New York prefers WHO personal protection gear protocol

The World Health Organization protocol for removing personal protection gear is the preferred method by the Mount Sinai Health System in New York over that of the CDC. “I don’t think (the CDC’s version) is inadequate. We still need to know what happened with the nurse in Texas (who tested positive for Ebola last week). Based on our experience, we’ve decided to use the WHO version,” executive director of infection prevention for the Mount Sinai system Brian Koll said. “What I like about the WHO version is, every time you take off a piece of PPE [personal protective gear], there’s a hand hygiene step built in.”

The CDC poster, on the other hand, recommends washing hands after removing all pieces of protective equipment, and only advises hand hygiene between steps if the hands have become contaminated while removing a given item. More specifically, the WHO urges healthcare workers to take off the first pair of the double gloves they wear, wash their still gloved hands, and wash them again each time after removing the waterproof apron, the shoe covers, and the gown. Finally, health workers should remove the second pair of gloves and wash their bare hands prior to removing the mask and goggles, and wash their hands one last time. “Every time a layer comes off, you wash the gloves, and when you are finally touching your face, you use your clean hands, and then wash them again,” explained Koll.  

Mount Sinai Health System has had five suspected cases of Ebola, two of which were also last week – though they turned out to have malaria and not Ebola. In addition to following the WHO’s personal protection gear recommendations, Mount Sinai has observers in the emergency department checking that staff members take off their protective equipment, and is considering extending the watch to other areas. At the same time, the organization is staging infectious-disease drills for staffers, as well as working on hastening the identification of potential patients. “We’re aiming for less than 15 minutes,” said Koll. “Our goal is not to repeat whatever happened in Dallas.”   

According to Koll, the news of the Ebola-infected nurse may increase the number of people with flu-like symptoms who think they may have the virus. He remarked that the disease is transmitted through direct contact with blood, vomit, urine, feces, and other body fluids. He added that contact with individuals who have been in Liberia, Sierra Leone, Guinea, and parts of Nigeria, is essential to distinguish it from other conditions. He advises people to call their physician – as opposed to showing up at the ER – if they think they fit these criteria.