Editing Infection Control and Safety (section)

=== Doffing sequence ===

The principle is to remove the most contaminated items first and to avoid touching the front of any item.

# '''Gloves''': the outside is contaminated. Grasp the outside of one glove at the palm and peel it off, hold it in the gloved hand, slide ungloved fingers under the remaining glove at the wrist, and peel it off over the first. Discard.
# '''Goggles or face shield''': the outside is contaminated. Handle by the headband or earpieces only.
# '''Gown''': unfasten ties, pull away from the neck and shoulders touching the inside only, turn it inside out, and roll it into a bundle.
# '''Mask or respirator''': the front is contaminated. Untie or remove the bottom band first, then the top, and handle by the ties or bands only.
# Perform hand hygiene immediately, and at any point during removal if the hands become contaminated.

'''Where to remove.''' Remove all PPE before leaving the patient room '''except''' a respirator, which is removed after exiting and closing the door. An acceptable alternative is to remove the gown and gloves together at the doorway by grasping the gown front, pulling away from the body so the ties break, and rolling it into a bundle with the gloves turned inside as they are peeled off.

'''Gloves are never a substitute for hand hygiene.''' Change gloves between patients and between a contaminated and a clean site on the same patient, and perform hand hygiene at every glove change. Latex allergy requires nitrile or vinyl gloves and a latex-safe environment; ask about allergy to bananas, avocados, kiwi, and chestnuts, which cross-react.