ACEP COVID-19 Field Guide

Author: Kelly Gray-Eurom, MD, MMM, FACEP, Chief Quality Officer/Assistant Dean for Quality and Safety, Professor of Emergency Medicine, UFCOM

Just as with preparing for work, plan your routine for returning from work to decontaminate everything that was exposed to COVID-19. Have a post-work decontamination area, ideally at the hospital. If your decontamination area is at home, designate a separate bathroom and keep it stocked with decontamination solutions, clean clothes, and laundry bags.

Think of the hospital as a “hot zone”

The hot zone is where infection is most likely to spread because many items are contaminated. You can still reduce your chances of infection, however, by following a rigid regimen:

1. Remove your personal protective equipment (PPE) in stages, including your gloves first and then your goggles, gown, and mask. Discard or decontaminate all of your PPE.
2. Perform hand hygiene.
3. Discard or decontaminate everything you had on shift.
4. Perform hand hygiene.
5. If possible, shower at the hospital with soap and shampoo.
6. Change into clean clothes and shoes for the ride home. Put your used clothes into a bag that can be washed or discarded. Place any other items that you are bringing home into an appropriate container.
7. Perform hand hygiene.
8. Minimize the number of surfaces you touch on the ride home. If you use mass or public transportation, use physical distancing and barrier precautions as you think necessary or wait to shower until you are at home.

A note about hand hygiene: Both soap and alcohol-based cleaners are effective against most respiratory viruses, including influenza and COVID-19. Alcohol-based cleaners, however, are inadequate for some pathogens like bacterial spores; some nonenveloped viruses; and several GI pathogens like Clostridioides difficile, norovirus, and Cryptosporidium. When in doubt, wash your hands with soap and water and use an alcohol-based cleaner at the end of your regimen.

Think of your home decontamination space as a “warm zone”

Although you are less likely to contract COVID-19 at home, exposure can still occur from germs brought home from your workspace if the proper decontamination steps are not followed. Steps for proper decontamination at home include:

1. Immediately go to your decontamination space when you arrive home.
2. Perform hand hygiene.
3. Disinfect any items that you brought home from the hospital that were not adequately disinfected already. Wash your work clothes in hot, soapy water.
4. If you did not already do so at the hospital, shower and shampoo. Do not substitute bathing for showering. Bathing is inadequate for decontamination.

Think of your “home zone”

What you did during your shift was hard and stressful. As part of your home decontamination routine, allow yourself the time and space to decompress. Personal time is one of the best “decontamination” techniques that we can give to ourselves. Don’t give short shrift to this part of your decontamination routine.