Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate...

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Respiratory Respiratory Protection Protection from Airborne from Airborne Infectious Agents: Infectious Agents: Use of N-95 Disposable Use of N-95 Disposable Particulate Respirators Particulate Respirators Vermont Department of Health, EMS Office This program was adapted in 2009 from materials developed by the New Jersey Dept of Health & Senior

Transcript of Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate...

Page 1: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Respiratory Protection Respiratory Protection from Airborne Infectious from Airborne Infectious

Agents:Agents:

Use of N-95 Disposable Particulate Use of N-95 Disposable Particulate RespiratorsRespirators

Vermont Department of Health, EMS Office

This program was adapted in 2009 from materials developed by the New Jersey Dept of Health & Senior

Services

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ObjectivesObjectives

Explain what N-95 disposable particulate Explain what N-95 disposable particulate respirators are and why they are necessaryrespirators are and why they are necessary

Describe their capabilities and limitations.Describe their capabilities and limitations.

Demonstrate proper use.Demonstrate proper use.

Describe the proper maintenance and storage Describe the proper maintenance and storage of N-95 respirators.of N-95 respirators.

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Why is an N-95 disposable Why is an N-95 disposable particulate respirator necessary?particulate respirator necessary?

Protection from airborne pathogens like influenza, tuberculosis, SARS, chickenpox, measles and smallpox.

It protects by filtering out infectious particles from the air you breathe.

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When is an N-95 disposable When is an N-95 disposable particulate respirator necessary?particulate respirator necessary?

• Respiratory disease outbreak or • Intentional biological event

N-95 disposable particulate respirators are the minimum level of protection needed for airborne infectious agents.

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What is an N-95 disposable What is an N-95 disposable particulate respirator?particulate respirator?

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N-95s reduce exposure to particles that N-95s reduce exposure to particles that

are small enough to be inhaledare small enough to be inhaled

Sizes of some pathogens (microns)

Fungi 2-200

Mold spores 1-70

Bacteria 0.5-10

Viruses 0.02-0.3

One meter = 39.37 inches

One millimeter = one-thousandth of a meter (0.04 inches)

One micron = one-thousandth of a millimeter (0.00004 inches)

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N-95s reduce exposure to particles that N-95s reduce exposure to particles that

are small enough to be inhaledare small enough to be inhaled

1-5 micron particles can enter upper airways

0.1 – 1 micron particles can enter lower lungs and alveoli

Viruses = 0.02-0.3 microns

N-95 filters are tested on particles greater than 0.3 microns in size.

Particles < 100 microns can be inhaled through nose and mouth

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What does “N-95” mean? What does “N-95” mean?

• N = Not oil resistant• R = Resistant to oil• P = oil-proof

An N-series filter that is at least 95% efficient in removing particles greater than 0.3 microns in diameter.

Respirators are evaluated by the National Institutes for Occupational Safety and Health (NIOSH)

• 95 = 95% efficient• 99 = 99% efficient• 100 = 99.97% efficient

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How can you tell if a respiratorHow can you tell if a respiratoris NIOSH-approved?is NIOSH-approved?

http://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/n95list1.html

NIOSH approval number on respirator:

Approval label in box

NIOSH Certified Equipment ListWebsite

84A-####

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Is an N-95 disposable respirator Is an N-95 disposable respirator the same as a surgical mask?the same as a surgical mask?

A surgical mask is not a respirator.

It is NOT NIOSH-approved.

NO

Page 11: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Is an N-95 disposable respirator Is an N-95 disposable respirator the same as a surgical mask?the same as a surgical mask?

A surgical mask may not provide adequate protection for EMS responders….

A surgical mask on the patient may limit the spread of respiratory secretions.

BUT . . .

Page 12: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

What N-95 respirator is being issued?What N-95 respirator is being issued?

