Covid 19 Reusable elastomeric respirators: How to test seal, clean and brief overview of the mask

all right welcome everyone my name is Kalin Calabrese I'm a certified registered nurse anesthetists in the United States I'm one of the many thousands of anesthesia professionals in the country who are right now considering other types of respiratory protection as we run out of n95 masks and we are reusing those masks and we're also considering cotton for the CDC mass in lieu of that 95 since we're rationing so what I want to talk about is other options other types of respirators that have not been talked about our not been considered those usually end up becoming reusable grade mass such as these these are typical mass in the contract we're all in the trade industries such as painting automotive anything that worked with stone stone dust and so on these masks are very common to protect people from asbestos to mold and so on these masks offer similar if not better protection and their ability to seal to your faces I think personally better now anything with these masks in the health arena is actually off-label I don't think they're really approved by the FDA so you're gonna have to use these at your own risk and speak to your own hospitals based upon their policies and what they think based on guidelines from the CDC and from OSHA and NIOSH and so on so again I'm not a professional with CDC or NIOSH but as an anesthesia professional who's going to be giving anesthesia to suspect it or confirmed coronavirus patients I'd like to talk about other options you have before you have to start wearing scarfs and bandanas as a CDC is put it so again we'll talk about these masks and we're going to use this one to demonstrate the first thing that I want to talk about is bit testing and then after fit testing I'll go into more details about how to put the mask together and different things that you might want to observe with the mask afterwards so we're not trying to fit testing with people who already know the masks and bear with me a couple minutes and we'll go in for the more details on how to use the mask so my background is actually firefighting I was a volunteer fireman for almost 15 years I know longer doing that anymore times have been busy and volunteering is really hard I give my hat off to all the volunteers out there a tremendous job you do every single day so when we would put on these mass similar mass to these not this one we had air systems and so on a little more complicated but every time I put on these masks on before any type of fire or hazardous type incident what you do is you want to make sure the mass has a good seal so you want to make you undo a negative pressure test with these masks I'm gonna demonstrate on how to do that but the basic concept is is that you're able put the mask on nice and snug to your face your hair is not on the way you don't have a beard of facial hair you're gonna have that straps nice and snug and tight to your phase-two right and the next thing you do is you want to clean that there's tuinstra torii ports on these masks right here and right here and you want to include these two sides with your palms with the mask on snug and what you're gonna notice is that you can't breathe in the area it's gonna create a negative pressure environment and when that does that the mass is gonna seat towards your face and you're gonna be looking for error at the in story port and air on the sides of the maps again if it creates a negative seal no air comes in the mass seats to your face and it has a little bit of a discomfort as you're breathing because you can't actually get air in one way you know it's a good seal to besides the mask seal into your face is when you release your hand you're gonna hear a loud gasp with air being brought in through the inspiratory port now you've now that you've gone from a negative pressure environment to one that's now got an entrance for air to come through so I'll put the mask on when I put the mask on to demonstrate this I'm going to tighten I'm gonna have each straps as loose as possible begin with and I'm gonna tighten each strap individually just a couple notches and the point is is you're trying not to put the mask on left or right side it if you're pulling in too much direction so go a little bit by a little bit with each side and keep working your way around the mass some people will go diagonally back and forth just try not to over-tighten towards one side or up and down so no care here feels pretty snug on the face I'm gonna push forward with the mask and with my other hand I'm gonna start tightening a little bit by a little bit on the strands you want to do some equally you see is pushing the mass nicely centered on the face as well to assist with the ratcheting step should be a snug the comfortable thing if you feel like it's it's not good enough and you're ready to try the negative pressure test the next thing you're going to do is he's gonna use your palms to clewd the inspiratory sides of this mask right this too so I'm gonna place the palms over the side I'm gonna take a tidal volume runner something that I would be taking on a regular basis if I'm walking around really taking care of patients in either the anesthesia environment or in the ice to you or the emergency room so right now even as I'm talking it is probably a good way of what by tiny bottoms gonna be when I'm breathing coz there's on talking I didn't have it usually roundish this is a good time to maybe test a seal so I'm going to take a deep I'm gonna take a moderate breath not a super deep breath now I'm gonna make sure to have a negative pressure NASA seating I have no air coming from the sides or from the axle in Centauri Sun I'll show you from the side and then you can hear at the end the air coming in if I release my hand while I have a negative environment then also tells you that's got a good seal great it's a great seal now I recommend that every time you put this mask on that you you test for that negative seal before you put your filter on you want to make sure you got a great seal before you go into a high risk environment it's hard talking your jaw right now hurts a little bit from trying to talk and push up against the elastic recoil this mask being on your face but again you want to practice as safely as possible so do a negative pressure test every single time you could also fit test these masks but the fit test is only as good as the time that you put the mask on with the fit test no one's gonna be there and make sure the mask is seated right with the spraying stuff inside the hoods so again every time you dawn up your proper your proper PPE do a negative pressure fit test you can do that on this mask as well again including both inspiratory sides so I highly recommend it if you don't get a seal loosen the straps check your