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Using the Stryker T4 Personal Protection System For High-Risk
Procedures During SARS Outbreaks
Randy Wax, MD, FRCPC (Critical Care)Laurie Mazurik, MD, FRCPC (Emergency Medicine)
Vagia Tsiaousidis Campbell, RRCPPrepared on behalf of the Greater Toronto Area
Critical Care/Emergency Medicine Advisory Group
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Indications for personal protection systems during SARS outbreak
Patient• Known or suspected SARS• Respiratory failure of unknown etiology
when SARS cannot be ruled outProcedure• Intubation• Extubation• Bronchoscopy
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Stryker T4 Personal Protection System
• Stryker T4 was designed for orthopedic surgeons performing total joint replacements to protect patient from contamination by surgical team
• This system provides total body droplet protection from the patient
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Stryker T4 Personal Protection System
• Use of this system is consistent with the “Directives to All Ontario Acute Care Hospitals for High-risk Procedures in Critical Care Areas During a SARS Outbreak” (Directive 03-06, May 1/2003)
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Surgical cap
Secure goggles with elastic strap or tape glasses
N95/N100 mask (new if time permits)
One pair gloves
Gown
Surgical scrubs
Note: don’t wear fabric shoes
Before putting Stryker suit on
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Get helmet
Note: these helmets should be stored and covered in plastic (not as shown here).
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Put helmet on
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Adjust headband
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Get battery
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Plug helmet cable into battery
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Secure cable connection with tape
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Assistant helps you gown
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Lift visor towards helmet
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Visor slot to helmet hook
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Place slot on hook
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Attach top velcro
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Lift hood over helmet
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Pull hood down
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Attach bottom velcro
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Pull zipper down
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Secure ties
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2nd pair of gloves (surgical)
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Extend glove over cuff of toga
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Tape outer gloves to toga
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Enter room
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Perform high risk procedure
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If intubating, confirm with EtCO2
Remember, you can’t use a stethoscope!!!
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Go to doorway
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Present back to assistant
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Assistant unfastens ties
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Unzip toga
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Disconnect cable from battery back
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Go back inside
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Pull shoulders of toga forward
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Pinch cuff and outer glove
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Peel down to knuckles
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Repeat with other hand
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Detach top velcro
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Detach bottom velcro
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Lift off hook and slide hood forward
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Pull hood down
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Rest hood on chest
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Remove hand from outer glove
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Repeat with other hand
Use free hand under gown to pull 2nd glove off
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Roll toga down arms and away
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Begin turning toga inside out
Remember the inside surface of the toga is clean.
Wrap clean inside around contaminated exterior when removing toga.
Don’t touch the outer surface of the toga once the outer gloves are removed.
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Take one hand out
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Only touch clean side of toga
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Remove other hand
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Touch only clean part of toga while rolling down
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Stop rolling at ¾ length
Avoid touching dirty bottom of toga
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Dispose of toga
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Leave room, remove remaining gloves
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Alcohol wash hands
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Put on new gloves
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Remove battery pack off belt/scrubs
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Remove helmet
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Remove inserts from helmet and discard
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Using accelerated hydrogen peroxide wipes…
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Clean helmet
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Clean cable
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Clean battery
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When helmet is dry, place new inserts
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Wrap helmet in plastic bag