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| On Nov 15 2005 4:47PM debbie.king wrote: |
Hi
What masks are you going for in pandemic flu - I know DH say surgical but is anyone going for N95?
Debbie |
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| On Nov 15 2005 6:34PM hjenkinson4 wrote: |
| No - going for sugical in comm |
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| On Nov 18 2005 12:03PM david.green wrote: |
| Debbie, I too have issues regarding using only surgical masks for close patient contact in a possible influenza pandemic. No decision has been reached but I can't help feeling N95 would be more appropriate. However that then raises the issue of sourcing them, funding and stockpiling for a possible outbreak that might not happen for some years. Will let you know. |
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| On Nov 18 2005 12:26PM infectioncontrol wrote: |
| how can you justify only going for surgical in the community? |
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| On Nov 21 2005 12:50PM david.green wrote: |
| I don't think anyone on this discussion thread is trying to "justify" using surgical masks for pandemic flu in the community or in acute settings. It is merely a reflection of issues raised by recent DH advice. It is they who have made the recommendation on surgical masks for those with close patient contact (i.e. within 3 feet). |
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| On Nov 21 2005 8:39PM hjenkinson4 wrote: |
| perfect description david well said |
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| On Nov 23 2005 9:54AM neil.wigglesworth wrote: |
On behalf of Helen Jenkinson and Viv Duncanson:
Information about Flu and wearing of Masks
during a pandemic it will not be business as usual for the NHS, there will be virus circulating widely in the community and the guidance produced is pandemic specific.
Pandemic influenza infection control - use of surgical facemasks and respiratory protection.
Pandemic influenza infection control guidance was published jointly by the Department of Health and Health Protection Agency on 19 October 2005. This was to fulfil an obligation to provide advice as to how Health and Safety
Executive (HSE) guidance would be applied in a pandemic and to set out how protective clothing should be used to minimise the risk of NHS staff acquiring influenza while caring for symptomatic patients. The guidance is
evidence based and includes the use of face masks and respiratory
protection.
The consensus view is that infection control precautions additional to those in routine use will be required to protect healthcare workers during a pandemic. This minimum recommended standard divides protection into two levels depending on the likely level of exposure to pandemic virus
associated with different clinical activities.
Droplet protection.
It is recommended that surgical facemasks are used by healthcare staff working in close proximity (<3 feet) to symptomatic patients. The facemask will provide a physical barrier and will minimise contamination of the facial mucosa by large respiratory droplets which are typically generated by coughing and sneezing. These droplets are one of the principal ways influenza is transmitted.
Surgical facemasks are widely used in clinical practice and most clinical staff are used to wearing them for a range of clinical activities. They will be used for most routine patient care together with other important
infection control precautions such as hand hygiene, use of disposable gloves and aprons.
Respiratory protection
When clinical staff are undertaking specific clinical procedures that have the potential to generate aerosols of respiratory secretions from infected patients a higher level of protection is recommended. This is to protect
against the inhalation of airborne droplet nuclei (5�m or smaller in size)by those undertaking the clinical procedure. In this instance respiratory protection providing the highest possible protection factor (i.e: an
EN149:2001 FFP3 disposable respirator) should be worn.
Staff must be trained in the use of FFP3 respirators and understand the need for fit testing as required by the HSE.
NB: N95 is not a legally recognised standard anywhere in
the EU.It in fact derives from USA. N95 is inferior to an FFP3.
Finally and perhaps most importantly that WHO have recently clarified their advice which is surgical mask for normal near pt contact and N95 for AGPs.
Thus the UK standards in our document are more risk averse already than currently recommended by WHO.
Many thanks
Helen jenkinson and Viv Duncanson
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| On Nov 25 2005 11:38AM Sue.Silvester wrote: |
Regarding the community staff use of surgical masks, out emergancy planning team have 2 concerns.
1.if standard surgical masks are only effective for a short time & the implications for cross infection assoociated with their 'inappropriate' use, why are we advoating use.
2. Community staff, who do we mean, is it just the nurses, or ist it the doctors, receptionists, admin staff and the public, they will demand these.
Has anyone been specific in thier flu plans to address this.
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| On Nov 26 2005 9:14AM hjenkinson4 wrote: |
please refer to flu infection control guidance on dh web
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| On Dec 1 2005 11:48AM nsmall wrote: |
A quick question or two.
If the experts at the WHO are recommending masks with a minimum filtration efficiency of 95%, why not use an N95 or indeed an FFP2 - if it exceeded (and can be independently substantiated) the specified minimum efficiency of 95%? Masks meeting the WHO requirements can be purchased for around a third of an FFP3.
The N95 is CE marked as a Medical Device under the Medical Devices Directive � the same as surgical masks. Is it fair to assume if a surgical mask is acceptable an N95 would too, if the clinician preferred a far higher level of protection?
This also leads to the question of surgical masks being recommended to protect the wearer from biological hazards. This is a quote from the HSE, in a document titled:
Biological agents: Managing the risks in laboratories and healthcare premises.
�If RPE is used to control exposure to biological agents, you should use filter-type RPE that controls exposure down to the lowest levels, ie the highest efficiency P3�
Incidentally, there is no current EU standard for surgical masks. They range from tissue products which have no place in healthcare to quality ones that remain effective for hours. A guide to selection may be useful?
Nigel
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| On Dec 5 2005 5:49PM david.green wrote: |
The advice on which mask to use appears to be consistent across the DH, HPA, CDC and WHO. The WHO do NOT recommend N95 or FFP2/3 for contact with pandemic influenza within 3 feet of a case. They recommend surgical type masks. They recommend N95 for procedures likey to create aerosols. WHO conclude:-
"Available evidence suggests that transmission of human influenza viruses probably occurs
largely through exposure to respiratory large-particle (> 5 �m in size) droplets. Therefore,
the use of surgical masks is considered beneficial and is recommended for all health-care
workers who will work within 3 feet of patients who are considered potentially infectious
with pandemic influenza."
The source of this quote is available at
http://www.who.int/csr/resources/publications/influenza/Mask%20Clarification10_11.pdf |
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| On Feb 10 2006 11:01AM david.green wrote: |
This subject has gone too quiet recently so I thought I'd open another can of worms. DH advice for those who fail fit test for FFP3 or who wear a beard is:-
"Other types of respiratory protective equipment (e.g., hoods/helmets) are available".
I've been searching for this type of respiratory PPE and can find nothing. Does anyone know where these hoods or helments are available from? |
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| On Feb 10 2006 11:47AM nsmall wrote: |
| I think these are powered respirators that have their own filtered fresh air supply. If you do a search on powered respirators you will find a selection of suppliers of this type of equipment. |
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| On Feb 10 2006 11:58AM lesleytayuk wrote: |
Hi David,
Try 3M rep Jan Mitton Mobile 07785 515785. Jan has
been really helpful with advice on all fit testing
issues, including alternatives for fit test failure.
Regards Lesley
Lesley McKay
Infection Control
North Cheshire Hospitals NHS Trust
___________________________________________________________
Yahoo! Messenger - NEW crystal clear PC to PC calling worldwide with voicemail http://uk.messenger.yahoo.com |
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