hair put the mask back on tighten it again and try all over again if you can't get a negative pressure seal the mask is worthless you need to try something else either go up in size or down most of these are mediums they fit most people this fits me as a 220-pound male six foot two and also fits women that are five foot five you know 120 pounds and so on so it's got a pretty wide range I'm not saying this won't fit thick or people are smaller but those are basically the generalizations I've seen for people who have actually worn this mask before so now let's get into details about the masks for those of you that still want to learn more about the basics the masks are reusable the filters are technically reusable in the home environments as far as the hospitals go they're probably not meant for that and most these filters are meant for the health environment but again we're in extreme measures here where we're trying to do the best that we can so follow your Hospital policies and think smart for how long you're gonna use these filters in different environments and if you're gonna clean them check out CDC guidelines NIOSH OSHA and see what people even from the manufacturer are saying and stuff for the Cova 19 response so these masks caps two inspiratory sides one two has one expiratory side which is in here a insert Orion extra Doria have one-way valve so if you're on the inspiratory it can only breathe and you can't breathe out and the excretory can only breathe out but not in so if you're gonna wear these masks in the operating room or in a sterile environment you need to protect the expert ory which is right through here you have to protect us you're not breathing onto the sterile field just like you would in the operating with normal surgical masks I would also highly consider that you protect the inspiratory side and the filters as well so you can get as many uses out of these as safely as you possibly can check your rings here these grommets you want to make sure these are flexed they're not cracked they're not dry because that's what's gonna create a seal between the filter or the cartridge and your mask other things are just making sure that your your housing has got no cracks in it that this plastic isn't old and and desiccated and dried out that's soft and flexible so I can create a nice snug fit then let's talk about filters so most of these masks including this one actually come with a bulky vapor cartridge which looks kind of like this or like that now I've seen people wearing these masks with nothing and just want to tell you this is just a one-way valve you have no protection everything come in the mask and then I've seen people just wearing vapor cartridges as far as I know the vapor cartridge provides no particulate protection at all it's for vapors okay we're not trying to protect the guns vapors here but again know your equipment you need the filter but the problem is with this setup is that you can't put the filter on that comes with these without the vapor cartridge so you got to put the vapor cartridge on first easy there turn counterclockwise actually these all turn clockwise so place your vapor Carter's on clockwise cartridge should go on pretty easily you should never force anything if it feels like you're forcing it you're probably breaking it and you did something wrong so now you got to put on your filter over your vapor cartridge they come with two filters per side you only need one these are in my case p 95 p 95 gives you 95% efficiency against point three microns which is identical to n 95 if you have a p 100 or m 100 it's a it's 99.97% particulate protection or efficiency against 0.3 micron so obviously the p 100 m and 100's are better but this should give you at least equal protection to the n95 under these situations so which side is a space well the writing on here tells you to have this face the mask so on the outside of this plastic housing you want the white only no wording face there's a flange that's right here and that's what this filter sits on top of you want to make sure the filter sits evenly on top of this flange so that there's no areas that are bunched up and open where things can get through and this is gonna sit right on top of right here and again when you go to places on you want place it on nice and evenly so that when you push on it nothing is crunched up or bunched up underneath itself so I think I was able to do that pretty efficiently and then you want to make sure that the the knobs here or underneath this underneath the housing for the vapor cartridge so the tabs go underneath I think that's the better way of saying it so that's pushed down all the way so I'm pretty much good to go I don't see anything bunched up in here as the seats really nice and flat on here and both sides are on these are nice and snug one other suggestion that I have is have a colleague tape this plastic housing on top of the vapor cartridge around the sides the reason for that is that you don't accidentally flip this off if you were to catch it on whether it was wiring or if it was IV tubing or the side of like an IV pole so you might want to tape this housing down and again you might also want to give put some type of protective cover over this that's breathable so air can come in again to prolong the use and protection for your of limited safety supplies in this case filters but pretty much you're ready to go the only thing to talk about is the other types of filters which are a little bit less bulky than these filters so in this case I have a 2091 filter from a 3m which I think superior because it's a P 100 so if filters 99.97% against point 3 microns and it's less bulky it goes directly to the mask unlike these filters which require the actual vapor cartridge and these filters are 5 p71 they're P 95 rated by NIOSH standards so these pancakes filters are a little bit easier to work with they're less weight and they're less bulky so you can be able to put a visor over this mask easier or also just simply have less weight on your face for long periods where you're going to be wearing this again making sure that this goes on nice and easily it's a nice snug fit against an o-ring that's in tact but I'm pretty much you're ready to go with these things just read up the directions and how to use these follow any links that I might post below or comments below as far as how to clean this and safely clean the filters and clean the mask and how long you can reuse them and so on a lot of guidance you can find again through CDC through OSHA NIOSH but best of luck to you guys I hope you all stay safe out there and we'll get off we'll get through this together

Channel: Calin Calabrese

Views: 8,230

Rating: 4.915493 out of 5

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Id: jxOBwk9QSx4

Length: 13min 35sec (815 seconds)

Published: Sat Mar 21 2020