Strategies for Optimizing N95 masks or FFR (Filtering Facepiece Respirator Reuse) Supply by CDC were designed to use the surge capacity approach. They are arranged in the order of regular (everyday practices), contingency, and crisis (known shortages). The N95 mask should be disposed of after each use. The CDC has developed crisis and contingency strategies to assist healthcare facilities in conserving their resources in times of shortages.

If N95 masks are not available due to expected shortages, it is important to preserve supplies using contingency strategies.

Contingency Strategies

Extended use of N95 FFRs means that they are worn for longer periods, for multiple patient contacts before being removed and discarded. This is in contrast to conventional strategies where an N95FFR is only used for one contact, then discarded. This will reduce the N95 FFR burning rate and help to alleviate supply issues.

For fit testing and training, N95 FFRs can be used after the shelf-life has expired.

If the above strategies fail to work and the N95 FFRs are still in short supply and the available supplies do not meet the current demand, you can use crisis capacity strategies.

Strategies for Crisis Capacity

Respirators (including N95 masks FFRs and other types of respirators) are used beyond the manufacturer-designated shelf life for health care delivery.

Although respirators can be used to mimic NIOSH-approved respirators, they are not NIOSH-approved and must be approved using standards from other countries. NIOSH evaluated some respirators that were approved internationally and published the results here: NPPTL Respirator Assessments To Support the COVID-19 Response.

An N95 FFRs can be used only once, and then it is doffed and stored for another patient.

This guide explains how to determine whether or not a healthcare facility should operate under N95 masks FFR emergency capacity situations during the COVID-19 Pandemic. It also teaches how to properly implement N95 masks limited reuse, including after decontamination.

How to decide if an N95 FFR Crisis Capacity Strategy is necessary

Crisis capacity strategies do not conform to US standards of care. They should be used only when there is a known shortage of N95 FFRs. Only then can conventional and contingency plans be applied.

Your inventory will determine your ability to implement crisis-management strategies. This flow chart will help healthcare facility respiratory program managers determine if their facility is in a crisis situation. To plan and optimize your use of personal protective equipment (PPE), you can use the Personal Protective Equipment Burn Rate Calculator.

What is FFR reuse limited?

The practice of using the same FFR (or another filtering facepiece respirator) for multiple encounters with patients and then removing it (doing) after each encounter is limited FFR reuse [1]. This is not extended FFR, where the same FFR can be worn continuously for multiple encounters with patients. The FFR is kept in between encounters so that it can be worn again (donned), before the next encounter with the patient. As part of limited reuse strategies, decontamination of N95 FFRs might be considered. Extended use can also be considered part of limited reuse strategies. This is where an N95 FFR may be worn for multiple patients and then decontaminated or stored before being re-used. Learn how to evaluate N95 FFR fit for limited reuse. More information about FFR reuse

To reduce the chance of self-contamination, there is a limited reuse strategy

To reduce the chance of infection by FFRs, issue five N95 masks or FFRs each day to healthcare workers who are caring for patients with COVID-19. Each healthcare worker can wear one N95FFR per day. The FFR should be kept in a bag made of breathable paper at the end of each shift. There should be at least five days between each use of the N95 masks or FFR. Rotate the use every day between the N95 FFRs. This will allow pathogens to “die-off” while it is stored [8]. This strategy requires at least five N95 FFRs per employee, provided healthcare personnel do not doff and store them properly every day.

Healthcare personnel should not treat reused FFRs like they are contaminated. However, it is important to follow the reuse guidelines here. Hand hygiene should include washing hands with soap and water or using an alcohol-based hand cleaner with at least 60% alcohol. This should be done before and after donning. Learn more about how to reduce the risk of FFR reuse.

The CDC recommends that an N95 mask or FFR be limited to five donning per device. Some FFRs can be worn more than five times. The respiratory protection program manager or other safety personnel should monitor the FFR’s fit performance during limited reuse. Learn how to evaluate N95 FFR fit for limited reuse.

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