1. Washington University School of Medicine Medical Student N-95 Particulate Respirator Training

2.  What is a N-95 Respirator?  How is it different from other respirators?  When/Where do I wear one?  How do they work?  Are there hazards associated with wearing an N-95?  How do I wear an N-95?  Are they Disposable or do I use them repeatedly?

3. What is a N-95 Respirator?  Air purifying, particulate respirator  Required for use when dealing with Airborne Pathogens  N, R, or P (not oil resistant, Oil Resistant, Oil Proof)  95, 99, 100 (efficiency at 0.3 microns)  N-95 the most commonly used respirator

4. How is an N-95 different from other respirators?  N-95 respirators only block particulates  They are relatively comfortable to wear  They will typically fit easily on most individuals  They are inexpensive and disposable

5. When/Where do I wear one?  Particulate Filter  Airborne Biological Pathogens (TB, Measles, Influenza (aerosolized during procedure), SARS, etc.)  Patient Visits  Surgery  Intubation  Sputum Induction  Bronchoscopy  CPAP & BiPAP  Open suction of Airways  Autopsy

6. How do they work?  Reduces respiratory exposure to particulates for micron size 0.1 microns to >10.0 microns  (TB is ≈ 0.5 microns by 4 microns)  Fluid Resistant to splash of body fluids  Provides >99% bacterial filtration efficiency against wearer generated micro-organisms  Latex Free

7. Respirator Effectiveness  Respirators are only effective when the seal around your nose and mouth is tight. If you cannot achieve proper fit, do not enter the isolation or treatment area. A respirator cannot be worn by anyone with facial hair that comes between the sealing surface of the mask and face. Individuals should be clean shaven before wearing a respirator.

8. Are there hazards associated with wearing an N-95?  Yes. Breathing through an N-95 respirator for long periods of time can be somewhat difficult. For this reason, Medical Evaluation are reviewed before this training.  Positive responses lead to further investigation  If you are Claustrophobic, it can lead to difficulties.  If you experience any issues while wearing a respirator, remove yourself from the source of the contaminate before removing the respirator.

9. How do I wear an N-95?  1. Cup the respirator in your hands.  2. One at a time, put the lower strap on your neck, and the upper strap on the crown of your head.  3. With two hands, push the metal bar down. Start at your nose and work down towards the check bones.  4. Perform the fit tests as described on the next slide

10. How do I wear an N-95? Negative Pressure Check Positive Pressure Check  1. One or the other may be difficult to tell. But at least one of the tests should be obvious.  2. Perform at least one of these every time you wear it.  1. Cup your hands lightly over the respirator.  2. Exhale Sharply though your mouth.  3. You should feel the mask puff out against your hands.  4. You should not feel any air coming out the sides of the masks or around your nose.  1. Cup your hands lightly over the respirator.  2. Inhale sharply through your mouth.  3. You should feel the mask collapse slightly against your hands.

11. How do I remove an N-95?  1. Grab one strap at a time and pull over head. Strat with the bottom strap first.  2. Make sure to not touch the front of the mask. You should assume the outside of the respirator is contaminated.

12. Are they Disposable or do I use them repeatedly?  Respirators should be changed if:  The employee experiences a significant increase in the amount of resistance to breathing  The respirator collapses due to excess moisture  The employee senses (smells/tastes) breakthrough  The respirator is visibly soiled or  The respirator no longer seals to the user’s face  If sufficient respirators are available, the respirator should be disposed of after each use. However, they can be used repeatedly. Again, assume the outside of the respirator is contaminated.

13. Limitations of the Respirator  If the respirator becomes wet or soiled. It should not be used  Does not supply oxygen and should not be worn in an atmosphere with less than 19.5% oxygen  Cannot be used in concentrations of contaminants that are immediately dangerous to life and health  Cannot be used with beards, facial hair, or other conditions that prevent a good seal between the face and the edge of the respirator  They are particulate respirators. They will not protect you against chemical vapors or gases.

14. Conclusion  3 rd year away rotations may or may not need further fit testing.  There are different Sizes.  However, the small is very small and should only be worn by those with small faces.  You must be clean shaven when wearing the respirator. Jon Kruyne kruynej@wustl.edu 747-8412 Questions?