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Masks thinking outside the box

J

janetn

New member
I could use the advise and thoughts from the members here. We are all aware that PPEs especially N95 masks are going to run out toot sweet quick. Its apparent that nobody is going to provide what we need to work without dying in droves. Ive given up on TPTB. They simply have written us off, end of story

Since most of us are employed as HCW were not in a position to spend buckets of money to protect ourselves. We need something thats safe as it can be, affordable and reuseable for more than one shift [which will make it affordable.

Ive been looking at the half face respirators. they are good but the filters if changed daily are going to be cost prohibitive.

Soooooooo. Thinking out loud here. What about a half face respirator, with tow really good filters [hepa] . Then attach vent circut hose to the ports run them down under your shirt to a HME [PALL filter] . Your first line of defence is your shirt. Virus droplets are usally wet, and they fall to the floor rather quickly. Those left in the air are first going to have to go through your shirt [which I would soak down with a germicidial substance] then you have the HME - its antibacterial and I believe antiviral too. now when I worked Vent cases we only changed them once a month, so what do you all think about using them a week? 3 days? give me a little feedback here. Then you finally have the hepa filters on the masks themselves. I would think we could reuse them too. A week???

Also what do you guys think of wearing a plastic garbage bag over your scrubs? Again another barrier the virus has to get through. Also completely disposable. I like the plastic bag idea for another reason - stuff dont stick to it, including viruses. If your at a bedside and you get sprayed with a cough you could spray it down with a bleach sol. rip it off and get a new one. For pennies you have a disposable apron. Slit the top for your head and a slit for each arm

I know some of this sounds wacky, but im trying to come up with something that will protect us that most of us could afford.

Id love some feedback, good or bad:D
 
WELCOME janetn!

WELCOME janetn!

Yes, janetn, thinking outside the "BOX" is what we need---so we don't end up in a box!

I am not a HCW, but I LOVE the trash bag idea. It sounds SUPER!

I am even sort of amazed that you are envisioning carrying on with your front line work, considering the lack of support out there--so far---for front line people.

The rest of your question could be answered by LMonty, perhaps?

Welcome! janetn,


JY
 
Re: Masks thinking outside the box

In no particular order, here are some thoughts:

1. Impermeable enclosures like trash bags get hot and sweaty really fast. Try this one at home, doing regular chores, for 4 hours. Can you tolerate it? But they do make decon easier. A compromise might be an impermeable apron, because most of the exposure comes from the front direction, not the back. Don't wear more PPE than you have to.

2. The nice thing about half-face respirators is that they don't fog up your eyes. The bad thing, they don't protect your eyes. Safety glasses with side splash shields might be a decent compromise between droplet protection and visibility. They even come in models with built-in magnifiers for, errrrm, more mature people who need to read tiny print.

3. A surgical cap over the straps will make decon simpler--now the outside buckles are not contaminated, so you can remove the cap, unglove, and undo the buckles. Double-gloving also makes doffing easier. Hours in gloves make your hands all pruney. But you know that.

4. You will need to wear a scarf under the mask buckles/suspension or your hair will get caught in them. Wearing the mask might give you a headache and your neck will hurt from the weight. And it has to be washed and dried daily or it will get moldy inside.

5. What do you do when you run out of filters? That's part of what I was trying to address in the project I was working on.

6. Note that, in 1918, the HCW working at the hospitals were not dying in unusual numbers despite just using rubber gloves and gauze masks. The contagious period for influenza does not coincide with the desperately ill period. The triage people/ ambulance people are the most exposed via asymptomatic or slightly symptomatic relatives of the very ill. It's the relatives who are shedding vast quantities of virus. I think there needs to be fever screening of anybody who walks into the building.
 
Re: Masks thinking outside the box

Hi janetn! Welcome to FT, glad to have you.

I absolutely love that youre looking for solutions! I am so glad to see that, because I agree with you- nurses and other heathcare workers are going to have to find ways to cope with exposure and the many other challenges a pandemic can cause.

Plastic bag idea is cool. Well the idea past anyway, it may indeed get quite warm as wetdirt mentioned, depending on your enviorment.

