Failure Rates During Reuse of Disposable N95 Masks in Clinical Practice in the Emergency Department
Autor: | Vamsi Balakrishnan, Ronald Check, Johnathan Pester, Donald Jeanmonod, Brian Kelly, Rebecca Jeanmonod, Kathleen McMahon, Leah Rivard |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
business.product_category N95 Respirators 03 medical and health sciences 0302 clinical medicine Equipment Reuse Humans Medicine Endemic Infections Prospective Studies 030212 general & internal medicine Respirator Disposable Equipment Prospective cohort study Pandemics Original Research business.industry RC86-88.9 Trauma center COVID-19 030208 emergency & critical care medicine Medical emergencies. Critical care. Intensive care. First aid General Medicine Emergency department Odds ratio Confidence interval Exact test Emergency medicine Emergency Medicine Equipment Failure Emergency Service Hospital business |
Zdroj: | Western Journal of Emergency Medicine, Vol 22, Iss 3 (2021) Western Journal of Emergency Medicine |
ISSN: | 1936-9018 |
Popis: | Author(s): Check, Ronald; Kelly, Brian; McMahon, Kathleen; Balakrishnan, Vamsi; Rivard, Leah; Pester, Jonathan; Jeanmonod, Donald; Jeanmonod, Rebecca K. | Abstract: Introduction: The coronavirus 2019 pandemic caused a shortage of disposable N95 respirators, prompting healthcare entities to extend the use of these masks beyond their intended single-use manufacturer recommendation with a paucity of supporting research.Methods: We performed a prospective cohort study of ED healthcare workers (HCW) (“subjects”) required to use respirators at an academic, Level I trauma center. Subjects had been previously fit tested and assigned an appropriately sized N95 mask per hospital protocol. Per study protocol, subjects were fit tested periodically throughout their shifts and on multiple shifts over the eight-week study period. Data points collected included the age of the mask, subjective assessment of mask seal quality, and fit test results. We analyzed the data using Fisher’s exact test, and calculated odds ratios (OR) to determine the failure rate of disposable N95 masks following reuse.Results: A total of 130 HCWs underwent fit testing and 127 were included for analysis. Mask failure rate climbed after day 2 of use, with 33.3% of masks failing at day 3, 42.9% at day 4, and 50% at ≥ day 5. Categorizing the masks into those being used for two or fewer days vs those in use for three or more, failure was more common on day 3 of use or older compared to those in the first two days of use (41.8% vs 8.3%, P l 0.0001) with an OR of failure with an older mask of 7.9 (confidence interval [CI], 2.8-22.3). The healthcare workers’ assessment of poor seal was 33.3% sensitive (CI, 18.6-51.9) and 95.7% specific (CI, 88.8-98.6) for fit test failure.Conclusion: Disposable N95 masks have significant failure rates following reuse in clinical practice. Healthcare personnel also performed poorly in assessing the integrity of the seal of their disposable respirators. |
Databáze: | OpenAIRE |
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