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PPE Plus ++

Personal protective equipment (PPE), is only a single part of a diligent and comprehensive plan for personal safety. This post will cover the best evidence on PPE for protection against COVID19, the basics on the types of masks and when to wear them, training on donning & doffing, wellness tips for the frontline provider wearing PPE for a 12+ hour shift, and other clinical pearls learned from my time in the ED caring for these patients during the NYC surge.


  • Assume that there are no “clean” spaces. A surgical mask and eye protection at all times (even if you’re not in the room with a patient) is the minimum!
  • You need to be able to assess the contagion risk of each encounter and use the recommended combination of equipment for that situation.
  • Aerosolizing generating procedures require an n95 mask and maximal PPE protection.
  • Masks and respirators should not be considered as isolated interventions. A face mask or respirator that is worn without the additional recommended protection will be less effective.
  • Train to perform correct wearing (donning) and removal (doffing) of PPE
  • For reusable PPE such as goggles clean after every patient encounter, don’t contaminant your workspace by leaving them on inanimate surfaces without cleaning after use.

Basics about masks. From New Zealand. These graphic designers are so good!

Donning & Doffing skills are essential part of personal safety

Wellness & PPE

Being vigilant and wearing PPE for a long clinical shift upwards of 12 hours at a time is not easy. Here are some of the pearls we’ve learned over time.

  • It’s hard
  • Don’t cut corners
  • Slow down & take time to do it right
  • Stay hydrated
  • Take breaks
  • Protect your skin
  • Avoid mask fog
  • Ear-savers can help

Surgical masks can hurt the ears. These can help

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