Would there be any value in the "scotchguard" type sprays? They may make a fabric more impermeable. they eventually wear off in washing, but several stored cans and occasional retreatments should do it.

One thing I plan, if I work during a pandemic, is to change clothes when I leave. Wearing shoe covers or a dedicated pair of shoes that dont come home with me. Plastic baggging the laundry and using bleach or vinegar in the wash. or another cloth sanitizer. Might be overkill, but its comforting to me. I do my laundry like that now when I'm dealing with MRSA or other goodies.

I like the double gloving idea. One pair stays on in the work area, and use handsaniter on the gloves and add a second pair between pts and glove changes. Something I do now when changing soiled dressings when I want to use dirty gloves first, and then change to clean ones.

When it comes to masks- I think buying a supply is one way to do it, right now many hospitals have them available at cost or close to it, grab a few boxes. I am also going for surgical masks- not as primary protections, but as a prefilter.

I think the surgical masks, if not damaged to much, would be fairly easy to heat and sterilize and reuse a couple of times. I may need to do a test on that to be sure, but we know the virus cant live at oven temps, so a dry oven for a short time ought to do it.

There is significant controversy over whether any method to reuse N95 or better is safe, since the moisture from breathing causes eventual breakdown of the baffles in the fiber. I've thought this one through, and still am not sure how I'll handle it. I do believe some protection - even from large droplets only- is better than no protection. The risk there is to assume youre protected when youre not, therefore engaging in risky behaviors and putting yourself at a higher likelyhood of infection.
 
Re: Masks thinking outside the box

Vasoline on the N95 respirators...after initial use...to extend their useful life?

Can they be sterilized in hot sun?
 
Re: Masks thinking outside the box

I'm not sure about vaseline- OK as a seal I suppose, though I dont think I'd trust it. It would gap too easily with movement. On the filter material part of the mask it would interfere with air exchange. I dont believe I'd use that.

What we need is a method that doesnt destroy the filtering material and ability of the mask, but does kill any virus in/on the fiber. Hot sun- earlier ideas Ive read elsewhere included sealing a mask in a zip lock baggie,and placing it in the sun for 3 days. I didnt come up with that, read it elsewhere when this first came up. I'd need to review the latest research on the survivability of the virus to see if thats still a viable idea. I think it has potential, BUT_
The potentially limiting factor is the reports that just wearing a mask for an hour or two can cause irreparable reduction of its capacity to filter, that cannot be restored.

The N95 and similar disposable respirators were made as disposables and arent meant for long term wear, not even for an 8 hr shift. For long term use, the permanant masks with disposable filters are really a better choice.

One "homemade" possibility I have heard bandied about, but I am not sure if anyone has produced a useful prototype yet- involves the use of hepa filters cut to replace the discs in half face masks.

One potential issue is not knowing just how safe the alternative and "home made" options are. Testing would need to be done, and that is over the head of most us-and real darn expensive, the cost of testing an alternative is much higher than buying enough masks to last a lifetime...
 
Re: Masks thinking outside the box

http://www.flutrackers.com/forum/showthread.php?t=18821

In this thread I describe a recent science fair project testing common materials. I tested two variations of vaseline on cloth myself, as well as HEPA material. The vaselined fabric is indeed breathable, and its particle filtration nearly as high as a standard P-100 filter. You can try it yourself--just fold up a bandana into 8 layers and smear the fabric with vaseline, and then hold it tight over your nose and mouth.

The problem with cutting up HEPA fabric and putting into cartridges is how well you can seal the edges. It isn't easy, and it has to be perfect because your life is depending on that seal. Also, the HEPA vacuum filter we tried BLOCKED MOISTURE. WHole thing fogged up the mask something terrible. This is something I'm glad I tried out before the rush, because the results were not at all what I thought going in.

There is evidence from 1918 that they knew and used vaseline gauze masks, and that in at least one instance they were spectacularly successful.
 
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Re: Masks thinking outside the box

I stand corrected, wetdirt. Thanks for taking the time to trial and then provide us with the info. It is appreciated.
 
Re: Masks thinking outside the box

Thanks everyone:)

Wetdirt your vaseline test is helpful I wouldnt have believed that it would have been breathable. One extra option is to mix betadine in the vaseline.

