Despite the use of personal protective equipment (PPE), reports show that many healthcare workers contracted COVID-19, which raises substantial concerns about the effectiveness of the PPE. Highly sought-after PPE used in hospitals and other healthcare settings is critical to ensuring the safety of those on the frontlines of COVID-19, but only if it is used properly.
A physician from Florida Atlantic University’s (FAU’s) Schmidt College of Medicine and collaborators from the University of Arizona College of Medicine-Tucson and the Indiana University School of Medicine conducted a novel training technique to reinforce the importance of using proper procedures to put on and take off PPE during the pandemic. Researchers were able to vividly demonstrate how aerosol-generating procedures can lead to exposure of the contagion with improper use of PPE.
To detect contamination, Patrick G. Hughes, DO, lead author, director of FAU’s emergency medicine simulation program and an assistant professor of Integrated Medical Science, FAU’s Schmidt College of Medicine, and collaborators, used a nontoxic fluorescent solution during a PPE training session for healthcare staff. They placed a highlighter refill in a warm water bath for 15 minutes to create a fluorescent solution, which is only visible under ultraviolet light.
For the experiment, published in the journal Medical Education, the researchers instructed healthcare staff to put on PPE, which included a cap, gown, surgical gloves, eye protection, face shield, and an N95 mask. In order to conserve vital PPE, supplies were wiped off and reused for multiple trainings. After the healthcare staff in the study put on their PPE, they went into a room to care for a simulated patient sprayed down with the invisible simulated contagion. In addition, the researchers added the fluorescent solution to a simulated albuterol nebulizer treatment, which was given to the mannequins during the scenario (not in a negative pressure room).
After completing the simulated case, the healthcare staff remained in their PPE and were taken to another room, where the lights were turned off prior to removing their PPE. Turning off the lights enabled the identification of widespread simulated contagion on the PPE, both on the gloves and gowns from directly touching the simulated patient and on the face shields and masks from the aerosolized solution. The researchers used a black light flashlight to examine each healthcare worker and to identify the presence of any fluorescent solution.
Following the flashlight examination, the healthcare staff completely removed their PPE. Researchers discovered the presence of the fluorescent solution on the healthcare staff’s skin, which represented an exposure to the contagion and indicated that they made an error while putting on or taking off their PPE.
Results from the experiment revealed that the most common error made by the healthcare staff was contaminating the face or forearms during PPE removal. In contrast, those who put on and took off their PPE according to guidelines had no signs of the fluorescent contagion on their skin or face.
