As the coronavirus spreads across the globe, healthcare practices are being forced to make tough decisions about medical supplies in the face of shortages and rationing.To help physicians, the Centers for Disease Control and Prevention has produced a tip sheet for extended use and limited reuse of N95 filtering facepiece respirators, the only ones currently rated to protect from the coronavirus.
Current guidelines on extending respirator supply
•Minimize the number of staff who need to use respiratory protection through engineering and administrative controls
•Use alternative respirators where feasible
•Implement practices allowing the extended use and reuse of N95 masks when acceptable
•Prioritize the use of N95 respirators for staff at the highest risk of contracting infection
Implementation
•Decision to implement policies permitting extended use or reuse should be made by physicians who control the practice’s respiratory protection program along with occupational health and infection control department, with input from local public health officials •Decisions on implementing these practices should be made on a case-by-case basis •These policies might be implemented before a shortage to ensure adequate supplies are available
Extended use recommendations
•Respirators must maintain their fit and function •Respirators can function within specifications for eight hours of continuous or intermittent use •Discard respirators following use during aerosol-generating procedures or that have been contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients •Discard respirators after close contact with or exit from the care area of an infected patient •Use a cleanable face shield over the respirator to reduce surface contamination •Wash your hands or use alcohol-based sanitizer before or after touching the respirator
•Discard any respirator that is obviously damaged or becomes hard to breathe
Reuse recommendations
•Hang used respirators in a designated storage area where they cannot come into contact with each other or in a clean, breathable container like a paper bag •Avoid touching the inside of the respirator and if you do touch it, wash your hands •Use a pair of clean gloves when donning a used respirator and performing user seal check then discard gloves •Follow manufacturer guidelines on how many times a respirator can be donned, if no guideline exists use no more than five times •Follow manufacturer’s user instructions for the respirators •Label containers used for respirators or the respirator itself (on the strap) with the user’s name
Risks
•Some respirators not FDA-cleared for reuse •Some manufacturers recommend discard after use •Contact transmission from touching the surface of a contaminated respirator •Rough handling or excessive reuse can reduce a respirator’s ability to protect the wearer •Extended use can lead to discomfort to wearers
