How to safely reuse N95 masks: new guidance, video posted

Sadie Spotz, a registered nurse in the COVID-19 unit at Hershey Medical Center, masks up in preparation for entering a patient’s room.

Penn State Health commends the efforts of staff who have taken steps to use personal protective equipment (PPE) conservatively in this time of uncertain supply. Here are some reminders for those using N95 masks:

• Please take care of your masks as outlined in the extended use and reuse policy available on the Infonet.
  • Masks should not be folded, carried around in pockets, worn with heavy cosmetics or oily substances or worn in any manner other than the properly fitted position over your mouth and nose.The mask’s ability to seal and filter is dependent on proper care.
  • Please store in a paper bag labeled with your name.

• Reuse and extended use of the N95 allows for respirators to be utilized up to six uses or up to 12 hours of continuous use in certain situations.Please see the policy for details.
  • Remember to track the number of uses (donning and doffing the mask) by marking the outside of the storage bag with tally marks.
  • Do not mark the mask itself because a pen may damage the mask’s integrity.
  • Mark the bag if the mask is ever used on patient with confirmed/highly suspected COVID.

• Take care to avoid contaminating the INTERIOR of the N95 mask. For example, do not touch the interior with potentially contaminated gloves or unsanitized hands.
• Assume the EXTERIOR of the N95 mask is contaminated (in case virus particles have become trapped in outer layers of the mask or the mask was inadvertently touched with a contaminated gloved hand).
• See the video and guidance document in the PPE section of the COVID-19 Resources on the Infonet on techniques for proper safe reuse of N95 masks.
• While you are in the room of a patient, AVOID touching the N95 with gloved hands. Gloves could be contaminated and thus quickly increase the burden of infectious particles on the exterior of the mask. If you must adjust the N95 mask before leaving the patient’s room, take the following precaution: Apply hand gel generously to gloved hands before touching the mask, just as would be done for hand hygiene when not wearing gloves.
• Users must perform a proper user seal check before each use of the mask.This should be done with every respirator before every use, including new masks. Please see the guidance document and the video in the COVID-19 Resources on the Infonet for guidance on how to perform the user seal check. A seal check demonstration can be found starting at 2:30 of the video.
  • Place your dominant gloved hand completely over N95 mask, covering as much surface of the mask as possible. Take care not to disturb the mask’s position.
  • Exhale gently.
  • Seal is considered adequate if slight positive pressure builds up inside the mask without evidence of outward leakage. Evidence of leakage includes:
    • Air movement around nose
    • Fogging of glasses
    • Lack of pressure buildup inside mask

• The N95 respirator should be worn with eye protection – either a face shield or a surgical mask covering the mask plus goggles. This is to protect you from exposure and also to protect the N95 respirator from soiling.
• If the N95 mask becomes soiled, damaged, the inside of the mask becomes potentially contaminated (i.e., if touched with unsanitized hands or potentially contaminated gloves) or if the elastics become loose, discard the mask and obtain a new mask.
• After caring for patient(s) WITHOUT confirmed or suspected COVID-19, after six donnings/doffings OR after 12 hours of use, check with your manager to see if the mask should be saved for potential reprocessing.

For areas participating in the sterilization trial at Hershey Medical Center

• Before obtaining a new mask, please proceed to the sterilized mask distribution location in your area and check to see if there is a sterilized mask with your name on it ready for use. There are various reasons a mask may not be returned for use, including physical damage, the mask has met the two-cycle limit or it has been removed from reprocessing for other reasons. If there is not a sterilized mask there for you and you need a new mask, request it in the designated manner in your area.
• All reissued masks must be fit-tested prior to use.The sterilization pouch should be open to air for one hour prior to fit testing. Please incorporate this requirement into your workflow and remember it is OK to have more than one mask of yours in this sterilization process to ensure availability.

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