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Guidance for the Selection and Use of Facemasks and Respirators

Guidance for the Selection and Use of Facemasks and Respirators. Materials referenced from CDC, FDA, NIOSH and OSHA. Current CDC & OSHA Recommendations. Healthcare Settings Workers:

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Guidance for the Selection and Use of Facemasks and Respirators

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  1. Guidance for the Selection and Use of Facemasks and Respirators Materials referenced from CDC, FDA, NIOSH and OSHA

  2. Current CDC & OSHA Recommendations • Healthcare Settings • Workers: • Standard and Contact Precautions + eye protection for direct patient care workers [NIOSH-approved N95 respirator] • N95 respirators for other staff in close contact with patients • Patients with ILI symptoms • Facemasks • Community Settings – None (facemasks as needed) • Part of overall Infection Control Practices

  3. Masks vs. Respirators • Facemasks • Designed to cover the mouth and nose loosely • Usually strapped behind the head • Made of soft materials and are comfortable to wear • Provide only minimal protection from respirable particles

  4. Masks vs. Respirators • Respirators • Fits tightly to cover the nose and mouth • Provide protection against inhalation of small and large airborne particles N95- Filtering Facepiece PAPR: Powered Air Purifying Resp. Elastomeric

  5. Rating of Protection Offered • Facemasks • Can protect from large particles from splashes • Not rated for protection from small inhalable particles • Respirators • Rated by oil-resistance and filter efficiency • N95: Not oil resistant, and 95% efficient against small inhalable particles • Elastomeric and PAPRs: typically HEPA (high-efficiency particulate air): 99.97% efficient F I l t e r

  6. OSHA issues workplace health and safety regulations. When required, employers must: Provide appropriate respirators Medical evaluation Fit testing Training Ensure workers do fit checking before each use CDC recommends when, what and how to use PPE Regulations & Recommendations for Respirators

  7. Current CDC Recommendations for Pandemic Influenza • Healthcare – Direct Patient Care Workers • NIOSH-certified N95 or higher recommended for use during high-risk activities including: • Aerosol-generating procedures • Resuscitation of confirmed or suspected influenza case • Providing direct care to confirmed or suspected influenza-associated • Only slight revision from seasonal influenza guidance • Part of overall Infection Control Practices

  8. Current CDC Recommendationsfor Pandemic Influenza • Healthcare Patients • Facemasks should be offered • as part of a respiratory hygiene/cough etiquette strategy, • to patients who present for care with coughing or have other ILI symptoms • Close contacts and those with travel history • worn until the cause of symptoms is determined not an infectious agent that requires isolation or patient has been appropriately isolated

  9. Current CDC Recommendations • Community Settings • Facemask use in proximity to a symptomatic person may not effectively limit transmission • Emphasis should be on • cough etiquette and • staying home • facemask use if near confirmed cases • If symptomatic persons cannot stay home, consideration should be given to having them wear a facemask in public • No recommendation for use by asymptomatic persons, including those at high risk for complications

  10. OSHA Occupational Risk Categories • Very High: Healthcare workers performing aerosol-generating procedures or collecting respiratory tract specimens from known or suspected cases • High: Healthcare workers and support staff exposed to known or suspected cases (including EMTs) • Medium: high-frequency contact with the public • Low: minimal occupational contact with the public

  11. Recommendations for OSHA Occ. Risk Categories • Very High: • Re-usable Elastomeric Respirator or PAPR or N95 • High: • Workers: N95, elastomeric respirator or PAPR • Patients: Facemasks • Medium: • Facemasks • Low: • None

  12. OSHA Guidance on Respirator Stockpiling

  13. OSHA Guidance on Facemask Stockpiling

  14. Respirator Re-Use • Elastomeric respirators and PAPRs • Designed for re-use following proper cleaning • Filter cartridges can last long periods • N95 Respirators • Designed for one time use; Not cleanable • Can be re-used in not grossly contaminated • Protect with a facemask or face shield • Single-user • Increased risk of contamination of hands and face

  15. Community Use of N95 Respirators • FDA has cleared the following N95 respirators for use by the general public • 3M™ Particulate Respirator 8670F • 3M™ Particulate Respirator 8612F • Pasture™ F550G Respirator • Pasture™ A520G Respirator • N95 respirators are not designed for people with facial hair or children. • People with chronic respiratory, cardiac, or other medical conditions that make it harder to breathe should check with their healthcare

  16. References • http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm • http://www.cdc.gov/flu/professionals/infectioncontrol/maskguidance.htm • http://www.osha.gov/dsg/guidance/stockpiling-facemasks-respirators.html • http://www.osha.gov/Publications/influenza_pandemic.html#classifying_exposure • http://www.osha.gov/Publications/3328-05-2007-English.html#RespiratoryProtectionforPandemicInfluenza • http://www.fda.gov/cdrh/ppe/masksrespirators.html • http://www.cdc.gov/h1n1flu/guidance_ems.htm

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