFaceshields–protectface,mouth,nose,andeyesPPEUseinHealthcareSettings第7页FactorsInfluencingPPESelectionTypeofexposureanticipatedSplash/sprayversustouchCategoryofisolationprecautionsDurabilityandappropriatenessforthetaskFitPPEUseinHealthcareSettings第8页GlovesPurpose–patientcare,environmentalservices,otherGlovematerial–vinyl,latex,nitrile,otherSterileornonsterileOneortwopairSingleuseorreusablePPEUseinHealthcareSettings第9页GlovesPurpose–patientcare,environmentalservices,otherGlovematerial–vinyl,latex,nitrile,otherSterileornon-sterileOneortwopairSingleuseorreusablePPEUseinHealthcareSettings第10页Do’sandDon’tsofGloveUseWorkfrom“cleantodirty”Limitopportunitiesfor“touchcontamination”-protectyourself,others,andtheenvironmentDon’ttouchyourfaceoradjustPPEwithcontaminatedglovesDon’ttouchenvironmentalsurfacesexceptasnecessaryduringpatientcarePPEUseinHealthcareSettings第11页Do’sandDon’tsofGloveUse(cont’d)ChangeglovesDuringuseiftornandwhenheavilysoiled(evenduringuseonthesamepatient)AfteruseoneachpatientDiscardinappropriatereceptacleNeverwashorreusedisposableglovesPPEUseinHealthcareSettings第12页GownsorApronsPurposeofuseMaterial–Naturalorman-madeReusableordisposableResistancetofluidpenetrationCleanorsterilePPEUseinHealthcareSettings第13页FaceProtectionMasks–protectnoseandmouthShouldfullycovernoseandmouthandpreventfluidpenetrationGoggles–protecteyesShouldfitsnugglyoverandaroundeyesPersonalglassesnotasubstituteforgogglesAntifogfeatureimprovesclarityPPEUseinHealthcareSettings第14页FaceProtectionFaceshields–protectface,nose,mouth,andeyesShouldcoverforehead,extendbelowchinandwraparoundsideoffacePPEUseinHealthcareSettings第15页RespiratoryProtectionPurpose–protectfrominhalationofinfectiousaerosols(e.g.,Mycobacteriumtuberculosis)PPEtypesforrespiratoryprotectionParticulaterespiratorsHalf-orfull-faceelastomericrespiratorsPoweredairpurifyingrespirators(PAPR)PPEUseinHealthcareSettings第16页ElementsofaRespiratory

ProtectionProgramMedicalevaluationFittestingTrainingFitcheckingbeforeusePPEUseinHealthcareSettings第17页Foradditionalinformationonrespirators…./niosh/npptl/respirators/respsars.html/niosh/99-143.html/niosh/topics/respiratorsPPEUseinHealthcareSettings第18页PPEUseinHealthcareSettings:

HowtoSafelyDon,Use,andRemovePPE第19页KeyPointsAboutPPEDonbeforecontactwiththepatient,generallybeforeenteringtheroomUsecarefully–don’tspreadcontaminationRemoveanddiscardcarefully,eitheratthedoorwayorimmediatelyoutsidepatientroom;removerespiratoroutsideroomImmediatelyperformhandhygienePPEUseinHealthcareSettings第20页Sequence*forDonningPPEGownfirstMaskorrespiratorGogglesorfaceshieldGloves*CombinationofPPEwillaffectsequence–bepracticalPPEUseinHealthcareSettings第21页HowtoDonaGownSelectappropriatetypeandsizeOpeningisinthebackSecureatneckandwaistIfgownistoosmall,usetwogownsGown#1tiesinfrontGown#2tiesinbackPPEUseinHealthcareSettings第22页HowtoDonaMaskPlaceovernose,mouthandchinFitflexiblenosepieceovernosebridgeSecureonheadwithtiesorelasticAdjusttofitPPEUseinHealthcareSettings第23页HowtoDonaParticulateRespiratorSelectafittestedrespiratorPlaceovernose,mouthandchinFitflexiblenosepieceovernosebridgeSecureonheadwithelasticAdjusttofitPerformafitcheck–Inhale–respiratorshouldcollapseExhale–checkforleakagearoundfacePPEUseinHealthcareSettings第24页HowtoDonEyeandFaceProtectionPositiongogglesovereyesandsecuretotheheadusingtheearpiecesorheadbandPositionfaceshieldoverfaceandsecureonbrowwithheadbandAdjusttofitcomfortablyPPEUseinHealthcareSettings第25页HowtoDonGlovesDongloveslastSelectcorrecttypeandsizeInserthandsintoglovesExtendglovesoverisolationgowncuffsPPEUseinHealthcareSettings第26页HowtoSafelyUsePPEKeepglovedhandsawayfromfaceAvoidtouchingoradjustingotherPPERemoveglovesiftheybecometorn;performhandhygienebeforedonningnewglovesLimitsurfacesanditemstouchedPPEUseinHealthcareSettings第27页PPEUseinHealthcareSettings:

