ABC | Volume 115, Nº1, July 2020

Review Article Costa et al. Cardiovascular Imaging and Interventional Procedures Arq Bras Cardiol. 2020; 115(1):111-126 5.8.3.1.Steps for putting on PPE in cases of suspected or confirmed COVID-19 (Figure 6) Outside the CCL procedure room • Remove any personal items • Hold hair fully back • Put on the lead gown and shoe covers • Perform proper hand hygiene • Put on the FFP2/N95 mask, securing ties or elastic bands at middle of head and neck, fit flexible band to nose bridge and snug to face and below chin, to ensure isolation and no leak. • Put on hair cover • Put on surgical mask over the N95 mask • Put on goggles and face shield • Perform hand disinfection with alcohol gel or foam • Put on the first pair of gloves • Enter the CCL procedure room Inside the CCL procedure room • Put on the water-proof gown • Put on the second pair of gloves 5.8.3.2. Steps for removing PPE in cases of suspected or confirmed COVID-19 (Figure 7) Inside the CCL procedure room • Disinfect the external pair of gloves with alcohol gel or foam • Remove the gown and simultaneously the external pair of gloves, discarding them in a waste container marked with the biological hazard symbol (do not push to avoid generating aerosol particles, because they can be infected) • Disinfect the internal gloves with alcohol gel or foam • Remove hair cover, face shield and shoe covers • Remove the internal pair of gloves • Perform hand disinfection with alcohol gel or foam • Exit the procedure room Limitations of the present document It is worth noting that this document is being written in a time when we do not completely understand COVID-19 transmission, severity, and proper treatment. The strategies herein suggested are based on limited evidence and recommendations might be subject to change. Figure 6 – Steps for putting on the personal protective equipment in cases of suspected or confirmed COVID-19. 122