Although we don’t know by what mechanism the nurses in Texas and Madrid were inadvertently exposed to the Ebola virus, investigators are looking for possible flaws in the complex procedures of donning or doffing PPEs as a possible point of contact.
These breaches have some experts calling for more PPEs, while others suggest less complex or cumbersome procedures may be safer.
A review is underway by the CDC, and infection control specialists at Texas Health Presbyterian Hospital, to try to determine what happened in Dallas, and how PPE protocols might be improved.
- One suggestion has been to spray down the outside of PPEs with a disinfectant prior to their removal to help prevent self-contamination, a step that is commonly employed by MSF in West Africa, but which has not been adopted in the United States (gloves are disinfected prior to removal).
- Another is always having a PPE safety coordinator or `dresser’ whose job is to watch, and correct, HCWs as they don and doff PPEs.
As you will see from the twin PDFs below - produced by the Nebraska Medical Center - the steps involved with both procedures are complex and cumbersome. While protective, when dealing with a deadly hemorrhagic fever, any mistake or lapse can have serious ramifications.