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:
- 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
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.
- 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:
- 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:
- 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 —
— Division Chief Kevin Lipscomb, NRP
— Regulation & Support Services
— Va Beach EMS Department
— “EMS Chief 7” (ECH07)