Donning and Doffing PPE During Management of Patients with Selected VHF in U.S. Hospitals
This guidance refers only to the following viral hemorrhagic fevers: Ebola, Marburg, Lassa, Crimean Congo Hemorrhagic Fever (CCHF), and the South American Hemorrhagic Fevers (i.e., those caused by Junin, Machupo, Chapare, Guanarito and Sabia viruses). Refer to the pathogen-specific pages for further information about the individual pathogens (e.g., signs and symptoms, incubation periods, routes of transmission, diagnosis, treatments).
The following informational materials demonstrate the procedures described in CDC guidance for donning and doffing (i.e., putting on and removing) personal protective equipment (PPE) for all healthcare providers entering the room of a patient confirmed to have a selected viral hemorrhagic fever (VHF) or a patient suspected to have a selected VHF who is clinically unstable or has bleeding, vomiting, or diarrhea. While the videos specifically mention Ebola, the content in the video also applies to the care of patients with Marburg, Lassa, Crimean Congo Hemorrhagic Fever and the South American Hemorrhagic Fevers (i.e., those caused by Junin, Machupo, Chapare, Guanarito and Sabia viruses).
These informational materials are intended to promote patient safety and increase the safety of the healthcare provider.
Prior to working with patients with VHF, all healthcare providers involved in the care of the patients must receive training and demonstrate competency in performing all VHF-related infection control practices and procedures, specifically in donning and doffing proper PPE.
PPE Training Videos
Select Your PPE Combination
This training module discusses the roles and responsibilities of Trained Donning and Doffing Observers (called Trained Observers or TO).
This donning procedure assumes the facility has elected to use a powered air-purifying respirator (PAPR) and a coverall. An established protocol facilitates training and compliance. Use a trained observer to verify successful compliance with the protocol.
The Trained Observer will read aloud to the healthcare provider each step in the donning procedural checklist and visually confirm and document that the step has been completed correctly. The trained observer in the donning process is a dedicated individual with the sole responsibility of ensuring adherence to the entire donning procedure.
In this video, you will learn how to doff, or remove, your PPE, in accordance with CDC protocols. Following the doffing protocol will minimize the risk for disease transmission, so it’s very important that you understand all the steps. Your Trained Observer will help you with the process.
Before you move from the patient’s room and into the doffing area, you will need to take a few minutes to do some important things. First, get the attention of the Trained Observer. Once he or she signals to you that it’s clear, enter the doffing area. Inspect your PPE. Are there any obvious signs of contamination or materials on it? If so, you will need to disinfect the surface of the PPE with an EPA-designated disinfectant wipe. Last, disinfect your gloves, also with an EPA-designated disinfectant wipe or alcohol based hand rub.
This donning procedure assumes the facility has elected to use a powered air-purifying respirator (PAPR) and a gown. An established protocol facilitates training and compliance. Use a Trained Observer to verify successful compliance with the protocol.
The Trained Observer will read aloud to the healthcare worker each step in the donning procedural checklist and visually confirm and document that the step has been completed correctly. The trained observer in the donning process is a dedicated individual with the sole responsibility of ensuring adherence to the entire donning procedure.
In this video, you will learn how to doff, or remove, your PPE in accordance with CDC protocols. Following the doffing protocol will minimize the risk for disease transmission, so it’s very important that you understand all of the steps. Your Trained Observer and Assistant will help you with the process.
Before you move from the patient’s room into the doffing area, you will need to take a few minutes to do some important things. First, inspect your PPE. Are there any obvious signs of contamination or materials on it? If so, then you will need to disinfect the surface of the PPE with an EPA-designated (Environmental Protection Agency) disinfectant wipe or alcohol-based hand rub. Next, disinfect your gloves, also with an EPA-designated disinfectant wipe or alcohol-based hand rub. Last, get the attention of the Trained Observer. Once he or she signals to you that it’s clear, enter the doffing area.
This donning procedure assumes the facility has elected to use an N95 respirator with a gown. An established protocol facilitates training and compliance. Use a Trained Observer to verify successful compliance with the protocol.
The Trained Observer will read aloud to the healthcare worker each step in the donning procedural checklist and visually confirm and document that the step has been completed correctly. The trained observer in the donning process is a dedicated individual with the sole responsibility of ensuring adherence to the entire donning procedure.
In this video, you will learn how to doff, or remove, your PPE in accordance with CDC protocols. Following the doffing protocol will minimize the risk for disease transmission, so it’s very important that you understand all the steps. Your Trained Observer will help you with the process.
Before you move from the patient’s room and into the doffing area, you will need to take a few minutes to do some important things. First, get the attention of the Trained Observer. Once he or she signals to you that it’s clear, enter the doffing area. Inspect your PPE. Are there any obvious signs of contamination or materials on it? If so, you will need to disinfect the surface of the PPE with an EPA-designated disinfectant wipe. Last, disinfect your gloves, also with an EPA-designated (Environmental Protection Agency) disinfectant wipe or alcohol-based hand rub.
This donning procedure assumes the facility has elected to use a powered air-purifying respirator (PAPR) and a gown. An established protocol facilitates training and compliance. Use a Trained Observer to verify successful compliance with the protocol.
The Trained Observer will read aloud to the healthcare worker each step in the donning procedural checklist and visually confirm and document that the step has been completed correctly. The trained observer in the donning process is a dedicated individual with the sole responsibility of ensuring adherence to the entire donning procedure.
In this video, you will learn how to doff, or remove, your PPE in accordance with CDC protocols. Following the doffing protocol will minimize the risk for disease transmission, so it’s very important that you understand all of the steps. Your Trained Observer and Assistant will help you with the process.
Before you move from the patient’s room into the doffing area, you will need to take a few minutes to do some important things. First, inspect your PPE. Are there any obvious signs of contamination or materials on it? If so, then you will need to disinfect the surface of the PPE with an EPA-designated (Environmental Protection Agency) disinfectant wipe or alcohol-based hand rub. Next, disinfect your gloves, also with an EPA-designated disinfectant wipe or alcohol-based hand rub. Last, get the attention of the Trained Observer. Once he or she signals to you that it’s clear, enter the doffing area.
Additional PPE Guidance Documents
PPE: Confirmed Patients and Clinically Unstable Patients Suspected to have VHF
PPE: Clinically Stable Patients Suspected to have VHF
Additional information
Please Note: These informational materials are made available for educational and informational purposes only and are intended to supplement the Centers for Disease Control and Prevention's PPE: Confirmed Patients and Clinically Unstable Patients Suspected to have VHF, current as of August 2023. These informational materials are not intended to constitute or be substituted for direct training, medical or treatment advice. The Johns Hopkins University and The Johns Hopkins Health System Corporation and their affiliates and subsidiaries disclaim responsibility and liability for any, and all claims of harm arising from or in connection with these informational materials and related activities.
These training tools are being released urgently to provide practical tools for healthcare providers preparing to manage or managing patients with VHFs in U.S. healthcare facilities. These videos will be updated and refined on an ongoing basis based on user feedback and best practices in managing patients with VHFs in U.S. hospitals.
Disclaimer: The names of any commercial products that appear in this video are for information purposes only, and the use of these names does not represent an endorsement of those products by the Centers for Disease Control and Prevention, the Johns Hopkins University, the Johns Hopkins Health System Corporation, or their affiliats.
Acknowledgment: These informational materials were created in collaboration between the Centers for Disease Control and Prevention, Johns Hopkins University, Salesforce Foundation, Miami University, Association for Professionals in Infection Control and Epidemiology, and the Society for Healthcare Epidemiology of America.
N95 and NIOSH Approved are certification marks of the U.S. Department of Health and Human Services (HHS) registered in the United States and several international jurisdictions.