Given that CDC, the Ohio Department of Health, and Ohio EMS all now firmly recommend N-95 mask or higher-level respirator when caring for suspected cases of 2019 novel coronavirus (2019-nCoV), we’ve been getting questions about fit-testing for N-95 masks.
Dayton MMRS has long recommended use of Qualitative Fit Testing (QNFT) for N-95 Respirator Masks procedures (as opposed to Quantitative), in part because quantitative fit testing of disposable N-95 Masks (using equipment such as a PortaCount) is a destructive test, requiring that a hole be punched in the mask. With QNFT, the person can keep the mask for use on a run. With 4,000 EMS personnel in our region, Qualitative fit-testing saves a lot of masks. If desired, you may use a soft-tipped pen (e.g., a "Sharpie") to write the person’s name on the mask. We also continue to recommend use of renewable PPE resources such as PAPRs when possible. Some PAPRs provide a higher protective factor, and PAPRs reduce respiratory work for the wearer.
Also, remind your personnel to place a surgical mask (not an N-95) on the patient.
A short overview on fit-testing and additional information can be found here:
https://www.3m.com/3M/en_US/safety-centers-of-expertise-us/respiratory-protection/fit-testing/
An instructional video on the Quantitative (QNFT) fit test process is here: https://www.youtube.com/watch?v=xl4qX6qEYXU. A “Guide to using the
3M Qualitative Fit Test Kits” is attached, along with fitting instructions.
According to OSHA, NIOSH, CDC, and the World Health Organization (WHO), properly fitted and worn N-95 Masks protect against Avian Influenza, SARS, and multiple other agents. Dayton MMRS recommends that partner agencies maintain an appropriate cache of Respiratory PPE. We would like to offer the following recommendations concerning N-95's:
1) Store and maintain N-95’s according to manufacturer’s recommendations;
2) Annually fit-test personnel who will utilize the N-95's according to current standards. Employees who are to wear N-95 Masks must be trained and fit-tested, and have an annual respiratory assessment. In one study, investigators found that only 24% (129 of 538) of participants wore the devices properly. N-95's can legitimately be fit-tested using non-destructive, quantitative tests (i.e., formalized “smell” testing);
3) Ensure that only providers with appropriate training utilize N-95's;
4) Promulgate an SOP, SOG, or other materials for your organization, requiring appropriate utilization of the N-95's by your agency’s personnel.
David N. Gerstner
MMRS/RMRS/EP Coordinator
Department of Fire I City of Dayton
300 N. Main St. I Dayton, Ohio 45402
Office 937.333.4551 I Fax 937.333.4561 I www.daytonohio.gov
24/7 Pager: 937-227-8705 or E-mail 9372278705@archwireless.net
Cell 937.776.4410
david.gerstner@daytonohio.gov I http://DaytonMMRS.org