Level 1 vs. Level 2 Isolation Gowns: What’s the Difference?

Protective apparel and drapes used in hospitals need to protect patients and employees from pathogen and fluid exposure. They must have an appropriate amount of fluid resistance for the situation without being overly heavy or difficult to move in.

The Association for the Advancement of Medical Instrumentation (AAMI) designed a scale for assessing medical gowns’ water and fluid permeability. The goal for these levels is to determine which gowns are ideal for low and moderate-risk situations like blood draws and which are optimal for fluid-intense surgical procedures.

All AAMI-compliant gowns are tested for low lint, abrasiveness, and flammability. However, the critical difference between the classifications lies in each gown’s ability to deal with increasing pressure and longer fluid exposure times.

AAMI Basics

The AAMI scale has 4 levels for liquid barrier performance and ability to protect the wearer. All 4 levels are commonly used in hospitals and levels 1-3 may be used daily in an average clinic depending on the type of procedures performed. They are made with non-woven materials to meet sanitation and lint standards.

AAMI Level 1 gowns offer the lowest level of protection from basic liquid impacts. Level 4 gowns are subjected to stringent fluid resistance and hydrostatic pressure tests on the critical zones of the gown that are most likely to be exposed to body fluids.

Any AAMI gown must meet the American National Standards Institute (ANSI) and AAMI PB70 standards. Each batch of gowns is thoroughly tested in the critical zones, including the front and sleeves.

Level 1 Gowns

Level 1 isolation gowns are non-sterile gowns with long sleeves. They fit the wearer loosely and usually tie in the back. They can be either washable or disposable, but washable gowns typically have a limit of around 100 washes before they start to lose strength.

Level 1 gowns are tested for water penetration under basic exposure, but they are not intended to repel large quantities of liquid or liquids under pressure. They are mainly designed to prevent the wearer’s clothes from transferring anything onto the patient or the hospital room environment.

Level 2 Gowns

Level 2 gowns are also non-sterile and look very similar to Level 1 gowns at first glance. They are more likely to be washable, as they are made of heavier material that can better withstand washings.

Level 2 gowns are designed to offer a basic level of fluid resistance, including under small amounts of pressure, without compromising breathability. They are not intended for likely exposure to fluids like Level 3 gowns, nor are they intended for constant contact with fluids like Level 4 surgical gowns.

level 2 gowns

Scenarios for Each Gown Level

Level 1 gowns are ideal for visitors, nurses working in family clinics, and others unlikely to be exposed to any fluids. Instead of letting people roam patient rooms with whatever they happen to have on, Level 1 gowns create a basic barrier between patients, visitors, and employees.

This helps keep nurses from accidentally transferring pathogens from one patient to another and also helps keep lint from getting onto patients. Although a situation where a patient is known to be ill may require a higher level gown, changing Level 1 gowns between patients provides a fundamental, cost-effective safeguard.

Level 2 gowns are for basic blood draws, stitches and sutures, and lab work. They still need to be removed as soon as possible if exposed to fluids, especially since they will not resist fluids under pressure. However, they will withstand splashes and droplets better than Level 1 gowns.

When in doubt, it’s wise to upgrade to the next highest level. Emergency rooms, in particular, can be fast-paced environments where patients’ conditions are not always well-understood before the practitioner enters the room, so a Level 2 or even Level 3 gown is often justified.

However, the exact procedures and criteria for determining the appropriate gown level will vary between situations and medical wards. By carefully evaluating each task that staff in your facility handle, you can train and retrain staff as needed on the appropriate gowns for everyday situations.

Keeping Stock of Your Gowns

It’s critical to keep enough supply of each gown on hand. If the correct gown type isn’t available, your staff may resort to using a higher-level and more expensive gown or a lower-level gown that won’t provide adequate protection.

ICU Production Inc. provides high-quality AAMI-compliant gowns to a variety of healthcare facilities. We know the ins and outs of these gown types and can ensure you have a steady supply of the gowns your team requires.

We also supply gloves, masks, and other personal protective equipment (PPE). We understand the PPE market well enough to be a reliable source even when PPE is in high demand. Reach out to us today by calling our PPE hotline at (323) 970-2513.