Masks - Recommendation of HICPAC Influenza A (H1N1) Working Group

[sharon sanders]

hat tip Fla Medic -

Recommendation of HICPAC Influenza A (H1N1) Working Group

At a public meeting held on July 23, the Centers for Disease Control and Prevention?s (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) unanimously adopted the recommendations of the Influenza A (H1N1) Working Group with regards to ?Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting.?

The Working Group recommendations were based on the results of a
systematic review on respiratory protection devices for Influenza A (H1N1) performed by the Center for Evidence-Based Practice at the University of Pennsylvania Health System in June 2009. The guidance development process continues with a CDC meeting to hear the views of labor organizations on July 28. On August 11-14, 2009, the Institute
of Medicine (IOM) will convene an expert panel on personal protective equipment for healthcare personnel in the workplace against H1N1.

The guidance development process is expected to be completed by October 1, 2009. APIC is pleased that the Working Group recommendations are consistent with an APIC-endorsed position paper.

As some of you are aware, a number of state health departments, after recognizing that the Novel H1N1 influenza was similar to the seasonal influenza, advised healthcare organizations within their jurisdictions that standard and droplet precautions should be followed for patients with Novel H1N1 rather than airborne infection isolation.

After a systematic review of the transmission of airborne infections, the H1N1 Working Group arrived at the following recommendations for minimum isolation precautions:

? Healthcare personnel should wear a surgical mask when caring for patients with suspected or confirmed cases.
? An N95 respirator is recommended for select procedures that are potentially aerosol-generating (e.g. bronchoscopy, intubation, CPR, open airway suctioning, and sputum induction).
? Healthcare personnel should adhere to standard and droplet precautions for 7 days after the onset of illness or until symptoms resolve, whichever is longer.

Healthcare facilities are advised to regularly perform risk assessments that consider the current activity of H1N1 in the community and related issues.

http://www.apic.org/Content/Navigat...PublicPolicyLibrary/HICPAC_H1N1_Guideline.pdf

 

[sharon sanders]

Re: Masks - Recommendation of HICPAC Influenza A (H1N1) Working Group

This is very controversial -

``Healthcare personnel should wear a surgical mask when caring for patients with suspected or confirmed cases.``


Surgical mask vs. N95

 

[sharon sanders]

Re: Masks - Recommendation of HICPAC Influenza A (H1N1) Working Group

FluTrackers policy is the recommendation to obtain and use the product that gives the best protection against pandemic influenza.

If N95 are available - they are preferable to surgical masks when treating infected patients.

Any health care worker that is pregnant or is not preventing pregnancy should be especially cautious about treating these patients.

 

[Flufreak]

Re: Masks - Recommendation of HICPAC Influenza A (H1N1) Working Group

This seems to be insane (the surgical mask) at first glance.
Our facility has 1000's of N95's and we were recently told they are for emergency short term use only, that the virus has been shown to be between droplet and airborne in it's spread capability. We are using PAPR (Positive Air Pressure Respirator) units for being present in the airspace of all suspected pandemic patients. We are working on acquiring 500% more units but they are very hard to get, 3M is backordered thru at least October.

IMO these new regulations may be due to lack of supply issues and the need to avoid panic in health care workers. The good news is that it seems to take a fair viral load currently to get infected (given lack of health care spread to date), so this may be what justifies a decreased level of PPE (Personal protective equipment). What worries me is if the viral infectiousness increases the indications will first be seen in the health care realm.