The Outfit That Fights Diseases
by James Hubbard, MD, MPH
Back when I was growing up, I don’t think the phrase “universal precautions” was in a health care worker’s vocabulary. Now, we’re well-versed in such “precautions”—techniques that help prevent spreading diseases. But back then, people were more lax.
We lived more like you might live at home with your family today—which is not like you’d want to live during a disaster.
Back then, sure, people with highly contagious diseases were isolated, but few health care workers were afraid of getting a little blood on them from someone with no obvious illness. (Of course they should have been because people did get hepatitis from contaminated needle sticks, cuts, etc.)
Even when I was in training, I knew of a pathologist who examined surgical specimens gloveless so he could get a feel of the texture.
Then came AIDS, and everything changed.
Nowadays we use every gadget available to keep us from contact with bodily fluid, whether we know it’s contagious or not. The terms “universal precautions” and “personal protective equipment” (often known by its initials, PPE) are as well-known to health care workers as “surgical masks” or “hospital gowns.” And, still, sometimes we get exposed.
In a disaster situation, or while traveling or camping, or any time expert medical care is a scarce commodity, it becomes all the more important to protect yourself against infectious diseases that spread from person to person. Catching even a minor disease could impair your abilities to perform your other survival activities. And sometimes, without the common treatments we take for granted, a minor illness could become deadly.
What Are Universal Precautions?
Universal precautions are techniques meant to keep you from coming in contact with bodily fluids, whether directly from a person or from instruments, clothing, bedding, the floor, the walls, or anywhere else.
Taking universal precautions also means assuming anyone’s fluids could be contagious, even if the person shows no signs of illness.
For my disaster version of universal precautions, I’m adding protecting yourself from airborne droplets (like from a cough or sneeze).
5 “Protective” Accessories to Store
Here are five pieces of “personal protective equipment” to store in case you have to treat a sick person yourself.
1. Goggles
Options: Full goggles, side shields for glasses, face shield.
My pick: Full goggles.
Details: Full goggles are more protective than side shields. (If you wear glasses, you can fit goggles over them instead of getting the side shields.) A face shield that covers your whole face works also, but goggles take up less room. Of course, goggles can also double as eye protection when you’re grinding metal or sawing wood, as you might be during a disaster.
2. Masks
Options: N95 (filters out at least 95 percent of particles), N99 (filters at least 99 percent), dust or surgical mask, scarf, gas mask, CDC-type mask.
My picks: At minimum, several N95 or N99 masks plus several dust or surgical masks.
Details: The key to getting N95 and N99 masks to work is making sure they fit properly and seal to your face. If there’s a leak, germs can get in. Try one on before you need it to make sure it fits. If you can, have a health care worker check the fit.
Get several because the outside of the mask may get full of germs, and you’ll need to throw it away in a sealed container when you take it off.
Dust or surgical masks, even scarfs, are better than nothing, but they let in a lot more germs. However, you’ll want some for the contagious person because N95 and N99 masks can be very uncomfortable, especially if you’re wearing them for long periods of time. Make sure any mask or scarf doesn’t adversely affect the sick person’s breathing.
Gas masks can help, but they’re more protective against certain chemical gases. Again, fit is key.
Of course, if you have one of those self-contained units like the CDC uses—the ones that include a mask, tubing, and an oxygen supply—that’s great, but the average person won’t have one.
3. Gloves
Options: Dishwashing, latex, vinyl.
My pick: Dishwashing (unless you’re allergic to latex).
Details: Dishwashing gloves are great because they’re thick and long. They do take up more space, and getting a bunch of them can be expensive, but still, I’d have a few around. If you need something less cumbersome for a finer touch, another option is disposable latex exam gloves. Vinyl gloves have the added benefit of being latex-free (again, to avoid that latex allergy).
Whatever type you choose, getting the gloves a bit too large is better than getting ones that are too small.
4. Gowns
Options: Liquid-resistant disposable gowns, apron, long coat, poncho, plastic garbage bag with a hole cut for your head.
My pick: Liquid-resistant disposable gowns.
Details: Liquid-resistant disposable gowns are ideal. Once you’ve used one, immediately throw it away in a plastic bag (and seal), or just burn the gown. If you don’t have these gowns, any apron or long coat, especially if water resistant, is better than nothing. You do need to be able to throw it away after treatment or soak it in a chlorine solution (one part chlorine bleach and 10 parts water) before reuse.
5. Shoe Covers
Options: Disposable covers, waterproof shoes.
My pick: Disposable covers.
Details: Commercial disposable shoe covers are best, but in a bind, just wear a pair of good, waterproof shoes. (After treatment, it would be wise to take off the waterproof shoes, wipe them down with a 1:10 chlorine solution, and store them. Put on some other shoes for the rest of your day.)