COVID-19 safety update — 4 things to know immediately about N95 masks

COVID-19 safety update — 4 things to know immediately about N95 masks

Now that an interim set of N95 masks are on ambulances and zone cars, you should know four things immediately.  This advice is taken from CDC guidelines:

 

  1. WHEN TO USE AN N95 MASK[a]

 

  • You should wear an N95 mask if you need to be within 3 feet of a suspected COVID-19-Like Illness (CLI) patient, and the patient is unmasked, or the patient’s mask needs to be removed for any period of time during the patient encounter.
  • You should wear an N95 mask if you are performing Aerosol Generating Procedures (AGPs) on any suspected CLI patient.  AGPs in our system include:
    • Bag-Valve-Mask (BVM) ventilation
    • Oropharyngeal suctioning
    • Endotracheal intubation
    • Nebulizer treatment
    • CPAP
    • CPR

Also consider the following with respect to AGPs on these patients:

  • Is the procedure strictly necessary during your encounter?  Consult medical control.
  • Perform the procedure in an open space; or with the ambulance parked, the rear doors open, and bystanders kept away.  If you must perform the procedure while transporting, rig the ambulance’s air flow features per prior guidance.

 

  • If you need to be within 6 feet of a suspected CLI patient, but you can stay more than 3 feet away, you should wear at least a surgical mask.
  • If you can stay more than 6 feet away from a suspected CLI patient, you do not need a mask.
  • If you need to transport a CLI patient, notify a supervisor.

 

  1. WHAT FACIAL HAIRSTYLES ARE APPROPRIATE WITH N95 MASKS[b]

 

To use an N95 mask correctly, the mask must form a tight seal on your face.  Facial hair can interfere with the seal.  For example, the facial hairstyles with a red X below should not be used with an N95 mask:

  1. HOW TO PERFORM A USER SEAL CHECK[c]

 

The following no-nonsense video is 4 minutes 39 seconds long.  Please watch it.  It shows how to don and doff an N95 filtering facepiece mask, and how to perform a user seal check:

 

 

  1. APPLYING THE ABOVE ADVICE ON CALLS

 

  • If you have facial hair, we ask you and strongly advise you to shave per the above guidance.  (Yes, I have taken my own advice.)
  • If you find yourself on a call where an N95 mask is indicated, and you are unable (for any reason) to use an N95 mask as described above, keep away from the patient and notify a supervisor.  The supervisor will reassign personnel appropriately.

We’ll keep you posted as our respiratory protection program evolves.

 

— Footnotes —

  1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/crisis-alternate-strategies.html
  2. https://www.cdc.gov/niosh/npptl/pdfs/FacialHairWmask11282017-508.pdf
  3. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html

 

— Division Chief Kevin Lipscomb, NRP

— Regulation & Support Services

— Va Beach EMS Department

“EMS Chief 7” (ECH07)