Your Personal Pandemic PPE Kit
In the first part of this series, I mentioned how I came to dislike the majority of Ebola PPE Kit offerings. I decided that building your own kit seems more reasonable. Below is a list of items you should have on hand, and some links to examples on Amazon. Study the items, read reviews, compare prices. After the list are some thoughts on why certain items are on it.
Quantities reflect possible usage rates per person, for a 1 month period nursing an infected person in a home Isolation Room. For general moving about “in the wild” without any plans for attending the sick, divide disposables by 4. Items toward the bottom of the list tend more toward an ill person’s needs.
- Tyvek or Tychem coveralls (Qty – see below)
- Tyvek footwear covers (Qty – see below)
- Rubber garden boots for working outside (Qty – 2 pair)
- Plastic aprons – to provide an extra layer of protection, or for emergency quick cover use (Qty 120)
- Peltor North 5400 or 7600 full face respirator
- Bleach cartridges for respirator
- P-100 cartridges (Qty 180)
- P-100 covers, used a pre-filters for P-100 cartridges (Qty 180)
- P-100 surgical mask, with exhalation valves, in the absence of a respirator (Qty 120)
- Nitrile gloves (Qty 120 pair)
- Safety goggles (Qty 4)
- Hibiclens antiseptic /sanitizer – a MUST for killing virus particles that get through to your skin
- PDI Super Sani-Cloth Germicidal Wipes – 2 Minute Kill, 160ct. Hard surface cleaner ONLY (Qty 3)
- Antibacterial cleanser such as wipes, bleach and spray bottles /cleaners
- Antibacterial hand sanitizer (Qty 3 pump units)
- Anti-diarrheal medications – enough to medicate for 3 weeks, read the label
- Immune boosting vitamins (C, D3, K)
- Electrolyte drinks
- IV kit and fluids
- Thermometer, contact (with disposable plastic covers) or non-contact version
- 5 gallons bleach per person
Tyvek or Tychem coveralls offer protection for the majority of your body surface. They vary by price and usage. This is where study comes in. Tyvek might not handle repeated bleach decontamination as well as the Tychem. Look at these product descriptions and reviews. Also, look at the comments on size recommendations. Most people say that the suits run tight, and they wished for a size larger.
A lot depends on your philosophy. You may feel better putting on a fresh suit each time, and not wondering if your decon routine worked. In that case, the Tyvek will do the job wonderfully. Tychem is designed for use in chemical environments, though the direct application of bleach to make them reusable may affect them. Reusable suits are VERY expensive. Use your judgment. It may be that you want to use the Tychem, bleach decon the garment and then take it off /trash it.
If you go the Tyvek route, the Tyvek overall with integrated footwear eliminates one possible gap in your PPE cover – the foot to leg area. By integrating the two sections, a very mobile connection is secured against pulls and twists during bending and lifting. Additional footwear covers add a second layer of protection against penetration of the basic garment. They can be removed and safely disposed. This prevents tracking things across the flooring by accident. None of the protective outfit should leave the decontamination area, but with removable foot covers, a person can step out of the isolation room with clean feet.
Peltor North 5400 /7600 masks are of the highest quality. The two recommended models work very much the same, with the exception that the 7600 includes a speech valve /diaphram that makes conversation easier. It may or may not be worth the added cost to you. Our 5400s seem to work just fine in the home. In a noisy environment, the 7600 will allow for easier conversation. Amazon’s price has come down about $15. I found ours on E-bay for less, but it took a couple weeks of watching auctions and hoping no one else saw my bid.
A good way to extend the value of the North respirator is to use P-100 components solely. I recommend pre-filtering with P-100 Filter Cartridges with the P-100 covers. Pre-filtering the air reduces the chances of cartridge failure, and will increase the lifespan of the cartridge. This is useful in stressful situations where respiration is increased or when the nurse is needed for an extended period of time by the patient. The covers will also absorb and trap infected liquids before they can enter the cartridge body. It is a form of mechanical isolation.
Depending on the presence and configuration of the isolation room decontamination foyer, or even the entrance to the building, you may need /want a bleach solution as a primary sanitizer. But working in a bleach cloud can be uncomfortable or dangerous. Bleach cartridges for the person performing the decontamination of another, or simply of a building area and items in it, will safely filter the air for a period of time. Consider them a single use item. They aren’t inexpensive, but they are very useful. Some come with a P-100 filter already attached.
Hibiclens is a must-have item. In the last segment of this series, I’ll share with you the importance of this antiviral cleanser from the CDC’s perspective. Here, though, are my thoughts as influenced by POTRBlog, CDC and NIH. If one particle of Ebola comes in contact with your skin, you are likely to become infected. It is that infectious. You should do everything you can to avoid this. However, we are not perfect, and even medical professionals make mistakes. The news is pulsating with stories of doctors and nurses testing positive, with little idea of how it happened. WE must prevent virus-to-skin contact. Hibiclens is an answer to this problem.
