Oh good lord: Sanjay Gupta and personal protective equipment

Some time last Tuesday, that strange sound you heard was thousands of scientists screaming in agony, and smashing their heads against the nearest keyboard/desk/wall. Good lord, Sanjay. Good lord. What is wrong with you?

This video is like the scientific equivalent of 'Two girls one cup'. After you saw it, youd run and show your friends, just to see them writhing in horror.

"What is this now? Why are you taping my reaction? Okay. Huh. I dunno... I dunno... Wait. What is he doing with the chocolate sauce?.... No. NO! OH MY GOD! OH MY GOD! WHY??? AHHHHHH!!! WHAT IS HE DOING???? AHHHHHH!!! WHY?????? WHY?????????"

That is not how you are supposed to put on/take off personal protective equipment. I have no freaking clue where Sanjay got his information. I dont know why he thought he was qualified to demonstrate this protocol. And I have no idea why CNN thought it was appropriate for some random physician to do this demonstration, rather than asking any of the hundreds (thousands?) of scientists in the Atlanta metro area, for whom this protocol is routine, to do a demonstration.

And this baffling display is not funny. Nurses and physicians who *need* to know how to protect themselves are *not* going to learn how to do that from watching Sanjay. And if you take a look at the comments posted on this video, and news articiles that reference this video, the public is predictably freaked out.

"Sanjay followed the CDC protocol and still got exposed! WE ARE ALL SCREWED!!!!!"

My lab asked the director of our BSL-3 facility if we could do a video to demonstrate how people are actually supposed to use PPE, but we cant for liability reasons.


Thankfully, there was a good video put out by CBS:

Note Sanjay got things wrong right off the bat-- The inner glove is supposed to be *inside* the gown cuff, the second pair is supposed to be *outside*. Sanjay put both gloves on the *outside*. NO.

You need to be able to easily take off your outer gloves (Ill come back to this later), and this facilitates that, and, the inner glove protects your arms when you take off those outer gloves, just in case the cuff creeps up your wrist. Speaking of that, I actually put my thumb through the cuff of my gown, after I put on my first pair of gloves, to keep the cuff from creeping up (think runners shirts with thumb holes).

Also important-- Two different colored gloves! If you are double-gloving with two of the same kinds of gloves (Sanjay) it is difficult to notice if you have a hole in your outer glove. Having a bright blue outer glove, and white inner glove, if you ever see 'white', you know to exchange your outer gloves immediately.

Also important-- Extended cuffs. Sanjay just used regular gloves. You can, but its not at all ideal. The cuffs of gown creep up, exposing your arms (my thumb notch trick prevents that), so the longer the cuff, the better.

Then we get to the chocolate sauce. Oh lord the chocolate sauce... If you are working with virus, radioactivity, basically any time you are double gloving, you need to change your outer gloves often. Dont think youve contaminated anything, but havent changed your gloves in a while? Change your gloves. Teeny tiny drops/touches? CHANGE YOUR GLOVES. Insanely huge contamination, as illustrated by Sanjays chocolate sauce? REMOVE THOSE GLOVES IMMEDIATELY! DO NOT TOUCH ANYTHING. DO NOT. TOUCH. ANYTHING. Exchange gloves, done. The wildly contaminated gloves are in the waste.

Unfortunately, the CBS video does not demonstrate how to take off the equipment. Well, you dont do it like Sanjay/Dr. Frank N. Furter in one fell swoop. The first thing I do is take off my outer gloves. Its a weird twisty motion I cant describe in text, but you never touch the outside of the glove with your inner glove. Outside touches outside. You can then take of your gown/face equipment with the inner gloves still on. You then take off the inner gloves with that weird twisty motion, NEVER touching the outside of the glove, and IMMEDIATELY wash your hands.

I have never touched anything with my bare hands. Ever.

I realize that some people might say, technically, that the back of your head should be 'clean', BUT, that is probably only true in a laboratory setting. In a lab, I am working with samples in a tissue culture hood. My samples are not sneezing, throwing up, bleeding as I turn around to get something from the fridge. Those things *do* happen in a clinical setting.

There is no freaking way I would touch anything bare handed.

For the love of god, Sanjay. Stop. Just stop with your Ebola 'reporting'.




UPDATE: This is how Emory does PPE

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Thanks, Abbie. I'm with you on this. The news media need to hear it in no uncertain terms from scientists: that they should stop screwing around, stop spreading panic, and start listening to experts.