HowtoSafelyRemovePPE第28页“Contaminated”and“Clean”AreasofPPEContaminated–outsidefrontAreasofPPEthathaveorarelikelytohavebeenincontactwithbodysites,materials,orenvironmentalsurfaceswheretheinfectiousorganismmayresideClean–inside,outsideback,tiesonheadandbackAreasofPPEthatarenotlikelytohavebeenincontactwiththeinfectiousorganismPPEUseinHealthcareSettings第29页SequenceforRemovingPPEGlovesFaceshieldorgogglesGownMaskorrespiratorPPEUseinHealthcareSettings第30页WheretoRemovePPEAtdoorway,beforeleavingpatientroomorinanteroom*Removerespiratoroutsideroom,afterdoorhasbeenclosed** Ensurethathandhygienefacilitiesareavailableatthepointneeded,e.g.,sinkoralcohol-basedhandrubPPEUseinHealthcareSettings第31页HowtoRemoveGloves(1)GraspoutsideedgenearwristPeelawayfromhand,turninggloveinside-outHoldinoppositeglovedhandPPEUseinHealthcareSettings第32页HowtoRemoveGloves(2)SlideunglovedfingerunderthewristoftheremainingglovePeelofffrominside,creatingabagforbothglovesDiscardPPEUseinHealthcareSettings第33页RemoveGogglesorFaceShieldGraspearorheadpieceswithunglovedhandsLiftawayfromfacePlaceindesignatedreceptacleforreprocessingordisposalPPEUseinHealthcareSettings第34页RemovingIsolationGownUnfastentiesPeelgownawayfromneckandshoulderTurncontaminatedoutsidetowardtheinsideFoldorrollintoabundleDiscardPPEUseinHealthcareSettings第35页RemovingaMaskUntiethebottom,thentop,tieRemovefromfaceDiscardPPEUseinHealthcareSettings第36页RemovingaParticulateRespiratorLiftthebottomelasticoveryourheadfirstThenliftoffthetopelasticDiscardPPEUseinHealthcareSettings第37页HandHygienePerformhandhygieneimmediatelyafterremovingPPE.IfhandsbecomevisiblycontaminatedduringPPEremoval,washhandsbeforecontinuingtoremovePPEWashhandswithsoapandwateroruseanalcohol-basedhandrubPPEUseinHealthcareSettings* Ensurethathandhygienefacilitiesareavailableatthepointneeded,e.g.,sinkoralcohol-basedhandrub第38页PPEUseinHealthcareSettings:

WhentoUsePPE第39页StandardandExpandedIsolationPrecautions第40页StandardPrecautionsPreviouslycalledUniversalPrecautionsAssumesbloodandbodyfluidofANYpatientcouldbeinfectiousRecommendsPPEandotherinfectioncontrolpracticestopreventtransmissioninanyhealthcaresettingDecisionsaboutPPEusedeterminedbytypeofclinicalinteractionwithpatientPPEUseinHealthcareSettings第41页PPEforStandardPrecautions(1)Gloves–Usewhentouchingblood,bodyfluids,secretions,excretions,contaminateditems;fortouchingmucusmembranesandnonintactskinGowns–Useduringproceduresandpatientcareactivitieswhencontactofclothing/exposedskinwithblood/bodyfluids,secretions,orexcretionsisanticipatedPPEUseinHealthcareSettings第42页PPEforStandardPrecautions(2)Maskandgogglesorafaceshield–Useduringpatientcareactivitieslikelytogeneratesplashesorspraysofblood,bodyfluids,secretions,orexcretionsPPEUseinHealthcareSettings第43页WhatTypeofPPEWouldYouWear?Givingabedbath?Suctioningoralsecretions?Transportingapatientinawheelchair?Respondingtoanemergencywherebloodisspurting?Drawingbloodfromavein?Cleaninganincontinentpatientwithdiarrhea?Irrigatingawound?Takingvitalsigns?PPEUseinHealthcareSettings第44页WhatTypeofPPEWouldYouWear?Givingabedbath?GenerallynoneSuctioningoralsecretions?Glovesandmask/gogglesorafaceshield–sometimesgownTransportingapatientinawheelchair?GenerallynonerequiredRespondingtoanemergencywherebloodisspurting?Gloves,fluid-resistantgown,mask/gogglesorafaceshieldDrawingbloodfromavein?GlovesCleaninganincontinentpatientwithdiarrhea?Glovesw/wogownIrrigatingawound?Gloves,gown,mask/gogglesorafaceshieldTakingvitalsigns?Gene