N-95 and Surgical Mask FAQs

What are the recommendations for when I should I wear an N-95 mask?

 During aerosol generating procedures (APGs)  While caring for patients on Airborne Isolation (active Tuberculosis, chicken pox, disseminated shingles, measles)  COVID Units or Enhanced Isolation: Providing direct patient care to a confirmed or suspected COVID patient. This will include ancillary staff entering the room (Environmental Services, Phlebotomy, Radiology, Physical Therapy, Patient Safety Attendants, etc.) coming within six feet of the patient’s head

Which procedures are considered aerosol generating procedures in healthcare settings?

Some procedures performed on patients are more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing. These aerosol generating procedures (AGPs) potentially put healthcare personnel and others at an increased risk for pathogen exposure and infection. Commonly performed medical procedures that are often considered AGPs, or that create uncontrolled respiratory secretions, include:

 Open suctioning of deep airways  Sputum induction  Cardiopulmonary resuscitation  Endotracheal intubation  Non-invasive ventilation (e.g., BiPAP, CPAP)  Bronchoscopy

Based on limited available data, it is uncertain whether aerosols generated from some procedures may be infectious, such as:

 Nebulizer administration  High flow O2 delivery

Are coughs or sneezes considered an AGP? Why or why not?

In the context of coronaviruses, and in particular SARS CoV2, the epidemiology of the infection has been demonstrated not to be airborne. Routine care of patients who cough or sneeze are sufficiently managed through standard and droplet precautions as indicated by clinical data comparing use of N-95 masks and surgical masks for the care of patients with acute respiratory infections.

N-95 and Surgical Mask FAQs

Do I need to wear an N-95 mask while caring for an asymptomatic COVID patient?

A surgical mask or N-95 mask will provide adequate protection. Positive PCR tests for SARS CoV2 only detects the presence of specific viral RNA, not live virus. A patient is most infectious just at the beginning of symptom onset. Current studies show that live virus is not detectable after eight days after the onset of symptoms. Asymptomatic transmission is extremely unlikely to occur. N-95s must be worn for AGP for all patients.

Do I still need to reuse or reprocess my N95 mask?

There is an international shortage of N-95 masks. At this time, we do not have these masks to support daily disposal. We are asking you to continue to conserve (wear for three shifts or, at AAMC, choose to reprocess) these masks.

The Supply Chain team continues to work diligently to increase our inventories and provide appropriate PPE across the health system.

What if I cannot find a mask that fits?

If you are having a difficult time finding a mask that fits with a seal, please utilize the best fitting option and avoid being in the room during AGPs.

When caring for COVID patients, the CDC recommendations state that staff may use a surgical mask with a face shield and to avoid being in the room during AGPs. The best fitting N-95 or duckbill mask would work in this situation as well.

Do I still need to wear my eye protection?

Yes. You must protect your eyes, nose and mouth. Mucous membranes are the reservoirs that SARS CoV2 must enter to cause illness. It is important to protect yourself completely when caring for COVID patients or interacting with anyone without a mask. Eye protection will prevent droplets from entering your eyes and transmitting COVID and other illnesses, like influenza and respiratory viruses.

Will a surgical mask and eye protection provide adequate protection when treating asymptomatic or pre-symptomatic patients?

Yes. Outside of aerosol generating procedures, surgical masks provide good protection against droplet transmissible diseases, including COVID. Surgical masks are constructed in a manner to filter large droplets. These medical grade masks also provide a moisture barrier that blocks the entry of blood and bodily fluids. Surgical masks can be worn in most care areas. N-95 and Surgical Mask FAQs

If I am performing an AGP on a patient who has not been tested and is not symptomatic, should I wear an N-95 mask or a surgical mask and eye protection?

It is recommended to wear an N-95 mask and eye protection (goggles or face shield) during aerosol generating procedures.

Are N-95s required in the ambulatory care setting?

Similar to the inpatient setting, surgical masks are the primary mask for patient care. If you are in an ambulatory care setting and providing medical care to a confirmed or suspected COVID patient or performing any of the listed AGPs, then an N-95 should be worn.

How will I receive a mask?

The distribution of masks will be very similar to other PPE supplies issued.

It is important to remember that we are still working to conserve masks. Mask supply will be controlled at the unit/department level and distributed by nursing or department leadership.

What should I do if my mask is soiled?

If your mask is visibly soiled or contaminated, it should be disposed of and a new mask obtained for use.

When can I discard my mask?

Based on current supply, staff can dispose of their masks after three shifts of continual use, or if they become damaged, deformed, visibly dirty, contaminated or are hard to breathe through.

What can I do to conserve masks?

If you are wearing your N-95 mask or surgical mask sporadically through your shift (not continuously) or wearing it in non-patient care, then it can be worn for a longer period of time.