We have more than enough world-class scientists to post one at every news desk full-time to correct the misinformation, without impairing vital research. Maybe that task should be assigned on a rotating basis to grad students.

Then when some nincompoop says or shows something absurd, a grad student from a relevant field pops up immediately, calls BS on it, and provides the correct information.

Someone ought to organize that and propose it. If nothing else, the proposal itself would be newsworthy. What do you think?

I think the problem, again, would be liability. No one wants to say anything On The Record, because then someone who maybe/maybe didnt follow your instructions got sick, they could complain. You def couldnt let a grad student do this kind of presentation (even though grad students do this protocol and stay safe every single day).

Grad student fact-checkers might be good for other media missteps though, like the 'super top-secret serum' nonsense.

Sanjay has two strikes now. I was very disappointed in Sanjay Gupta's speech he gave on Saturday October 18th at Rochester Institute of Technology. My son is a student at RIT. In his speech he told the students that a soda is worse for the heart than a cheeseburger. This sends the message that it is fine for the heart to eat a cheeseburger. When you are an important figure to whom young impressionable minds look up to you have a responsibility to send the right message and to send it clearly without ambiguity especially on matters of health, on matters of life and on matters of death as heart disease is the number one killer in the United States. Such a statement is analogous to saying that smoking cigarettes is worse for the lungs than smoking pot. To a college crowd of young impressionable minds do we want them to walk away believing that simply because one is moderately less harmful than the other that 'less harmful' equals 'perfectly alright'? Sanjay Gupta did a disservice to our children with his statement. We all know for a fact that a cheeseburger is never a healthy choice and I have never read in any study or medical journal where a cheeseburger has been declared 'heart healthy'. I understand what Sanjay was saying. But did our students walk away with the same understanding? I doubt it. I found his speech very irresponsible and a lost opportunity for him to make the right impression on our youth.

By Laurie Conrad (not verified) on 20 Oct 2014 #permalink

It's frustrating how so many seemingly intelligent people just can't get their heads around the correct use of PPE. I use PPE all the time in my job(cleaning contaminated diesel to bring it back to usable condition) and it took all of five minutes to figure it out, I checked the formal procedures after that and had it perfect. If a brain damaged, PTSD suffering Autisic like me can why can't others?

For hazardous chemical exposure we were issued with one-piece back-entry suits that were a hell of a lot easier to seal, they came sealed but for a zipper in back, and were pretty easy to get out of without contacting the outer surface.

We stepped in with soft booties while wearing a SCBA. Once in we slipped a hooded cape over the top, put on heavy outer gloves, and boots. And off to work.

The outer gloves and boots were there to protect the sealed suit from mechanical damage and we had long-handled versions, think waders and heavy gloves with sleeves to the shoulder, for jobs where knees and elbows might get wear. The cape was a special chemical resistant plastic with a layer of aluminum to delay soak through where the chemical rain was likely to be heaviest and it helped protect the zipper in back.

Getting out you got decontaminated, pulled off the outer gloves and hood, stepped out of the boots onto a piece of AstroTurf that served to make sure the integral booties were not punctured, sat down on the end of a bench. Then gloved and respirator protected helper unzipped the suit and helped roll it away from the zip as you scrunched forward to get your head and arms out. They you lay back and the suit is pulled off the lower body and you were treat to a shower with nothing but your respirator, soft booties, and underwear on. After a cold shower you remove the SCBA and booties.

That shower, typically in the great outdoors, at sub-freezing temperatures when we trained, was a trip because they have to rinse-wash-rnse you and it takes several minutes. Gratefully we were allowed to wear Speedos. We were told sticklers would demand nothing but skin.

You made our day yesterday, when i passed this around. We aren't biologists here at Unnamed CRO (that you could easily identify if i name the city we live in), we are actually a mix of medicinal and process chemists. But i currently work in our High Potency Suite on compounds known to have significant toxicity issues. As such, our gowning procedures fall short of BL2 (no forced air hoods on scales less than a kilo or so, e.g.) but well above that of 99 % of most research chemists, and we take it pretty darn seriously.

Regardless, everybody was just as horrified as you were.

By Double Shelix (not verified) on 21 Oct 2014 #permalink

Given that the CDC changed their guidelines and that Dr Gupta ' s video was shown at a congressional hearing, I am with Gupta on this one. He followed the CDC protocol to a T, but it was a bad protocol. He made an excellent point.

By Stephanie (not verified) on 22 Oct 2014 #permalink