Hibiclens is the commercial name of a product called Chlorhexidine Gluconate. CHG kills the virus on contact. When used as a wash, it cleanses the skin and leaves a protective barrier behind. The remaining film will also kill the virus as long as contact isn’t harsh enough to abrade the skin. Using CHG is a preemptive practice. Washing hands after treating someone, with soap and water or Purell, will not work. That is an attempt to kill or remove infectious agents after contact. By using CHG before interacting with an infected person, you are in effect wearing a second set of gloves. The portable pump dispenser version is an excellent choice to take along with you as you travel. Use it at regular intervals if you must move about for work or other reasons.
Antibacterial /Antiviral products are necessary to help sanitize rooms and items. The ill person has a weakened immune system and secondary infections can make his condition worse. Your own sanitation is important, too. Wipes and hand sanitizers can help conserve water and the all powerful bleach. Where viral contamination is unlikely, these are first line cleaners /sanitizers. Do not use products designed for objects on people. If the package says that skin contact is not authorized, pay attention to that!
Sanitizing Hard Surfaces – Our personal experience with medical germicidal and virucidal products includes the PDI Super Sani-Cloth Germicidal Disposable Wipe. On Amazon it is listed as Hard Surface Disinfectant Super Sani-Cloth® Wipe Pull-Up (1 Canister/160). This is a “2 minute kill” for just about everything it wets. The list of viruses it kills or disables covers the spectrum. Its designed to wipe out just about everything within 2 minutes as long as the hard surface remains wetted. That means, don’t spread it so thin that it dries in under 2 minutes! It is approved for use in hospital settings where surfaces previously in contact with bodily fluids need to be sterilized. It is the real deal, and one container is just over $12. Hard to beat. If you don’t get any other surface sanitizer, get this.
Bleach kills viruses quickly. It kills a lot of things quickly, including people if the fumes are too strong. For use as a virucide, a spray bottle can be used, but care must be taken to allow the spray to gently fall onto the surface being treated. If the bleach is sprayed directly at the surface with force, it may blast the virus into the air within its protective liquid transport. This is one way to aerosolize the virus. A few cases of medical worker infection are suspected to be the result of blowing the virus airborne before the bleach could kill it. Imagine a water hose blasting a pile of dog leavings. Picture how the material is blown up and away. It becomes widely dispersed and difficult to clean up. Let the bleach solution fall onto the affected area /items, and soak. Then carefully wipe it up while wearing heavy cleaning gloves.
Anti-diarrheal medications are important. Each time a patient has an episode of diarrhea, he loses large quantities of liquids his body needs. These must be replaced with drinks that supply electrolytes, such as oral rehydration salts, or even the better sports drinks. Orange juice, even. But if he keeps losing what you are putting into him, the battle to increase the overall liquid retention will be long and slow. Anti-diarrheal medications help lessen the fluid loss, acting like a plug in a leaky bucket. Along with rehydration routines, these can help keep a patient alive long enough for his system to recover and win out in the battle.
It isn’t really thought of much, but immune system support vitamins can be taken even after a person falls ill. Any that will help support the immune system is helpful. In Part I, I wrote about the cytokine storm effect, and referenced information on how a healthy system can produce a fatal cytokine storm response when the body realizes it is infected, and decides to react. For persons with weak systems, this isn’t likely, and immune system support is helpful. It’s a judgment call, and requires thought. I personally don’t have an issue with it, but your own reading might present you with a different view point. Some research suggests that Ebola has a mechanism that depletes the body of Vitamin C, probably by giving the immune system a reason to pull hard on that antioxidant. Also, since Vitamin C is water soluble, fluid losses through diarrhea lower its levels.
I hesitated to include IVs and IV fluids to the list. Only trained personnel should attempt to alter the body’s fluid makeup and levels directly via IV. The wrong fluid, at the wrong time, or in the wrong quantities can quickly produce shock, and kill a person. I’ll leave it to you to decide if you want to pursue this further. You may not even be able to acquire the needed items. If you can legally do so, where you live, you might want to have them on hand to be used by someone qualified to do so, when they determine the need is present, or see about getting certified training. I was able to locate suppliers on-line through other Ebola articles. We have opted not to include these in our preps. I’ll leave it at that.
No-touch thermometers are all the rage right now. I’m not a fan of them. I’ve seen reports of varying accuracy among them, and especially against traditional thermometers. Any traditional thermometer can be used, as long as it can be sterilized after use, and never leaves the patient’s bed side table. It should never be used with more than one person – each patient gets his own. If you go the traditional route, use a unit that comes with disposable plastic sleeves. When you have finished taking the temperature, carefully dispose of the sleeve in a properly prepared container for later safe and sealed transport out of the room.
5 gallons of bleach. Why 5 gallons? Honestly, I can’t really say. I’ve seen that number elsewhere and from personal experience, 5 gallons of any cleaner goes a long way. It isn’t hard to store, but it is hard to conjure up when you dump your only bottle by accident. Set aside more than you think you will need.
In upcoming segments I’ll cover quite a few other things including immune system support supplements, Isolation and Decontamination Rooms and their build-out /usage. This will include, among other things, supply lists for the rooms, some entertainment ideas, and thoughts on food, water, medications and sanitation. As always, think about what is shared – study-up and make wise choices.
Nobody said this was going to be easy….