Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases
IPC for Marburg Virus Disease (MVD):
PPE Part 2 – Putting On and Taking Off
PPE
Healthcare Settings with Limited to Intermediate Resources
Updated: March 2023
Learning Objectives
After this presentation, participants will be able to
• Explain why carefully putting on and taking off PPE is important
in the context of Marburg virus disease
• Describe at least three considerations for putting on PPE
correctly in the context of Marburg virus disease.
• Describe at least three considerations for taking off PPE
correctly in the context of Marburg virus disease.
Why PPE?
Marburg virus disease can spread through direct contact (such as
through broken skin or mucous membranes in the eyes, nose, or mouth)
with
• Blood or body fluids
• Objects contaminated with blood or body fluids
PPE works as a barrier to protect your eyes, nose, mouth, skin, and
clothing from contact with a patient’s body fluid keeping you and those
around you safe.
Discuss
Based on what you already know
about PPE use, what
recommendations would you give
this man in the red shirt to help him
better protect himself and others?
PPE can protect you from infection but…
PPE only works if it is used correctly every time.
Definition: Donning & Doffing
Donning = putting on an article
of clothing
Doffing = taking off an article of
clothing
https://phil.cdc.gov//PHIL_Images/18351/18351_lores.jpg
Exactly how to don and doff PPE
depends on the specific PPE items
available.
PPE
Donning &
The link below provides videos on
Doffing Videos donning and doffing:
https://www.cdc.gov/vhf/ebola/hcp/ppe-tra
ining/index.html
Donning PPE: Notes
• Before donning PPE
– Wear dedicated clothing or
garments that can be replaced or
laundered (e.g., scrubs)
– Take off jewelry and accessories
– Perform hand hygiene
– Check for tears and other damage
in PPE that could reduce
effectiveness
• Donning a gown
— Secure at neck and waist with ties
Donning PPE: Notes (continued)
• Face mask
– Place mask over nose, mouth, and chin
– Fit flexible nose piece over bridge of nose
– Adjust to fit
• Face shield or goggles
— Place over face and eyes
— Adjust to fit
• Gloves
— Inner pair of gloves goes under cuff of gown
— Outer pair of gloves goes over cuff of gown
When to Doff PPE
Change PPE if it becomes…
• Heavily contaminated with blood or body fluids
• Damaged (e.g., glove tears, gown rips)
Take off PPE after…
• Caring for patients
– Before leaving the isolation area
– In the designated doffing location
• Completing waste management or environmental cleaning tasks
Key Points for Doffing PPE
• Risk of self-contamination is very high when removing PPE
– Potential for contamination from PPE to hands and from hands to mucous
membranes, clothing, and skin
– The outside of PPE should not touch your skin or any other body part
• Remove PPE slowly and carefully
• Remove outermost PPE first
– It is likely to be the most contaminated (e.g., outer gloves)
Doffing PPE: Notes
• Gloves
– Pinch one glove at wrist and peel away
from hand, allowing glove to turn inside
out
– Hold removed glove in other hand and
slide fingers of ungloved hand inside wrist
area; remove by rolling down and folding
inside out
• Gown
— Break knot around neck and side
— Grasp external front shoulders and pull
forward slowly
— Pull away from body and fold inside out as Avoid touching outside of gown to body
you remove
Doffing PPE: Notes (continued)
• Face shield or goggles
— Remove from back by lifting head band
or earpieces
— Keep eyes closed Avoid touching front of face shield or
— Discard (or, if reusable, place in goggles, which may be contaminated
appropriate bin for reprocessing)
• Mask or respirator
– Grasp bottom of strap and lift
over head (or untie bottom strap)
– Lift off top strap or tie
– Bring forward off face
– Discard Avoid touching front of mask or
respirator, which may be contaminated
Doffing PPE: Waste Disposal
Disposable PPE Biohazard waste bin
(e.g. face masks,
disposable gloves) Biohazard waste bin
(can be yellow or red)
PPE to be reprocessed
Bucket
(e.g. goggles, rubber
boots) Bucket for dirty,
reusable PPE to be
reprocessed
Doffing PPE: Hand Hygiene
• When to Perform Hand Hygiene
– After every item of PPE you take off
– After completely doffing PPE, when
your hands are bare
Knowledge Check: PPE
If you saw a co-worker taking off their gloves like this, what suggestion
could you make to help them do this more safely?
Feedback: PPE
• Incorrect method to remove gloves (risk
of splashing)
• Grasp glove at wrist/palm and carefully
roll inside out
Reflection
• What challenges have you experienced
with donning and doffing PPE properly in
the past?
• Do you expect to have similar challenges
with PPE for Marburg virus disease?
• How can those challenges be overcome?
Key Takeaways
• PPE helps protect you from infection.
• Protecting yourself helps protect your patients, co-workers,
family, and friends.
• But PPE only works if it is worn and removed correctly.
Thank you!
For more information, contact CDC
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the
official position of the Centers for Disease Control and Prevention.
