PROTECT YOURSELF: THE FACTS ABOUT THE N-95 RESPIRATOR

With the presence of the H1N1 (swine flu) respirators are on the minds of health care workers. As direct care providers, Nurses in the VAMHCS are required to wear NIOSH (National Institute for Occupational Safety and Health) approved respirators to protect against communicable diseases spread via respiratory route (TB, SARS, and other infectious diseases requiring airborne precautions.) Workers who are required to wear NIOSH approved respirators must participate in the entire respiratory protection program. This includes medical surveillance, fit testing of negative pressure face masks, and training.

Medical surveillance includes filling out the medical questionnaire which can be found on the VAMHCS home page and bringing it to employee health for clearance to be FIT tested. Once cleared, you can contact Alan East Industrial Hygienist to set up a time to be FIT tested.

FIT testing is ESSENTIAL to ensure maximum safety. During the initial FIT test the wearer shall receive instructions including demonstrations and practice in how the respirator should be worn, how to adjust it, and how to determine if it fits properly. You must be formally fit tested at least annually or if there is a significant change in your physical condition. If unable to wear a respirator or achieve proper fit employees are to be provided a powered air-purifying respirator and the respirator (PAPR) in lieu of any negative pressure respirator, and the respirator will provide adequate protection to employees. Negative air purifying respirators shall NOT be worn when conditions prevent a good face seal (i.e. due to beards or sideburns). SPD has disposable hoods available if you must use a PAPR. Each unit should have the respirator (air pack and hose) available for individuals unable to be FIT tested.

During your annual FIT test you will be given information regarding the type and size if the N-95 respirator/mask. You will be given this mask for personal use. You should store this mask in a plastic bag keeping it free from losing shape. Masks are multi-use but should be discarded if damaged, soiled, or deformed. Replacement masks are available from SPD but you must make sure the replacement is the same type and size you were FIT tested for. Prior to each use of the N95 respirator the user should inspect the respirator for damage, check to ensure the respirator is the correct size and type they were tested for and perform a FIT check. A FIT check is done by putting on the mask and pressing the nose piece firmly down with both hands (don’t pinch with one hand) on the nose piece and then blow out (while your hands are off the mask just above the upper nose seal) if you don’t feel any air movement you have an adequate seal (This mask you are using has already been officially fit tested for size and type.) and can enter the respiratory isolation area.

A surgical face mask CANNOT replace a respirator. Respirators work by filtering 95% of particles (0.3microns size) prior to inhalation while surgical masks prevent the release of infectious aerosols. Placing a surgical mask on patients when it is medically necessary for them to leave the negative pressure room is acceptable for this reason Respirators are NOT for use with gases and vapors. Respirators filter PARTICLES not gases.

It is the responsibility of the VAMHCS to provide the program and equipment necessary but your RESPONSIBILITY to use it. If you are a direct care provider and have not been FIT tested DO IT NOW!!! Make your nurse manager aware of this situation and keep yourself safe!!

Test your knowledge with this informal quiz and KEEP YOURSELF SAFE!!!

1. N95 respirators provide protection against?

A. Infectious Tuberculosis

B. Severe Acute Respiratory Syndrome (SARS)

C. Infectious Diseases Requiring Airborne Precautions

D. All of the answers are true

2. N95 respirators are effective when used to protect against gases and vapors?

A. True

B. False

3. The difference between a N95 respirator and surgical mask is?

A. None, both the N95 respirator and surgical mask provide the same level of protection

B. The N95 respirator protects patient from gases and vapors.

C. The N95 respirator filters the air before it is inhaled by the wearer, while the surgical mask on the patient helps prevent the release of infectious aerosols

4. Prior to donning the N95 respirator the user should

A. Inspect the respirator for damage

B. Check to ensure the respirator is the same manufacturer and model that they were fit tested on

C. Be adequately trained on the proper use of the respirator

D. All of the answers are true

5. Once fit tested for a N95 respirator, the user can

A. Don any N95 respirator regardless of manufacturer and model

B. Don only the N95 respirator of the same manufacturer and model they were fit tested on

C. Don a N95 respirator as long as it is the same manufacturer

6. When must fit testing be performed?

A. Prior to initial use

B. Annually

C. When the user experiences significant changes in their physical conditions

D. All of the answers are true

7. The N95 respirator requires disposal when

A. It becomes soiled

B. It becomes deformed

C. It becomes damaged or contaminated

D. All of the answers are true

8. Always perform a user seal test every time the respirator is donned?

A. True

B. False

9. The N95 respirator has a filter efficiency level of 95% against particle 0.3 microns in size?

A. True

B. False

10. When storing the respirator, ensure the respirator is protected from:

A. Contamination and dust

B. Deformation

C. Excessive moisture

D. All of the answers are true

ANSWER KEY

1. D

2. B

3. C

4. D

5. B

6. D

7. D

8. A

9. A

10. D