Personal Protection Equipment

There is no single combination of suits or protective devices which protects against all hazards and they each have risks and benefits and need to be tailored to the hazardous environment which is anticipated for exposure. Level A involves a fully encapsulated, non-permeable garment with fully contained breathing apparatus. It is very protective from vapor and liquid exposure but offers no protection against flames or fire and is very cumbersome and hot in warm climates or with physical exertion. Communications is also hampered by the suit and face shield. Performing complex procedures or advanced life support interventions is also a challenge in some types of bulky personal protective gear particularly with heavy gloves.

The choice of personal protective equipment needs to be predicated on the chemical or biological agent suspected in the environment. The physical characteristics of the agent are also important in equipment and PPE choice as dissemination may occur in different physical states. The half life of the agent is also important in considering the ongoing rescue efforts or care of exposed patients and personnel.

Levels of protection are guided by OSHA (Office of Safety Health Administration) and NIOSH National Institute of Occupational Health as well as other regulatory bodies thru un-funded mandates and policy.

The time to don PPE is before you are entering or encountering people or removing people from a contaminated environment. This may include a: casualty collection area of an incident, the warm zone area where contamination still exists however not as concentrated at the center of the incident (hot zone). Traditionally, physicians are in the warm or cold zones due to training requirements and the staff limiting, and inherently physically arduous aspects of Level A personal protective equipment.

It is critically important to protect the healthcare providers and first responders who may themselves become victims to a hazardous environment as has been seen in recent chemical terrorist events where self triaged patients presented to hospital environments and healthcare providers became ill from exposures of contaminated patients. Vapor exposure can be released from contaminated clothing exposing and affecting healthcare workers and first responders.

Back    Next

Back to MRT Table of Contents