The HME filters Im talking about would also serve as a moisture reducer [they absord moisture] and having a 12 to 18 inch piece of circuit tubing gets the initial filering down below your face which adds to the moisture reduction also .

Ive actually used garbage bags when Ive done home insulation, they are not as hot as you might think. The bags arent exaxtly form fitting;) there is some air flow. No matter how you look at it working under pandemic conditions will be uncomfortable to say the least. I just want to see if we can put our heads together and make it survivable.
Could one of you who are technically orientated google HMEs and see what Im getting at [wet dirt dont mean to bug you but you seem like the kinda person who could really get your head around this and help a lot:applause: . Those of you who are in healthcare who know what Im talking about with the HMEs share your expertise and thoughts freely. If Im way off base here please just say so dont worry about offending me Im a pretty tough ol broad:D Just want the collective knowledge to work for the benefit of all of us. If somehow we can come up with a cheap [oops affordabel ] safe PPEs system, that our HCW can get themselves without going bankrupt. We would be by proxy saving a few more people. TPTB certainly are not going to any effort on our behalf
Please dont applaud me for considering working, believe me I wont be working if I cannot figure out how to do it safely. I want to come up with something i can share with my coworkers too. Id like to see one or two of them survive also.

TPTB dont care if they kill us all. We are on our own. Thanks all for the input and keep it coming. Im sorry I didnt respond quicker but I worked two back to back doubles and all I had time for inbetween shifts was sleeping. But im not working so much this week so I ll be hanging around, hoping to brainstorm with all of you

Thanks all;)
janet
 
Re: Masks thinking outside the box

Hello janetn,

http://bja.oxfordjournals.org/cgi/content/full/91/2/249

has a really good outline of the development and issues in the HME/Pall system.

Thinking about it, several questions come to mind:

Do all HCW need the same level of protection? If not, who needs the most?

The studies I've read don't agree on whether droplets or sub-micron floating viruses are more dangerous. The Pall system is good for the sub-micron stuff, but nobody seems to know whether that is really as big a problem as droplet/fomites. There weren't huge losses among HCW in 1918, either.

There haven't been admitted losses among HCW in Egypt, Indo, and Vietnam, and we don't know exactly what PPE they are using.

Unless you vaseline your shirt, from the tests on dry fabric we did, it won't make any difference to the Pall unit.

UV sterilizers in ductwork would do a lot to kill off the submicron stuff that's floating. I wish they would install them in airliners and at airports, too.

I don't think you can reduce the risk to zero, no matter what you do. But if you don't know the actual risk, there is no way to figure out exactly how far to reduce it.

You don't have any way to tell when the Pall filter is used up. I can't think of a way to test its useful life. I don't think it's a good idea to guess.

In my mind, I see all the disposables being used up in the first couple of weeks anyway. Thus my investigation into what would be the most effective system that is reusable, washable, and easy to make of ordinary materials.

I will be off the grid for the next week, so I won't be able to continue this discussion till then.
 
Re: Masks thinking outside the box

Since we are thinking out of the box let me throw something out for discussion. As a hobby I restore antique motorcycles and cars. I do my own painting. Usually I "requisition" a box of surgical masks. I have tried quite a few including the Niosh95 and the cartidge respirators over the years. You can always tell when they leak as you end up with streaks of paint where the paint has squeezed past the mask. Usually around the sides of the nose. Also you can tell when your blow your nose. So for years I have used nylon tape to seal around the nose. Respirators are better but they still leak and they clog up easily (not a problem with influenza). Anyway for the past half dozen years I have been using Epoxy and Poyurethane paints which are basically poisonous. I have had excellent success with 100% non-rebreather masks that I acquire from the respiratory department. Since they have a positive pressure they seldom leak. They are infinately reusable and can be soaked in an anti-viral solution. There are some drawbacks. One being that you are tethered to your air supply and the hose gets in the way. Second being that not everyone has an unlimited supply of Oxygen. I usually have a tank of oxygen in the garage because I do a lot of welding however I could just as easily use some of the compressed air from my compressor but I kind of need that for spraying the paint.
 
