1. Application and Fit Checking of a P2/N95 Mask

2. P2/N95 respiratory protection must be worn while caring for patients who have known or suspected:
Tuberculosis (TB)
Severe Acute Respiratory Syndrome (SARS)
Varicella (non-immune staff)
Measles (non-immune staff)

3. Objectives
To have knowledge of how to effectively don (put on) your P2/N95 mask
To have knowledge of techniques to ensure a correct fit check of your mask
To have knowledge of safe practices for doffing (taking off) your mask
This presentation is intended as a guide only.
The mask shown in this presentation is the mask most commonly fitted to SAAS operational staff.

4. Before Donning Get your particular N95/P2 mask ready
Ensure the mask is not damaged in any way
Perform Hand Hygiene before applying your mask
You would have been fitted to a P2/N95 Mask by either A qualitative fit test using test agents such as saccharin or BitrexTM (a bitter tasting aerosol) or a A quantitative fit test using the Portacount™ Plus machine.
Always perform Hand Hygiene before applying your mask. You will be putting you hands near your face and therefore your mucous membranes of eyes, nose and mouth.
Ensure the mask is not damaged in any way. The integrity of the mask needs be checked to ensure that it will perform as the manufacturer intended. Faulty or damaged masks should be discarded.

5. Points to Consider Beard or facial hair Earrings Glasses/spectacles
Points that you should consider are:
Do you have a beard or facial hair?
If you have facial hair (including a 1–2 day beard growth) be aware that an adequate seal cannot be guaranteed between the P2/N95 mask and your face.
Are you wearing earrings or glasses/spectacles?
When donning your mask you may find it easier if you remove earrings and glasses prior to putting it on.
This is the mask commonly fitted to operational staff, the 3M 9322
3M 9322

6. Step 1 Separate the mask edge Put a small bend in the nose wire.
Separate the mask edge
Put a small bend in the nose wire
Hold upside down and gently shake the straps out
Separate the edges of the mask, this will allow you to put a small bend in the middle of the wire nose piece, this will later be conformed to the shape of your nose. Tip the mask upside down and gently shake the mask to remove the headband straps .

7. Step 2 Separate the 2 headbands
Ensure the nose piece is at the top of mask
Use index fingers and thumbs to separate the bands
Use your thumbs and index fingers to separate the headband straps of your mask. Ensure that the mask is up the correct way, the nose wire should be at the top

8. Step 3 create a “cup” for your chin
create a “cup” in which the chin can be placed.

9. Step 4 Place chin into “cup” of mask
Pull headbands up and over your head
Placing chin into mask cup will stabilise the mask while you position the straps on your head. Lift both headband straps up and over your head.

10. Step 5 Release lower headband Position at the base of the neck
Position other headband on the crown of your head
Once you have pulled the straps up and over your head position the lower headband straps at the base of your neck and the 2nd headband strap on the crown of your head.
The positioning of the straps is important to ensure that the mask is firmly positioned. The strap on the crown of your head will assist in pulling the mask firmly against the bridge of your nose and the strap at the back of your neck will assist to pull the mask firmly in against your face to reduce the risk of incorrect fit.

11. Step 6
Ensure that the mask is symmetrical on your face and the edges aren’t folded
Mould nose piece to your nose and across cheek bones
Adjust mask until good/ comfortable fit is achieved
Ensure that your mask is positioned symmetrically on your face and that none of the edges are folded under, particularly under the chin.
Use your fingers to firmly mould the mask to the shape of your nose and across your check bones. Ensure the mask is well positioned under your chin.
Continue to adjust the mask until it is positioned comfortably on your face and a good fit has been achieved.

12. Check list Mask firmly positioned under chin?
Mask fitted across bridge of nose and cheekbones?
Straps positioned at base of neck and on crown of head?
Ensure that the mask is fitted firmly under your chin and that is conformed to the bridge of your nose and across your cheekbones. Check that the headband straps are positioned at the base of your neck and on the crown of your head.

13. Fit checking Valved Mask
Cover the front of the mask with both hands – don’t disturb the position of the mask
Inhale sharply. If any air flows around the nose, re-adjust by re-moulding the nosepiece

14. Fit Checking a non valved mask
Click on the links below to view specific application and fit checking instructions provided by the companies currently available for SAAS
ProShield N-95
Kimberly-Clark-N95
Moldex-1500 Series N95

15. Incorrect fit Signs of an incorrect fit may be:
Air leaking around mask
Glasses or face shield/goggles fogging
If your mask isn't fitting correctly:
Reposition the mask
Repeat the fit check
If you detect air leaking around the mask you should reposition the mask and repeat the fit check until a good fit is achieved.
Speak to your TL if you can not achieve a good fit. You may need to be fit tested to an alternative mask.

16. Removal Perform hand hygiene Remove mask by the headbands only
Discard mask carefully
Always perform hand hygiene before removing your mask, as you will be putting you hands near your face, therefore, your mucous membranes of eyes, nose and mouth. You need to protect yourself from potential pathogens that may be on your hands.
Removing mask by the head bands at the side of your face will minimise your exposure to pathogens. Lift the straps away from your crown and over your head, move mask forward away from your face. Never touch the front respirator of the mask as this is likely the most heavily contaminated part.
Perform hand hygiene again after you have removed the mask as your hands may have become contaminated in the removal process.

17. Remember A fit check must be performed every time you put your mask on
Never re-use a mask
Wet or damaged masks must be replaced immediately
Always perform hand hygiene before putting on and after removal of your mask
No matter how often you use a P2/N95 mask it is imperative that you perform a fit check every time you apply one. You must ensure that it is correctly positioned before caring for the patient to protect yourself from airborne diseases.
Never re-use a mask. If a mask has been removed for any reason it must be discarded and a new mask obtained.
If your mask becomes wet or damaged during the course of patient care you should remove the mask and don another following the steps outlined previously.
It is important to always perform hand hygiene before you apply your P2/N95 mask and before and after you remove it.

18. SAAS Operational staff will need to complete an annual fit check competency, this will generally be managed at a PDW.
This annual fit check replaces the annual fit test using the hood and test agents such as saccharin or BitrexTM (a bitter tasting aerosol)

19. For more Information
Belinda Purvis Clinical Practice Consultant - Worker Health – SA Ambulance Service
216 Greenhill Road. EASTWOOD 5063
DX 718 Phone | Mobile:
Fax: