Ch. 11 (Personal Protective Equipment)

Routine _____________ prevents retention of blood underneath the fingernails.

gloving

Putting on PPE begins with the _____________ & progresses sequentially to the ___________ or ______________________, _________________ or ________ ________, & finally, the __________.

gown, mask or respirator, goggles or face shield, & gloves.

Which type of gloves is best suited for handing chemicals?

nitrile

Which step is first in the chain of chairside asepsis?

place the patient's bib

Protective eyewear should have?

solid side shields

Which glove provides the best fit?

surgeon's glove

Heat-resistant gloves are designed for which task?

unloading sterilizers

Which of the following ASTM level surgical face mask has a high level of barrier effectiveness in the presence of splash, spatter, spray & aerosols?

Level 3

Masks should be used when?

Spattering of contaminated fluids is possible.

Gloves

The last of the personnel protective barriers to be put on before patient treatment begins.

Irritant contact dermatitis

The most common type of skin reaction to gloves.

Percutaneous

Wearing gloves at chairside helps prevent which of the following routes of entry of patient's microbes into the body?

Latex Allergy

A type 1 hypersensitivity (mediated by immunoglobin E antibody) resulting from contact with a chemical allergen in latex materials (latex gloves) or in materials associated with latex products (airborne powder from latex gloves).

Allergic Contact Dermatitis

A type IV hypersensitivity resulting from contact with a chemical allergen (poison ivy, certain reactions to patient care gloves); the cell-mediated reaction occurs only where contact with the allergen has been made.

Task-specific gloves should be worn by all OHCP to prevent contamination of the hands when ________________.

Anticipating direct contact with blood, mucous membranes, non intact skin, & OPIM. Having direct contact with patients who are colonized or infected with pathogens transmitted by the contact route. Handling visibly or potentially contaminated patient care items & environmental surfaces.

The ______ recommends a hierarchical sequence of steps for putting on PPE & for the safe removal of PPE that will prevent skin, mucous, clothing, or environmental contamination.

CDC

Which of the following federal agencies is the nation's health protection agency that makes evidence-based recommendations related to the prevention & control of disease, injury, & disability?

CDC (Centers for Disease Control & Prevention)

A medical device for which general regulatory controls alone cannot assure safety & effectiveness is categorized by the FDA as a ______________?

Class II medical device

Personal Protective Equipment (PPE)

Equipment (gloves, masks, protective eyewear, & protective clothing) that help protect the body from exposure to potentially infectious agents or hazardous chemicals.

The following statement related to protective clothing - True or False? "Scrubs, or clinical & laboratory coats or jackets worn for comfort &/or purposes of identity are considered appropriate PPE."

False

The following statement with respect to face masks - True or False? "Face shields can be worn without surgical masks."

False

The following statement with respect to gloves - True or False? "Surgeon's gloves are subject to design control requirements & are classified as Class II medical devices."

False

The following statement with respect to goggles - True or False? "Personal eyeglasses & contact lenses are considered adequate eye protection."

False

The following statement with respect to patient examination & surgeon's gloves - True or False? "There are significant differences in the barrier properties of unused intact gloves."

False

When leaving chairside to get a new package of sterile instruments from the sterilizing room, what barrier should be removed & then replaced on returning to chairside?

Gloves

Goggles

Must be worn by OHCP & patients to prevent the transmission of pathogens through the conjunctival mucosa either directly (splash, spatter, spray, or aerosols) or by touching the eyes with contaminated hands or other objects. They are Class I medical devices, must fit snugly from the corners of the eyes across the brow. Indirectly-vented goggles with anti-fog coating provide the most reliable eye protection.

Which of the following federal agencies is responsible for setting & enforcing regulations to assure safe & healthy working conditions?

OSHA (Occupational Safety & Health Administration)

What is a limitation of examination gloves?

Provide little protection from sharps-related injuries.

With respect to surgical gowns:

Repellency & pore size of the fabric affect blood & OPIM penetration of the barrier & contribute to gown performance. Regardless of the material used to manufacture surgical gowns, they must be resistant to liquid & microbial penetration. Several gown sizes should be available in oral healthcare settings to ensure appropriate coverage for all staff members.

With respect to the use of surgical gowns:

Surgical gowns should be changed between patients. When penetrated by blood or OPIM, even intra-procedure, surgical gowns should be changed as soon as possible. Surgical gowns should be changed before leaving patient-care areas.

Cleaning (utility or general purpose) gloves:

The FDA does not regulate cleaning (utility or general purpose) gloves used for routine janitorial functions in healthcare facilities. It is illegal for manufactures to label or to suggest that such gloves as suitable for medical use. Gloves used for cleaning patients, or cleaning or handling surfaces or items contaminated with requirements for patient examination gloves.

Wicking

The drawing of microorganisms or other particles through material that is wet (bacteria contaminating the outside of wet paper instrument packs are drawn thorough to the inside of the pack contaminating the instruments).

With respect to surgical masks:

They must be worn by all OHCP during clinical activities likely to generate splash, spatter, spray, & aerosols. They are Class II medical devices, are labeled according to their performance level on testing standards developed by the American Society for Testing & Materials (ASTM). Fluid resistance, bacterial filtration efficiency (BFE), particulate filtration efficiency (PFE), breathability, & flammability of the mask material determine surgical mask performance.

To safely remove PPE begins with the gloves & progresses sequentially to goggles or face shield, gown, mask or respirator, & concludes with hand hygiene immediately after removing all PPE OR the gown & gloves & progresses sequentially to goggles or face shield, mask or respirator, & concludes with hand hygiene immediately after removing all PPE.

True

A mask should be replaced?

With every patient.

Overgloving refers to

covering examination gloves with a pair of plastic gloves.

For individuals who do not use gloves routinely, the primary cause of contracting hepatitis B is a ______________ on the unprotected hand.

cut

Examination gloves should not be stored in:

direct sunlight

An ungloved hygienist would inoculate 20 patients with:

herpes labialis

Powder-free gloves are used to?

limit the spread of latex protein allergens

Which benefit is associated with properly fitting gloves?

prevents hand fatigue

Eliminating contact with the ________ agent is the only way to prevent allergic contact dermatitis.

sensitizing

Which type of glove is used in dental surgery?

sterile

The mechanism of allergic contact dermatitis is the same as?

the reaction to poison ivy

Designated containers for used disposable or reusable PPE should be placed in a location convenient to _______________________________________________________________ of contaminants.

the site of removal to facilitate containment

donning

to put on or dress.

Heavy utility gloves should be used?

to work with contaminated instruments

Respirator

A device designed to prevent inhalation of airborne particles (the N-9 respirator meets minimum filtration performance criteria for respiratory protection in areas of tuberculosis exposure).

Wet masks should be changed because they?

Cause more air to enter around the edges.

Gloves worn by dental personnel protect the?

dental personnel & patients

Which protective barrier is donned last, before treating a patient?

gloves. In the sequence of protective barriers, gloves are the last barrier placed before treating a patient.

Irritant Contact Dermatitis

A nonimmunologic irritation of the skin by chemicals

The following statement with respect to surgical gowns - True or False? "Disposable & reusable surgical gowns are Class I medical devices."

False