Re: Masks thinking outside the box

This is a historical note really out of the box. When I was a kid my family had what I think was an old military gas mask (possibly WWI?) and I was told the filter, a small cylinder that hung off the front of the mask, contained ground up peach pits. The material the mask was made out of (that fit over the head) looked like some sort of oiled canvas (It could just be that it was old or how it was stored). The lens for the eyes may have been glass. My dad used it on occasion. I would not want to bet my life on it.

I found this exserpt in the following post:
http://www.religion-online.org/showarticle.asp?title=3110

"In those days there were barrels on the street corners so we could contribute peach pits to the war effort. The army made them into charcoal, they said, for the filters in gas masks. It took hundreds of pits to make just one of them. So we all ate peaches on grounds of patriotism, which actually made them taste a little different. The magazines were full of soldiers wearing gas masks, looking stranger than we did. It was a remarkable time."

The following post discusses the manufacture of the masks.
http://www.almc.army.mil/ALOG/issues/MayJun99/MS283.htm
 
Re: Masks thinking outside the box

You have some good ideas regarding droplet and larger particle spread protection. One thing I should caution is that some home-made solutions may not work as initially thought, so please consider the nature of what you are trying to avoid. For example, Gullwing's solution of using non-rebreather masks is known to allow a considerable amount of air entrainment such that they deliver 55-75% oxygen due to dilution. Therefore, smaller particles and noxious fumes will also enter into the mask to some degree. (Garcia, et al. Chest 128 (4): 389S (2005) and Earl http://www.cardinal.com/mps/focus/respiratory/abstracts/abstracts/ab2003/OF-03-257.asp)

Regarding taping surgical masks to the face, they have also been seen to be ineffective to some degree (Derrick and Gomersall, Journal of Hospital Infection (2006), doi:10.1016/j.jhin.2006.06.021. and Journal of Hospital Infection (2005) 59, 365?368).

I would like to inform the group that a new mask is being released in Canada in the next week or so. The ISO-O2 mask was first described in the Annals of Emergency Medicine in October 2006 (Abstract found at: http://www.annemergmed.com/article/S0196-0644(06)00942-5/abstract). This is a different take on patient oxygen masks, where the mask portion is a N95 mask. It was designed to contain a significant amount of exhaled particles during the patient care phase, before a definitive diagnosis is made. Because it delivers more oxygen than a conventional non-rebreather mask, it can be applied in most scenarios of prehospital and emergent care as well as transport of known respiratory infectious patients. The inflow of oxygen eliminates the work of breathing associated with this type of mask as well.
It was not designed to replace other sources of protection, but (as the other solutions listed above) act as another barrier to existing practices.

T
 
Re: Masks thinking outside the box

Amish Country said:
This is a historical note.... an old military gas mask (possibly WWI?) and I was told the filter, a small cylinder that hung off the front of the mask, contained ground up peach pits.
Click to expand...

I'm not suggesting that ANYONE start crushing and burning peach pits for a mask filter but are there any gas masks that do not require filters changes (or have filters that last more than a day) that might work during a pandemic? It just seems strange to me that a reusable mask effective against repeated mustard gas attacks could be Rube Goldberged together almost a hundred years ago but there is no equivalent for viruses and bacteria epidemics or pandemics. The thought of trying to work for extended periods in a mask (imagine hot weather! :( ) does not thrill me but it would beat the potential alternative.
 
Re: Masks thinking outside the box

gsgs said:
what about the nasal masks for CPAP ?

e.g.:
http://www.cpap.com/advanced-find-cpap-products/Nasal-Masks-Respironics
http://www.cpap-europe.com/masks-c-2.html?gclid=CPvI27nDl5ICFQQduwodtRDTRA
http://www.advanscpap.com/cpap-masks/


attach it to a N95 in your pocket
Click to expand...

I don't know about that...

Many patients that are supposed to use CPAP masks refuse because
they are so uncomfortable. When I see them wearing them, I thank God
that I don't have to.
 
Re: Masks thinking outside the box

Under no circumstnace use peach pits! They contain cyanide. Nothing like a litle cyanide gas to ruin your day.
 
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