Disposable N95 masks are the standard face covering when health care providers require high-level respiratory protection, but during the pandemic, providers experienced widespread supply chain shortages and price increases, Dr. Chalikonda said. He said hospitals need a long-term solution.
"We don't know if there will be a shortage of N95s again. We don't know how long the pandemic will last and how often there will be virus surges," he said. "We believe now is the time to invest in an elastomeric mask program."
Dr. Chalikonda said an immediate supply of elastomeric masks in a health care system's stockpile of personal protective equipment is "game changing" given the advantages.
Elastomeric masks are made of a tight-fitting, flexible, rubber-like material that can adjust to nearly all individuals' faces and can withstand multiple cleanings, Dr. Chalikonda said. These devices, which resemble gas masks, use a replaceable filter. According to the Centers for Disease Control and Prevention (CDC), elastomeric masks offer health care workers equal or better protection from airborne infectious substances compared with N95 masks.1
Like many hospitals during the COVID-19 crisis, AHN was disinfecting and reusing N95 masks for a limited number of uses. However, Dr. Chalikonda said, "Many caregivers felt the N95 masks didn't fit quite as well after disinfection."
At the end of March, AHN began a one-month trial of a half-facepiece elastomeric mask covering the nose and mouth. The mask holds a P100-rated cartridge filter, meaning it filters out almost 100 percent of airborne particles.2
Until AHN could procure more elastomeric masks, the system began its program for P100 elastomeric mask "super-users": those providers who have the most frequent contact with COVID-19 patients. At each of AHN's nine hospitals in Pennsylvania and Western New York, the first providers to receive the new masks were respiratory therapists, anesthesia providers, and emergency department and intensive care unit (ICU) doctors and nurses. Initially, providers shared the reusable masks with workers on other shifts, and the masks underwent decontamination between shifts using vaporized hydrogen peroxide similar to the technique used to sterilize disposable N95 masks.
As more masks became available, workers kept their own mask and disinfected it themselves according to the manufacturer's guidelines. Gradually AHN provided more staff with the new masks.
Among nearly 2,000 health care providers receiving fit testing for an elastomeric mask (as required for any mask to make sure no unfiltered air penetrates it), 94 percent could wear one, the investigators reported. The small number of workers without a proper fit received an alternate type of respirator mask.
After a month of use, no one wearing an elastomeric mask chose to return to an N95 mask, according to the authors. Regarding the elastomeric masks, Dr. Chalikonda said, "Our clinicians were very comfortable with the fit, knowing it was an equivalent if not superior amount of protection, and that these masks were intended to be reused."
Furthermore, patients were receptive to their care providers wearing this type of respirator, he noted.
MEDICA-tradefair.com; Source: American College of Surgeons