As two nurses from Texas Health Presbyterian Hospital who helped care the first U.S. Ebola patient now battle the deadly virus themselves, federal and state health officials are trying to determine how to more effectively keep health care workers safe. This requires extensive training and the right personal protective equipment, also known as PPE.

There are a number of different PPE options that offer different levels of coverage and risk. More is not always better, and there are a number of potential pitfalls. Dr. Michael Reilly, director of the Center for Disaster Medicine at New York Medical College, told CBS News that many hospitals are wrestling with what type of gear to provide to their medical staff.

The U.S. Centers for Disease Control and Prevention recommends health care workers treating Ebola patients adhere to the agency's Recommended Standard, Contact and Droplet Precautions, he explained. This ensemble includes two layers of gloves, a liquid-impervious surgical gown and boots, hair covering, mask and face shield. In most instances, the CDC recommends health care workers replace the basic surgical mask with a more protective N95 particulate respirator. This disposable filter forms a tight-fitting shield over the nose and mouth, and screens out 95 percent of airborne pathogen particles that are greater than 0.3 microns in size.

The respirator is especially important when performing medical procedures that may increase the potential for exposure to infectious bodily fluids.

"Aerosol generating procedures could be anything like administering a nebulizer to a patient, to intubation, or placing a patient on a ventilator, suctioning secretions in or around their mouth, performing a bronchotomy or lung exam or biopsy. That would result in a provider being very close to a patient and where you would have sputum or other biological fine particles coming into the breathing zone of the provider," said Reilly. "In that case, that's when you increase the level of respiratory protection to the N95 over the surgical mask."

This set of gear is tested and certified by the National Institute for Occupational Safety and Health, part of the CDC, to protect health care workers from an array of infectious diseases. However, in the current Ebola crisis, this standard of PPE may not be enough.

"There is concern among health care providers about whether or not this particular ensemble is sufficient in protecting them against Ebola exposure," said Reilly as he demonstrated the "donning and doffing" procedures for standard PPE with his colleague, Jared Shapiro. "One of the limitations is some skin exposure -- back of his neck, collar of his shirt, hair -- potential routes of splash or inadvertent aerosolization of infectious material could come in contact with him."

This is why Ebola clinics in West Africa and high-containment medical facilities such as Emory University Hospital in Atlanta -- where two American missionaries were successfully treated for Ebola and where Texas nurse Amber Vinson was transferred on Thursday -- have opted for what Reilly calls "enhanced precautions for high-risk health care workers."

CBS News

The rest is here:

What should Ebola health care workers wear?