PPE
Is an acronym with multiple connotations from a list of over 60 possibilities including; Purple People Eater, Palmar-Plantar Erythrodysesthesia, Partnership for Public Engagement, or Philosophy, Politics and Economics. In 2020 the most common meaning is Personal Protective Equipment aka (PPE)
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| Personal Protective Equipment donned in the operating room during the AIDS epidemic circa 1988 Charity Hospital, New Orleans, LA |
Modern day Dentists have all been schooled on the attire necessary to don in order to shield oneself from contamination of infectious agents. The 80’s highlighted this phenomenon during the AIDS surge, with the use of protective gloves goggles and masks being codified as a custom of practice for adequate protection. As a healthcare worker it is the act of covering oneself with a hat, goggles, gown, mask, gloves, and booties that comprises the protective coverings. As the name implies, it’s the garments covering the body that are directly over the operator. Prior to this, it was the custom to examine and treat dental patients’ sans these items. My recollection of the body of knowledge at that time while practicing as a Dental Hygienist and Dental student, was to perform routine care without gloves and masks. Utilizing these items was indicated only when there is a known break in the skin that needs protecting or utilizing a mask if the operator or patient had an upper respiratory infection or risks for transmitting one. Data at that time revealed infectious diseases like hepatitis could be transmitted between the patient and provider as a result of exposure to infected body fluids. Root planning and scaling of teeth frequently meant that the encounter included a blood laden field which routinely bathed fingers and hands, a known source for potential infection.
MATERIAL TYPES USED TO CREATE PPE:
The quality or type of material that the PPE is constructed from will affect its ability to function properly. For instance, the utilization of imperviable gowns protect providers. Similarly, donning vinyl gloves versus latex gloves will differ in their ability to prevent contamination. Therefore, providers must consider the situation or the pathogen that the PPE will be chosen to protect themselves. For example, in addition to the full body suits, the use of water-proof aprons is also recommended when caring for Ebola patients displaying vomiting, bleeding or diarrhea.
Utilization of protective equipment has always been the standard in modern day hospital operating rooms and my training as an oral and maxillofacial surgeon makes this experience an important foundation for our specialty. Surgeons are familiar with sterile technique and procedures requiring a hospital operating room even those who perform limited care in hospitals. Our four to six-year hospital-based training assures this.
PROPER UTILIZATION OF EQUIPMENT:
Utilization of PPE itself is not enough to protect an operator, just like equipment, it’s necessary to don and doff the surgical apparatus properly. Following precise practices will adequately protect the user. An extreme example of this is from one of the recent public Ebola outbreaks. Recall the doctor’s nurses and other providers who cared for these patients and who became infected as a result of potential improper practice or process that exposed them. Ebola has a higher degree of infectivity and most infected individuals don’t have the adequate immunity to ward off the disease. Fortunately, not all infectious diseases have the same virulence and require the same extreme practices like those necessary to protect against the Ebola virus.
The apparatus used to cover the skin and mucus membranes are essential in maintaining a safe work environment and for many centuries, providers used limited resources to perform healthcare. It has been proven that the virulence of a disease will determines which tools and to which extent they are used to shield the worker. Additionally, a minimum safety requirement is essential for all healthcare personnel.
This image above is just one example of how dental professionals understood the necessity of protection. This isn’t from 2020 and it’s not from within this century, it’s from 1988 when Dentists understood that creating aerosols in a contaminated field is an atmosphere of potential infectivity. Just like in the 80’s we take the health of the public as a serious topic and we work to do everything necessary to protect the health of the public, our staff and ourselves.
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| Members from Suffolk County Dental Society wearing PPE, Suffolk Dental Bulletin, Fall 2020, Volume 49, Number 3 |
http://suffolkdental.org/assets/Fall_20_bulletin_v25.pdf
The Girldoc😉
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