This EMS agency uses these N-95 disposable particulate respirators:

Brand Model Sizes

#1 ______ _____________ _____

#2 ______ _____________ _____

Page 13: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Advantages of N-95 disposable Advantages of N-95 disposable particulate respiratorsparticulate respirators

LightweightLightweight

Fairly comfortable to wearFairly comfortable to wear

Mobility not restrictedMobility not restricted

DisposableDisposable

Low costLow cost

Require no cleaning or maintenanceRequire no cleaning or maintenance

Page 14: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Limitations of N-95 disposableLimitations of N-95 disposableparticulate respiratorsparticulate respirators

______ deficiency______ deficiency

Harmful chemical gases and vaporsHarmful chemical gases and vapors

_____ or ______ contact with _____ or ______ contact with pathogenspathogens

High concentrations of _______High concentrations of _______

They DON’T protect from:

Page 15: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Limitations of N-95 disposableLimitations of N-95 disposableparticulate respiratorsparticulate respirators

OxygenOxygen deficiency deficiency

Harmful chemical gases and vaporsHarmful chemical gases and vapors

SkinSkin or or eyeeye contact with pathogens contact with pathogens

High concentrations of High concentrations of pathogenspathogens

They DON’T protect from:

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WhaWhat do these limitations mean t do these limitations mean for EMS?for EMS?

Don’t enter an oxygen deficient Don’t enter an oxygen deficient atmosphere.atmosphere.Don’t use an N-95 disposable particulate Don’t use an N-95 disposable particulate respirator for protection from chemical respirator for protection from chemical hazards.hazards.If the airborne infectious agent is also If the airborne infectious agent is also spread by skin or mucous membrane spread by skin or mucous membrane contact (such as SARS), use eye contact (such as SARS), use eye protection, gloves and gown. protection, gloves and gown.

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WhaWhat do these limitations mean t do these limitations mean for EMS?for EMS?

If an intentional biological event has If an intentional biological event has occurred, higher levels of respiratory occurred, higher levels of respiratory protection may be required.protection may be required.

N-95 disposable particulate respirators N-95 disposable particulate respirators must be worn the entire time you are close must be worn the entire time you are close to potentially infectious persons.to potentially infectious persons.

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If N-95 disposable particulate respirators If N-95 disposable particulate respirators are issued, EMS agencies must comply with are issued, EMS agencies must comply with

OSHA’s Respiratory Protection StandardOSHA’s Respiratory Protection Standard

1. Written respiratory protection program with an assigned program administrator

2. Proper selection of respirators3. Training about the hazards and proper use4. Medical clearance initially and every three years

(more often if there are changes)5. Fit testing (annually) 6. Evaluation of program effectiveness (annually)

Page 19: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Proper Use of Your Brand Proper Use of Your Brand and Model of Respiratorand Model of Respirator

Proper donningProper donning Seal checkSeal check RemovalRemoval ReuseReuse

OBTAIN AND REVIEW THE MANUFACTURER’S INSTRUCTIONS FOR:

Page 20: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

General Seal Check Procedures for General Seal Check Procedures for N-95 Disposable RespiratorsN-95 Disposable Respirators

Whenever the respirator is donned:Whenever the respirator is donned:

1. Place one or both hands completely over the1. Place one or both hands completely over the filtering facepiece. filtering facepiece. 2. Inhale and exhale sharply2. Inhale and exhale sharply. If air leaks around your nose,. If air leaks around your nose, readjust the nosepiece. If air leaks between the face andreadjust the nosepiece. If air leaks between the face and

faceseal of the respirator, reposition it by adjusting thefaceseal of the respirator, reposition it by adjusting thepanels and straps.panels and straps.

3. If you cannot achieve a proper seal, 3. If you cannot achieve a proper seal, do not do not enter theenter the contaminated area. See your respiratory programcontaminated area. See your respiratory program administrator.administrator.

Page 21: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Proper UseProper Use

No facial hair that interferes with face to facepiece No facial hair that interferes with face to facepiece sealsealIf shape of the N-95 is compromised, it may not fit If shape of the N-95 is compromised, it may not fit properlyproperlyIf respirator becomes damaged, soiled or if If respirator becomes damaged, soiled or if breathing becomes difficult, leave the breathing becomes difficult, leave the contaminated area and replace the respiratorcontaminated area and replace the respiratorIf used in caring for patient with a disease spread If used in caring for patient with a disease spread through contact, dispose of N-95 after each use.through contact, dispose of N-95 after each use.

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Medical EvaluationMedical Evaluation

N-95 use requires medical evaluation and N-95 use requires medical evaluation and clearance before use.clearance before use.

The medical evaluation is repeated in three The medical evaluation is repeated in three years (or earlier if change occurs that might years (or earlier if change occurs that might affect ability to use a respirator safely).affect ability to use a respirator safely).

The medical evaluation includes a The medical evaluation includes a confidential respiratory questionnaire confidential respiratory questionnaire and/or in-person medical evaluation.and/or in-person medical evaluation.

