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VHF 4 Dress-Out (Donning) with CPC

The idea of proper dress-out (donning) depends on the level type and duty task as well as the support system for continued use that is in place on site. What exactly does this statement mean? Once your level of protection is chosen, how will you support it? Are parts of the ensemble’ re-useable? Does some or all of it need replacement as limited (or once) use only? These questions need full answers before you implement a program, and acquire resources and personnel for continued operation over an extended period of time. There are however, beyond these pre-planning stages some commonalities that remain constant for the minimization of health care worker contamination and subsequent possible cross-contamination. There very well be many more steps you want included in YOUR dress-out plan, and these will enhance your operation to be even more efficient than the general model. This is how the decontamination process evolves to a better form. The following steps are seen as a “minimum” and must be adhered to for decontamination to safely function for the health care worker. They are;

1] Removal of body jewelry and personal items for clean and safe storage.

ALL personal items must be removed prior to dress-out and entry. This technique eliminates the loss of your personal adornments. I always tell my students when you are expecting the Haz-Mat guys to arrive they will be the ones who dress the grubbiest and are carrying multiple bottles of water with them. They know how important hydration is while wearing CPC and they have also had personal clothing and jewelry lost due to contamination. Most wear clothes they specifically purchased from discount or resale shops as they do not want to worry about their clothing being destroyed if it becomes contaminated. If you have personal items on your person that become contaminated, they will become hazardous waste. The choice is yours.

2] Removal of street clothes and acquire or “don” scrubs clothing.

For health care workers, this is the best option. These garments are easily identifiable and easily disposed of by hospital laundry personnel. They are identifying and inexpensive to replace. A good idea for your operation is too additionally offer a specified color for highly contaminated clothing and or operators. This will key-in hospital employees to the special and severe aspect of the employee’s role in your emergency operation. Choose a color that NO ONE else is allowed to wear. In this way you will minimize any cross-contamination that may occur and remove the possibility that infected garments leave the site. Whatever the choice for your facility, NO worn clothing must ever leave the hospital site. Many workers are already adapted to the wearing home of “scrubs” both to and from hospital work. This practice must not be allowed under ANY circumstance! The possibility of contamination leaving the site and entering the general population directly violates the decontamination principle!

The next step included is your travel route to the hospital exclusion zone. Going towards the initial contamination zone is not an issue. However, when you decontaminate you could be cross-contaminating the general hospital facility with residual contamination. This is why, it is always best to have a locker-room type facility next to the isolation area that contaminated patients will be seen. Here you can properly prepare contaminated scrubs for laundry or disposal and complete a full body showering before donning street clothes for exit. We will cover this more in depth in the decontamination process yet to come.

3] Enter the VHF dress-out area.

One should think; that this area will also be the end area where decontamination takes place. Therefore, it must be an area that can contain the hazardous waste AND decontaminate it, to a level that it can be safely handled towards its next step. Your bio-hazard bags will be filled in this area and decontaminated before they are sent off to the appropriate hazardous waste facility. If there are going to be multiple entries, (which there are almost certainly will) then this area itself will need isolation from the contaminated bio-hazard bags after they are filled. So almost certainly you are looking at 2 (two) different areas that need separation. In your “clean” area you will;

4] “Don” level “B” SPLASH protective garment ensemble’.

This includes respiratory protection, inner and outer gloves, and protective booties. The details of this operation are only covered in practical training and cannot effectively be explained. There are so many variations from CPC types and what the individual facility will opt to use for their employees deciding the ultimate choice.

5] Have the “buddy” system in place to seal all openings.

The buddy system is integral to all haz-mat work. Many openings cannot be seen by the wearer so a “buddy” is used to make sure that all openings from contamination are closed. Additionally, work is done with your buddy to insure that no one is left in a position where they can be injured or hurt without team knowledge. This perpetuates the “no-one-left-behind” concept. Individuals who operate without the “buddy” system are at great risk to contamination and injury. Be sure that this concept is always employed during all your hazardous work tasks.

Lastly, be sure that once a comfortable “fit” is achieved; NEVER readjust equipment inside the contamination isolation area. This will cross-contaminate yourself and expose you to the VHF. Keep all equipment inside the isolation room perpetuates your work-buddy becoming your personal logistics, supply, and decontamination assistant just as you are theirs. Next month we look at VHF 5; disinfectant solutions to be used with VHF.

           Haz Mat Mike


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