Guidelines for usage of masks and respirators

Guidelines for usage of masks and respirators

Riktlinjer Munskydd Andningsmask (Respiratorer)
· Riktlinjer Munskydd Andningsmask (Respiratorer) Folkhälsomyndigheten Uppdaterad version från 20-04-02 Rekommendationer för handläggning och val av skyddsåtgärder mot covid-19 inom vård och omsorg Skydd mot dropp- och kontaktsmitta Visir, skyddsglasögon och munskydd Vid arbetsmoment som innebär risk för kontakt med kroppsvätskor ska ögon, näsa och mun skyddas mot stänk. Enligt Arbetsmiljöverkets föreskrifter (AFS 2018:4) ska visir användas vid arbetsmoment som innebär risk för kontakt med kroppsvätskor. Om visir vid riskbedömning inte bedöms helt skydda mot stänk mot munnen kombineras det med munskydd. Som ett alternativ till visir kan skyddsglasögon tillsammans med munskydd användas. Utifrån en riskbedömning och de arbetsmoment som utförs väljs det mest lämpliga alternativet. Vid risk för aerosolsmitta Andningsskydd

Tillpassat andningsskydd FFP2, FFP3, PAPR (powered air purifying respirator) eller motsvarande används när lokal riskbedömning visar att ett arbetsmoment genererar aerosol med droppar från luftvägarna och därmed ökad smittrisk.

Aerosolgenererande arbetsmoment kan till exempel vara endotrakeal intubering och extubering, trakeotomi, trakeostomivård, icke-invasiv ventilering (BiPAP- och CPAP-behandling), hjärt-lung-räddning, handventilering, provtagning från nedre luftvägar och bronkoskopi.

Andningsskydd FFP2 och FFP3 är av engångstyp, men om de inte tagits av, skadats eller förorenats kan de enligt WHO:s rekommendationer användas upp till 4 timmar.

Mer information om andningsskydd hittar du på Arbetsmiljöverkets webbplats.
WHO 2020-03-19 Advice on the use of masks in the context of COVID-19 Health care facilities

Health care workers should: Wear a medical mask when entering a room where patients with suspected or confirmed COVID-19 are

admitted;
Health care facilities

Health care workers should:

Use a particulate respirator at least as protective as a US National Institute for Occupational Safety and Health-certified N95, European Union standard FFP2, or equivalent, when performing aerosol-generating procedures, such as tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual
WHO 2020-03-19 Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19) Recommendations for optimizing the availability of PPE
Ensure PPE use is rational and appropriate:
● The type of PPE used when caring for COVID-19 patients will vary according to the setting and type of personnel and activity (Table 1).
● Health care workers involved in the direct care of patients should use the following PPE: gowns, gloves, medical mask, and eye protection (goggles or face shield).
Recommendations for optimizing the availability of PPE Ensure PPE use is rational and appropriate: Specifically, for aerosol-generating procedures (e.g. tracheal intubation, non-invasive ventilation, tracheostomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy) health care workers should use respirators, eye protection, gloves and gowns; aprons should also be used if gowns are not fluid resistant.
ECDC February, 2020 Infection prevention and control for the care of patients with 2019-nCoV in healthcare settings Hospital Patient management: Healthcare workers in contact with a confirmed case, or a suspected case of 2019-nCoV, should wear PPE for contact, droplet and airborne transmission of pathogens: FFP2 or FFP3 respirator tested for fitting, eye protection (i.e. goggles or face shield), long-sleeved water-resistant gown and gloves; Hospital Patient management: Aerosol generating procedures (AGS) include tracheal intubation, bronchial suctioning, bronchoscopy, and sputum induction have been linked to increased risk of transmission of coronaviruses and require particular protection measures [3]. AGS should be performed in a negative pressure isolation room. The number of persons in the room should be limited to a minimum during such procedures and all persons present should wear: a well-fitted FFP3 respirator; eye protection; long-sleeved impermeable protective gowns; and gloves.
NHS/Pulic Heath England Uppdaterad 20-04-06

Guidance:

COVID-19 personal protective equipment (PPE)
Fluid resistant surgical masks Fluid-resistant (Type IIR) surgical masks (FRSM) provide barrier protection against respiratory droplets reaching the mucosa of the mouth and nose. FRSMs should be well fitted and subject to same level of care in use as respirators (section 10.1).

FRSMs are for single use or single session use (section 6) and then must be discarded. The FRSM should be discarded and replaced and NOT be subject to continued use in any of the circumstances outlined for respirators (section 10.1).

The protective effect of masks against severe acute respiratory syndrome (SARS) and other respiratory viral infections has been well established. There is no evidence that respirators add value over FRSMs for droplet protection when both are used with recommended wider PPE measures in clinical care, except in the context of AGPs.
Filtering face piece class 3 (FFP3) respirators

Respirators are used to prevent inhalation of small airborne particles arising from AGPs.

Se även avsnitt 8 som specificerar vilken typ av skyddsutrustning som behövs vid ett antal olika vårdsituationer:

PPE guidance by healthcare context:

8.1 Aerosol Generating Procedures

8.2 Higher risk acute inpatient care areas

8.3 Inpatient areas

8.4 Emergency department and acute admission areas

8.5 Transfer of cases and other duties requiring close contact

8.6 Operating theatres and operative procedures

8.7 Labour ward

8.8 Ambulance staff, paramedics and first responders

Etcetera
CDC

Senast uppdaterad 20-04-01

Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic
Adhere to Standard and Transmission-Based Precautions

Respirator or Facemask

Put on a respirator or facemask (if a respirator is not available) before entry into the patient room or care area.
Adhere to Standard and Transmission-Based Precautions Respirator or Facemask

N95 respirators or respirators that offer a higher level of protection should be used instead of a facemask when performing or present for an aerosol-generating procedure (See Section 4). See appendix for respirator definition.