Page 23: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Medical EvaluationMedical Evaluation

Medical provider sends written clearance to Medical provider sends written clearance to the employerthe employer– Says only that the EMS responder can or Says only that the EMS responder can or

cannot wear a specific respirator cannot wear a specific respirator – No confidential information is includedNo confidential information is included

Medical provider keeps questionnaire in Medical provider keeps questionnaire in confidential file.confidential file.

Page 24: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Elastomeric

Documentation of Medical Evaluation for Disposable N-95 Respirator Use

Name of responder/employee: _________________________________________ Name of agency/employer: _________________________________________ This responder/employee has been medically evaluated regarding the ability to be fit-tested for and wear a disposable N-95 respirator. The information required by the OSHA Respiratory Protection Standard 1910.134 (Section (e) and Appendix A, Part A, Sections 1 & 2) was obtained in the course of performing this evaluation. Based on the medical evaluation, the responder/employee: _____ is NOT cleared to be fit-tested for a disposable N-95 respirator _____ requires further evaluation before a decision can be made regarding fit testing for

a disposable N-95 respirator _____ is cleared (with any limitations shown) to be fit-tested for and wear a disposable

N-95 respirator

Date of this written recommendation: ________________ Health care professional signature: ___________________________________ Health care professional name: ___________________________________ Address: ___________________________________ ___________________________________ Phone: ___________________________________ Health care professional: Keep a copy of this form and provide the original to the responder/employee.

LIMITATIONS _____ No _____ Yes Description: _______________________________ _______________________________________________________________ ______________________________________________________________________

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Fit-TestingFit-Testing

If a respirator does not make a tight seal around the face during inhalation, contaminated air may leak around the edges of the face seal. The only way to tell if a respirator fits and is capable ofprotecting properly is to fit-test the respirator.

OSHA requires fit-testing prior to initial use and annually thereafter.

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Quantitative: Computerized meansof detecting faceseal leakage

Qualitative: Relies on wearer’s subjective response to taste, odor or irritation

Quantitative vs. Qualitative Fit-Testing

Page 27: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Respirator Training and Fit Testing Report Respirator Training Name of person trained/tested: ________________________________________

Person’s organization/employer: _______________________________________

The individual named above has successfully completed: initial refresher respiratory protection training for use of N-95 respirators. The training included the elements required by the OSHA respiratory protection standard (29 CFR 1910.134(K)). Name of trainer: __________________________________

Signature of trainer ________________________________ Date ________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Fit Testing Test method: Qualitative 3M FT-30 Test date: ___________________________

Model: N-95 Respirator manufacturer: ____________________________________

Mask style: __________________ Size _____ NIOSH approval # _______________

Exercises Pass? Yes No Normal breathing ___ ___ Deep breathing ___ ___ Head side-to-side ___ ___ Head up and down ___ ___ Talking ___ ___ Bend and touch toes/step in place ___ ___ Normal breathing ___ ___ Name of fit tester: _________________________________

Signature of fit tester _______________________________ Date ________________

Signature of employee ______________________________ Date ________________ Employee’s signature indicates the employee has undergone respirator training and N-95 fit testing. Fit tester: Give one copy to this report to the employer and give the original to the employee.

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After the plan is initiatedAfter the plan is initiated

OSHA requires annual program OSHA requires annual program evaluation evaluation

Responsibility of program administratorResponsibility of program administrator

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Respiratory protection is Respiratory protection is effective only if:effective only if:

The correct respirator is usedThe correct respirator is used

It’s available when you need itIt’s available when you need it

You know when and how to put it on You know when and how to put it on and take it offand take it off

You have stored it and kept it in working You have stored it and kept it in working order in accordance with the order in accordance with the manufacturer’s instructionsmanufacturer’s instructions

Page 30: Respiratory Protection from Airborne Infectious Agents: Use of N-95 Disposable Particulate Respirators Vermont Department of Health, EMS Office This program.

Vermont Department of LaborVermont Department of Labor Occupational Safety & Health AdministrationOccupational Safety & Health Administration

Project WORKSAFEProject WORKSAFE 802-888-0620802-888-0620

www.labor.vermont.gov/?tabid=74www.labor.vermont.gov/?tabid=74

For more information, contact the For more information, contact the

Vermont Department of HealthVermont Department of HealthEMS responders:Office of EMS800-244-0911www.vermontems.org

Other health care workers:Personal Protective Equipment Manager 802-951-0058