NY Times Explains the PPE Evolution

I would recommend that healthcare workers read the complete article.  We are used to outfit #1, but the details for #2 and #3 (especially their removal) are hazy for many of us, since we have never before had to use this level of personal protection to protect ourselves from our patients' infections.

Changes to Ebola Protection Worn by U.S. Hospital Workers

The Centers for Disease Control and Prevention issued new Ebola protection guidelines on Oct. 20, more than a week after two nurses in Dallas became infected with the virus while treating Thomas Eric Duncan. The recommendations are based on protocols used by Doctors Without Borders, which tends to Ebola patients in Africa. They also closely reflect procedures that were already in place at many hospitals in the United States, including those in the North Shore-Long Island Jewish Health System and the Nebraska Medical Center in Omaha — one of four facilities in the country equipped to isolate patients with dangerous infectious diseases. UPDATED Oct. 22, 2014 RELATED ARTICLE

Levels of Protective Gear

These protocols, some specified by the C.D.C., were in place at some hospitals when Mr. Duncan was being treated in Dallas.

Mask or
respirator

Hood that covers the neck

Goggles, safety glasses or face shield

Sealed hood

A thicker outer glove

Two layers
of gloves

One pair
of gloves

Impermeable bodysuit made of material that is difficult to tear

Impermeable
gown that fully
covers the arms
and body from
neck to midthigh

Breathing pack filters air to protect workers from airborne viruses

Fluid-resistant
leg and shoe
coverings

Seams taped

Original C.D.C. Guidelines

The suit above represents the
original C.D.C. guidelines for
hospital workers who would
come in contact with Ebola
patients but would not be
exposed to their blood or other bodily fluids.

North Shore-L.I.J. Level 2 Suit

The original C.D.C. guidelines recommended extra levels of protection, as shown above, in cases where workers could come into contact with a patient’s bodily fluids. Many hospitals, including the Nebraska Medical Center, required this outfit as the minimum. North Shore-L.I.J. required the use of this suit with patients suspected of having Ebola, but has since upgraded to the Level 3 suit.

North Shore-L.I.J. Level 3 Suit

After the second nurse in Dallas was confirmed to have Ebola, North Shore-L.I.J. upgraded its Level 3 suit by adding an impermeable gown on top (not shown).

WHO issued new PPE guidelines on October 31.