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Difficulty: MediumInfection Control and Hospital-Acquired Conditions

A 32-year-old male patient is brought to the emergency department by ambulance due to a 4-day history of high fever, severe myalgias, and a progressive, diffuse vesicular rash. The patient recently returned from a trip abroad and was exposed to an individual with similar symptoms. Clinical suspicion for disseminated varicella-zoster virus is high. The triage nurse immediately moves the patient to an airborne infection isolation room (negative pressure). The admitting physician prepares to enter the room to perform a comprehensive physical examination. The hospital uses a standard sequence for personal protective equipment (PPE) to minimize transmission risk.

Arrange the following steps for donning personal protective equipment in the correct sequential order before entering the patient's isolation room.

  1. 1Perform hand hygiene using an alcohol-based hand rub or soap and water
  2. 2Don a fluid-resistant isolation gown and secure all ties
  3. 3Don an N95 filtering facepiece respirator and perform a user seal check
  4. 4Don a face shield or goggles for eye protection
  5. 5Don clean, non-sterile gloves and extend them over the gown cuffs

Answer

The correct donning sequence is: Hand hygiene -> Isolation gown -> N95 respirator -> Eye protection -> Gloves.
The correct sequence for donning personal protective equipment (PPE) according to CDC guidelines is essential for preventing healthcare-associated infections. The process must always begin with hand hygiene to ensure hands are clean before handling the PPE. The isolation gown is put on next as the foundational layer to protect the torso and arms. This is followed by the N95 respirator, which requires two hands to secure and mold properly to the face. Eye protection is then added, sitting over the mask to avoid disrupting its seal. Finally, gloves are donned last and pulled over the cuffs of the gown to ensure there are no gaps in protection at the wrists before entering the patient's room.

Step-by-Step Solution

1
Perform hand hygiene.
Hands are decontaminated before touching clean PPE.
Prevents inadvertent contamination of the protective equipment during the donning process.
2
Don the isolation gown.
Torso and arms are covered.
The gown serves as the base layer of protection.
3
Don the N95 respirator.
Respiratory tract is protected.
Requires two free hands to secure straps and mold to the face properly before other headgear or gloves are on.
4
Don the face shield or goggles.
Eyes and mucous membranes are protected.
Must be placed over the respirator straps without breaking the critical mask seal.
5
Don gloves.
Hands are protected and wrists are covered.
Gloves must extend over the gown cuffs to ensure continuous coverage, which requires the gown to be on first.

Key Concept

Correct sequencing for donning personal protective equipment (PPE)
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Topics

Infection Control and Hospital-Acquired Conditions

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