PPE Donning & Doffing Sequence

The order you put on PPE protects you. The order you take it off protects everyone else. Reversing even one step can turn removal into the exposure event.

Donning follows a clean-to-covered sequence: hand hygiene first, then gown (ties in back), then mask or respirator (fit-check if N95), then eye protection (goggles or face shield), then gloves last — gloves go on last because they overlap the gown cuffs, creating a continuous barrier at the wrist. Doffing reverses the contamination logic: gloves come off first because they are the most contaminated item. Use the glove-in-glove technique — pinch the outside of one glove, peel it off, tuck it into the remaining gloved hand, then slide a bare finger under the wrist of the second glove and peel downward. Next remove the gown by breaking ties and rolling it away from the body (contaminated surface inward), then eye protection lifted from the back or sides (the strap, not the front lens), and finally the mask or respirator — removed by the ties or elastic only, never by touching the front. Hand hygiene is performed after glove removal AND again after all PPE is off. The critical principle: the outside of every item is contaminated; you only touch insides, backs, ties, or straps during removal.

Key Distinctions

Students confuse donning order with doffing order — donning ends with gloves, doffing starts with gloves. A common error is grabbing the front of the mask during removal; the front is the most contaminated surface. The gown is rolled inward (dirty-to-dirty), not pulled off and folded — folding exposes the contaminated outer surface.

Clinical Pearl

On, go Gown-Mask-Eyes-Gloves ("Going My Exam Gloves"). Off, reverse it: Gloves-Gown-Eyes-Mask. Gloves are always the bookends — last on, first off.