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

Doffing can be a tricky phase of personal protective equipment (PPE), but the same attention to detail that we give to doffing PPE can be applied to creating a post-shift decontamination routine. Think about returning home like you think about setting up for an airway. Pre-plan and pre-set before you have the need.

• Know your equipment.
• Know your work space.
• Know your patient (you).
• Know your plan before you start.

Before you head out the door to work, have your home decontamination space set up. Keep it separate from other home spaces, if possible. Stock it with the items you will need to change, clean, and store your work things and decontaminate you and your clothes.

Think of the hospital as a “hot zone”

Doff your PPE. WASH or FOAM your hands.

Wipe down and store your eye protection, masks, and other PPE, as suggested by your hospital protocols. WASH or FOAM your hands. 

Wipe down your cell phone, ID badge, pen, and other items you carried around during your shift. WASH or FOAM your hands.

If you can, change into clean scrubs or clothes for the ride home. Put your used scrubs into a brown paper bag or a tote bag that can be easily washed or wiped down. Place any other items that you are bringing home into an appropriate container. WASH or FOAM your hands.

Try to 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.

Think of your decontamination space as a “warm zone”

Immediately go to your decontamination space when you arrive home. Do not pass go. Do not get distracted. Set your routine. Keep your routine. 

WASH or FOAM your hands. Wipe down any items that you brought home (credit card, keys, cell phone). Remove and wipe or spray your shoes. If possible, leave your shoes in your decontamination space.

Remove your travel clothes. Some suggest setting your work scrubs and travel clothes aside or in the sun and then laundering them later. Others suggest immediately laundering them. The key is to keep them away from you and others until they have been washed in hot, soapy water. 

Go shower or bathe. Establish a set pathway to get from your decontamination space to your shower or bath. If possible, keep the doors open and the lights on to avoid touching doorknobs and light switches. Set out what you need beforehand, so you don’t need to open cupboards to get toiletries or towels.

Think of your “home zone”

What you did during your shift was hard. It was stressful. Allow yourself the time and space to decompress as part of your home decontamination routine.